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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes pain on right lower side of the chest?

I am 55 years old, female. I had a provisional diagnosis of ankylosing spondylitis in 1980 but only had a MRI scan confirming the disease last year after I referred myself to a private rheumatologist (bless her she put me back onto her NHS list immediately), For the last 20 yrs I have been treated with first morphine then fentanyl and oramorph, 10 years ago sulphasalazine was stopped due to leucopaenia, I was not referred back to a rheumatologist! The MRI done last year showed severe erosion and fusion in my pelvis and lumbar vertebrae. I had some fluid surounding some costal joints, other costal joints have fused. T6 T7 facet joints have fused and T3 disc has prolapsed. I also have severe disc degeneration of all lumbar discs. I am hoping to see my rheumatologist in the next few months, as yet I am still only on analgesia steroids caused severe depression within 3 weeks. My question:- For the last 5 weeks I have had pain on the right lower side of my chest not exacerbated by breathing deeply, but if I turn to the right the pain increases. The pain is constant, the ribs when pressed do not hurt more than usual and hurt no more than the left side. I have had costochondritis before and this feels different, the pain doesn t feel like it is radiating from the spine it is localised just under the right lower ribs. I have no appetite and feel ill. I am loathe to call my GP( he diagnosed me with chronic fatigue whilst on 100mcgs Fentanyl and sleeping 18 hours a day. He forgot opiates make you sleepy!!!!! There is only one Surgery in our area) Is this pain enough to warrant a call to my rheumatologist. I am also being tested for sjogrens disease. I don t want to bother her if it is not important. Thank you for your time
Sat, 21 Sep 2019
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General & Family Physician 's  Response
Hello,
Thanks for the query.
Conditions like costochondritis has to be considered.
As of now you can use analgesics/anti inflammatory combination like aceclofenac/seratiopeptdase for symptomatic relief.
If symptoms persist, it is better to consult a physician and get evaluated.
Wishing all the best.
Thanks
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