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Forum Name: Neurology Topics

Question: Ribcage pain, Headache, Neckpain and Fatigue


 deepumo - Mon Mar 23, 2009 1:31 am

Dear Sir,

I am 32 year old male, and started having the pain on my left rib cage around the left nipple area about 3 months ago. I also had some numbness in the my hands and slight tinginess on my hands and legs.

Initially I thought I was having some sort of heart disease. So, I went to a GP and had ECG and stress test done and both came out ok. My blood test was also ok. Cholesterol level was fine. Creatine Kinase (CK) levels were slightly high at about 400. After visually examinig by back, he said I might have dislocated ribs.

So Next, I went to orthopedic specialist who said there is no such thing as a dislocated rib!! and gave me some nuerobion tablets saying that i might have some nerve disorder.

The situation eased up for 2 weeks or so after that and now it has come back even worse than before.

Now on top of the chect pain which has spread to all around my upper ribcage (just below the shoulder blades), I am also experiencing severe pain in my neck which slowly radiates to my head. Usually the headache is on the left side of the head and amazingly it can shift to other areas when i change my body posture!! (e.g whenlying down in diffrent postures). I also experience some uneasiness in my chest area when I breathe and when I straighten my back, most of the time the headache and neck pain eases.

Since this problem started, I am also really fatigued even with adequate rest. All my muscles seem very tired and stiff when i am at rest, especially so, the muscles on the neck and face. It really feels like they are about to cramp but most of the time as I move or excersice the feeling goes away and once I am at rest it stiffens up again.

I can understand sprained/dislocated ribs causing ribcage pain and neck pain. I am at loss for having muscle cramps and fatigue. Can they be related?? Please advice on the kind of diagnosis/treatment i should seek.

Thanks!!
 John Kenyon, CNA - Tue Apr 21, 2009 8:35 pm

User avatar Hi there --

While the presentation is really pretty strange, I think deeper consideration should be given to neurological causes, especially now that the discomfort has spread and symptoms have evolved. One thing that may not have been considered is a variant presentation of MS, which can cause these sorts of painful body "hugs." These are spasms that usually show up later in the course of this particular disease, but MS is one of those oddball diseases that can show up in a number of disguises. It's just one possibility, but I feel it hasn't been ruled out at all, so should be at this point. There are still other neuro possibilities, but I believe in getting the big things out of the way first. An MRI of the brain wouldn't be out of order at this point, and while that's needed usually for a ruleout of MS, it can also expose other things that could be causing this. The muscle fatigue and cramping and fatigue, along with rather random pains and stiffness do sound suspiciously like an MS-related problem. It could be totally off base, but it's suggestive enough to rule this out. If that's done successfully then there's less urgency to sort out the rest of this, and those exams, as with the MRI, could expose some other potential causes as well.

Hope this helps. Good luck to you and please follow up with us as needed.

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