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Forum Name: Miscellaneous Orthopedic Topics

Question: Chronic Rib Pain

dealdr - Tue Jan 20, 2004 8:47 pm

Hello. I have fought with chronic rib pain, lower left side, for 17 months. My rib sticks out farther than the others, and the harder I work, the farther it sticks out, to a point. It's been almost 1/2 inch 'higher' than the other ribs. I believe the injury resulted from being bit by a brand new electric fence charger (supposed to power up to 30 miles of fence), which really hit me hard. I swear I felt my heart stop! I have gone to two local hospitals who claim all is well on x-rays and have labeled me as a chronic rib pain case, and have also been seen by a chiropractor who said he couldn't help me but recommended either cortisone or having the rib removed. Can you help with advice?

Dr. Russell M - Fri Jan 23, 2004 2:23 pm

Hi! I wonder why your are not on any pain medications even though you claim to be suffering from your problem for 17 years? When was the surgery for your fibrous histiocytoma done? How is it that when you find your rib thickened externally, it fails to appear on the X-ray? Warm regards, Bill

dealdr - Tue Feb 03, 2004 6:51 pm

Bill, It has been 17 months, not years. As for medication, I have taken just about every OTC med. I have tried percoset, percodan, morphine, adhesive patches, etc. I am very tolerant of pain medication, and it take a lot to affect me, and NOTHING has come close to relieving the pain. The pain itself in now a constant but at varying degrees, to the point of sharp pain with each inhalation and exhalation. It sure is fun... The rib has not thickened, it horizontally protrudes farther than the other ribs. The more active I am, the more it protrudes, up to about 1/2 inch. Any other questions?

Dr. Russell M - Wed Feb 04, 2004 5:55 am

Oops! Sorry about that. I see that you have had opioids to the level of tolerance. Has your doctor tried meds for neuropathic pain? Neuropathic pains don't respond to opioids usually. Neuropathic pains respond to antiepileptic and Antidepressant medications. Regional anesthesia or block may be required if all fails. It would be best to discuss regarding these with your doctor. Hope this helps. Warm regards, Bill

dealdr - Thu Feb 05, 2004 6:47 pm

Bill, Thanks for your time and suggestions. I suppose a little more detail is in order on my part. I have discussed this with my doctor. Honestly, I am leery of a regional block, mostly because they are repetitive. He also said that he would be cautious on cortisone in lieu of puncturing a rib or lung. That made me wonder as to his ability... I would not have the rib removed unless no other option were available. I will be going to the V. A. soon, since the local hospitals have written me off. I have a large dislike of 'brain' medications, such as Anti-depressants. I feel that they are over-used and for the most part unnecessary in anyone's daily life. That is beside the point, though. I have seen the effects they have on acquaintances, though. I would not consider taking them unless you could change my mind. Enlighten me. Steve

Dr. Russell M - Fri Feb 06, 2004 1:23 am

Hi! When I mentioned the Antidepressant/antiepileptic usage for neuropathic pain, do not be misled by the terms used to describe these medicines. Eventhough the terms imply its usual indication in Depression or Epilepsy, there can be more than one use for a single drug. And the dosage used for its Antidepressant action or antiepileptic action is different from that when used for its Analgesic action. Another fear among the medical profession as well as the society is the addiction potential of Analgesic drugs like opioids. It would be enlightening to note that there is no ceiling effect for the use of morphine, as long as pain ramains. Multiple studies have indicated that because of this common 'fear,' such medicines are underprescribed, leaving patients to suffer pain at the expense of an unrealistic addiction potential. As for your doctor's reluctance to anesthesia, I would presume it to be medicolegally founded. Risk exists even in prescribing Tylenol, let alone surgical procedures. I hope the experts in V. A. figure out some way to release you from the pain you suffer. Warm regards, bill

teacher - Mon Oct 17, 2005 2:56 am

My son, who will be 17 in December, has SUFFERED from rib pain for almost 4 years. We now must home school him. NOTHING HELPS HIS PAIN. He has been diagnosed with costochondritis, and now UCLA says it is a virus of soem kind and who knows when it will go away. We feel so helpless.

Lancet - Tue Jan 24, 2006 5:38 am

I also have had chronic rib pain for over 4 years now. Started with a water tubing accident where I fell off a tube at over 40 MPH and broke/injured my left floating ribs (9-12) it seems. Symtoms are severe, sharp pain followed by a dull ache. Pain will last for days after onset and has reduced me to bed for long periods of time. The pain is typically at the costal margin of the lower 4 ribs. Symtons appear whenever I use my abdominal muscles (sitting for over an hour, lifting anything bent over, driving, etc.) I have tried the Proto therapy with no luck. Went on to Cryro nerve desensitivation - extremely painfull (10) with no long term effect. Tried radio nerve desensitivation - using heat to desensitive the area. Lasted about 4-5 mmonths. Am taking 10/325mg Hydrocodene 4-5 X a day and 10mg baclofen 1-3X a day (new). The baclofen leaves a copper taste and does'nt do allot except make me a little sick to my stomach. I need to find a expert in this pain type. I am willing to have the ribs removed if it will stop the pain. Lancet Any info will be appreciated

RRT - Wed Feb 01, 2006 1:08 pm

Hey All, I am a 57yo w/m. I have had chronic rib pain for four years with no diagnosis. I am a respiratory therapist and suspect I injured myself on the job. I haven't been able to work in a hospital since developing this condition. The pain is constant, in my right rib cage and medication only helps tolerate the pain, it does not go away. I am taking Hydrocodone 10/500 4-6 hours, Neurontin 600mg TID. The Neurontin (anti-epileptic) seems to help alot in combination with the Hydrocodone. When I want to do something (Physical) I get a tapering dose prescription for oral steroids, whch helps reduce inflammation and gives me the ability to get around better, only used these three times. I have been to three neurologists, 11 spinal blocks (no help), 3 MRI's, Nuclear Medicine, oxycontin, morphine, the patch, Anti-depressants, nothing helps. Like most, I just want the pain gone so I can get my life Back. And yes...my right rib cage looks bigger than my left??? I am now going to Mayo clinic, waiting for results of last MRI, ran me through the tunnel three times. What is this stuff?

a2wong - Sat Feb 04, 2006 9:25 pm

I started receiving pains on the left side of my ribs. It hurts when I lightly push on it. I get no pains on the other side. It does stick out a little more then my right side. I didn't get injuried in anyway. Is this something that I should be concerned with. Its not hurting too bad now. But just want to know what I can do now, in case it gets worse. I don't have health insurance, so I'm pushing off going to the doctor. So advice will be greatly appreciated[/list]

a2wong - Sat Feb 04, 2006 9:30 pm

[quote="a2wong"]I'm 23 years old, female, and I just got over a flu, so I'm not sure if that has something to do with it. But I started receiving pains on the left side of my ribs. It hurts when I lightly push on it. I get no pains on the other side. It does stick out a little more then my right side. I didn't get injuried in anyway. Is this something that I should be concerned with. Its not hurting too bad now. But just want to know what I can do now, in case it gets worse. I don't have health insurance, so I'm pushing off going to the doctor. Some advice will be greatly appreciated

a2wong - Sat Feb 04, 2006 9:30 pm

I'm 23 years old, female, and I just got over a flu, so I'm not sure if that has something to do with it. But I started receiving pains on the left side of my ribs. It hurts when I lightly push on it. I get no pains on the other side. It does stick out a little more then my right side. I didn't get injuried in anyway. Is this something that I should be concerned with. Its not hurting too bad now. But just want to know what I can do now, in case it gets worse. I don't have health insurance, so I'm pushing off going to the doctor. Some advice will be greatly appreciated.

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