Chronic back/rib pain

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Where to begin... I started getting left side chest pain about two years ago, which has progressed and developed into severe & longterm pain. My entire left rib cage seems to be effected, but the pain feels extremely deep. I can cause some pretty bad pain by leaning forward and arching my back. I've also noticed that my upper abdominal is very sore and painful to the touch at times. Unfortunately I am only 24 and already dealing with great amounts of pain. I can run long distance just fine and I don't get anything that seems like cardiac fatigue.

The pain ranges from 6-7 on a scale of 10 at all times. Sometimes it's extremely sharp, but most of the time is more chronic aching and burning.

The pain is so general (meaning I can exactly pinpoint it) so I've been taking shots in the dark as far as testing goes.

What I've had tested:

Cardiac -

Echo, EKG, Stress test, 24-hr monitor. All came back normal

Endoscopy - Came back normal

Chest Xray an CT Scan - Normal

Pulmonologist reviewed CT - said nothing wrong with lungs

Blood work- Normal

Thorasic back MRI - Normal & no bulging discs

Back physical therapy - didnt work

Chiropractor - didnt work

Physical Therapist for ribs - in progress but not looking good

Other symptoms - constant muscle twitching throughout my body

I'm at a loss here guys.. And it's driving me insane. Without becoming too much of a hypochodriac, I was thinking these are potential things to test for:



Neck & Lower Back MRI 

Aortic Aneurism


Other organs - Kidneys, Pancreas, etc?


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6 Replies

  • Posted

    It seems nervogenic and neuralogic pain rather than orthopedic or cardiac one. If you dont have a kyphoscholios or spondylolisthesis ( which can be rulled out just by some specific  standing and twisting x rays) , then go for a neurologic visit. Sometimes a nerve or a path , may be trapped ,so called "dumping nerve syndrome" .

    Since you have leaning and extention pain , another possibility is the involvemet of diafragm and this needs a CT spiral test to rull out. 

    Since you dont have respiratory symptoms , its very unlikely that it be the pericard or plura. 

    Other least probable diagnosis include some rare type of Mediastinal tumors. Generally these can be rulled out by testing tumor markers.

    if all of these process were normal , one must think to G.A.D and starting treat it effectively.

    Sincerely yours. Dr. Aidin

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    • Posted

      Thank you Dr. Aidin. Could you elaborate on the involvement of the diafram? 

      The one thing that is throwing me off is that I am simultaneously getting constant twitching throughout my body.

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    • Posted

      Simultaneously constant twitching  is also in favor of  CNS problem. 

      This sometimes is called Dystonia.

      take Gabapentin capsules (300mg or higher)  twice daily  with Pergabalin  150 mg orally. And one sertralin 50 mg pill  before bed. (Qhs)

      also you can use Biperiden  injections Per needed. 

      I'll bet these would be like water on fire ! 

      Try it. 

      Dr. Aidin 


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  • Posted

    Hi, Nobody ever considered costochondritis, inflammation in the cartiladge in you ribcage, as you diagnosis. I have it, its an annoying condition, has many faces, but its not harmful, doesnt kill. Can happen to anyone, at any age, just comes out of the blue or as a result of some physical activity, injury, some underlying condition (autoimmune). Mine came out of the blue, dignosed in January, still annoying me. It can become chronic. Ask your doctor about it (doctors dont know very much about it, though. All the ppl in ERs know, because lots of ppl come to the ER and think they are having a heart attack when they actually have severe costo pains) and there is a lot of into on this site.
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    • Posted

      This was one of the first things I considered, but the pain seems to be deeper, and more towards the back of my spine / ribs. This is incredibly painful. Can this really create ongoing excrutiating pain?


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    • Posted

      Hi, of course I don't know for certain, but I think it can. And considering all  the tests Uve done...I  just know that my costo is sometimes giving me sudden shots of incredible pain in the left hand side of the rib cage, aching neck, a swollen collar bone, ache in the hands, aching shoulder blades, stomach pain and cramps.
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