# Tietze's Syndrome - or inflamed rib cage



## summerdays (9 Jun 2008)

According to NHS direct:


> Tietze's syndrome is caused by inflammation of the cartilage, which joins the ribs to the breastbone (costochondral cartilages). The inflammation causes pain, swelling, and tenderness. The pain may be confused with a heart attack, as it is localised on the front of the chest wall. The cause is unknown.
> Although the pain usually disappears spontaneously, the swelling may persist after the tenderness has disappeared. The pain is made worse by moving, coughing, or sneezing. Treatment is with pain relief e.g. ibuprofen or paracetamol.



Has anyone had this? This is now what the doc is suggesting that I might have but he didn't explain why I would have developed it, and if it is cause by my cycling or aggravated by it?


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## Chuffy (9 Jun 2008)

Yup, I do. I've had it for many years (at least 20) and I've no idea what caused it. I couldn't tell you what makes it flare up either. I was quite relieved to have a diagnosis, because for a long time I thought I might have a heart condition. Luckily the discomfort (it's not bad enough to be pain) doesn't last long, so it's not a big problem.


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## bazzadigz C+ (10 Jun 2008)

While I was off after having 4 wisdom teeth I went to use my laptop and I had a pain in my chest in a really bad way. just like a heart attack, i could move either.

Obviously this was quite worrying so my girlfriend called NHS Direct who, thanks to their new procedure, anyone who experiences chest pains must be taken to hospital in an ambulance. They ran 3 ECGs on me as well as various other tests and just like the results from America they came back as clean as a whistle!

After these tests they sent me round to the GP Centre and after several hours wait I got to see a doctor who went over the results and assured me that nothing was wrong with my Vital Organs (that he could see).
I then asked the question of what it could be so he asked me to stand up, he then asked me to tell him if I felt any pains. With his hand he pushed between my ribs, this caused soo much pain that I nearly passed out. he then examined my back and he came forward with the following conclusion.

I have/am suffering from:
Kyphosis of the thoracic spine (which is causing)
Tietze's Syndrome (compression of the cartilage between the ribs)

He said there's very little that can be done apart from issuing anti inflammatory tablets. As it was his area of expertise he did recommend seeing a physio and going to the gym to build up muscles in the spine (esp the lower spine).

I've looked on the internet and it says that Kyphosis can be made worse from cycling, also that acupuncture and massage make you feel alot better, they say that the long term solution is to work on the spinal muscles, stomach muscles and posture. Also that Tietze's can replicate the feeling of having a heart attack.

Now I know that my case may be different to yourselves but could the cause be the same? i've spend the last 6months in my shell worrying about what it could have been. now I know the cause i'm attending the gym to build my upper body muscles which i must say has had a fantastic result.

Could this be something that could help you?


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## summerdays (10 Jun 2008)

I would say that mostly the pain in my chest area is continuous dull nag rather than sharp pain so I didn't think about a heart attack (also at 41, non-smoker, female, and BMI under 25 hoping that a heart attack isn't on the cards just yet). And I think the thing that makes it Tietze's rather than Costochondritis is that it is characterised by a boney sort of lump. And the main lump and associated pain is on the right side of my body.

My problem is that I don't like tablets ... so I forgot to buy some today.

Off the internet I have found:


> *What is the treatment for costochondritis and Tietze syndrome?*
> 
> 
> Costochondritis can be aggravated by *any activity that involves stressing the structures of the front of the chest cage. It is generally best to minimize these activities* until the inflammation of the rib and cartilage areas has subsided.
> Rest, anti-inflammatory drugs, physical therapy, and even cortisone injections have been used as therapy for the inflamed, painful cartilage of both costochondritis and Tietze syndrome. Ice packs applied to local swelling can sometimes help to reduce pain and inflammation. Local lidocaine analgesic patch (Lidoderm) application can reduce pain.



What I'm worried about is whether the cycling is causing the problem and if I can alter my bike set up to reduce "stressing these structures", as I don't want to, can't contemplate even being off the bike for ages to get better.

I'm also worried by Chuffy - I hoped it was going to go away .. .I guess you just learn to live with it.


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## bazzadigz C+ (10 Jun 2008)

summerdays said:


> I would say that mostly the pain in my chest area is continuous dull nag rather than sharp pain so I didn't think about a heart attack (also at 41, non-smoker, female, and BMI under 25 hoping that a heart attack isn't on the cards just yet). And I think the thing that makes it Tietze's rather than Costochondritis is that it is characterised by a boney sort of lump. And the main lump and associated pain is on the right side of my body.
> 
> My problem is that I don't like tablets ... so I forgot to buy some today.
> 
> ...



I should have said that do usually have the dull pain in the left shoulder that you refer to...it develop into sharps pains once every couple of months


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## Chuffy (10 Jun 2008)

summerdays said:


> *I'm also worried by Chuffy* - I hoped it was going to go away .. .I guess you just learn to live with it.


Don't be, I'm harmless. 
In my case it's very infrequent. I know I'm having a bout of it (for want of a better description) because of the sharp pain when I sneeze or breathe in heavily. It really isn't anything to worry about, it's not debilitating or something that I've needed to learn to live with. It was just a bit alarming, until I found out what it was. Once you know what it is, it's no big deal. I've never taken anything for it and it doesn't have any impact on my cycling, or any other aspect of my life. Hopefully your case will be no worse.


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## janeho (12 Jun 2008)

Working to strengthen the muscles of the upper back can help.
The ribs attach to the thoracic spine, run round your chest wall and the attach to the sternum (breastbone)
Therefore working the upper back muscles, primarily the scapular retractors (muscles that pull the shoulder blades backwards) alters the position of the shoulders and ribs.
Try this one:
Starting position: Lie on the floor on your front with your arms by your sides.
Action: keeping your hands on the floor draw your shoulders blades back and together as far as possible. lower down to find the middle position (ie halfway between the starting position and as far back as possible) Hold for 10 secs gradually lower then repeat.

Hope this makes sense and helps


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## Kirstie (12 Jun 2008)

janeho said:


> Working to strengthen the muscles of the upper back can help.
> The ribs attach to the thoracic spine, run round your chest wall and the attach to the sternum (breastbone)
> Therefore working the upper back muscles, primarily the scapular retractors (muscles that pull the shoulder blades backwards) alters the position of the shoulders and ribs.
> Try this one:
> ...




There's a pilates move which is exactly this. Have you tried pilates at all, summerdays? It has pretty much erradicated any back pain that I have and massively improved my core strength. Perhaps it could help you too?


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