Research on complexities and side effects in my case of Tietze and Costochonditis

This is my first post here, so I don't know how much one can or should write. Generally, if you want to treat a condition, you should have an idea how it came about. Please note that my rubbish Windows 10 has given up on making hyperlinks. So you will have to type the links into google or such yourself.

 Tietze syndrome or costochondritis are not quite the same. Tietze syndrome affects the cartilage between the ribs and the sternum, costochondritis affects the sternum itself.

I seem to have both conditions.  There is no "cure" in the sense of medical intervention  and so the doctors are not very interested in getting to the bottom of it, i.e. to arrive a  meaningful diagnosis. But there is some interesting research about. I have looked it up - from the perspective of my own case -  and gained some insight about why I got it, what keeps making it better or worse.

How I got it: I overdid  the DIY in the autumn and was under some serious emotional stress.  A little pulled muscle (pectoralis major) in the left chest would not heal. Not acknowledging that I was exhausted and my immune  system compromised I carried on working around the house and garden and dancing tango. I had some Acupuncture and Shiatsu treatment, which helped, did before it could resolve, I did more damage. In January a lightly I  pulled a muscle in the right chest (pectoralis minor) right at the point of it insertion in the chest, close to the cartilage of the 3rd or forth rib. This produced a little sharp pain with certain movement of the arm or ribcage. I carried on dancing and cleaning windows etc. and kept  things from healing.

What made it worse: Then in February a sneeze came on very suddenly and violently. It just tore my chest apart. The pain was now getting worse. I noticed a growing bumb on the sternum (chest bone) and on the cartilage of the ribs on the right around the injury.  Pain was low level and constant, and worse for movement.  Due to this,  over time  my whole ribcage became stiff and locked up in places. One day, from one minute to the next, and no obvious reason, I suddenly could not move my arms or even breath without excruciating, hysterical pain that stood in no relationship to either the muscle injury, the sternum inflammation or how I had felt throughout the morning. I was in agonie, could hardly get into bed and the next morning the whole chest and the area under the arms was full of fluids.

I recognised both the fluid collection (histamine) and the excruciating, hysterical pain.  I had had that pain and swelling before, also following a little injury to a tiny muscle in my shoulder.

What may it be about: The symptoms fit a condition called Mast Cell Activation Syndrome (MCAS). https://en.wikipedia.org/wiki/Mast_cell_activation_syndrome

Research suggests that mast cells are involved in bringing about inflammatory diseases. Tietze syndrome and costochondritis are  not (yet) on the list of the researchers, but they are  inflammatory responses to physical and emotional or mental stress factors and  not really fully understood.

As inflammation is always caused by an immune system response and such responses are dependent on a variety of complex chain reactions in our metabolism, we would be well advised to look out for all sorts of issues in our health and wellbeing that may have brought about or hinder the healing of inflammatory disease.

What are contributing factors in my case:

 I suffer from Histamine Intolerance (HIT), which is primarily a digestive disorder but it also compromises the immune system. Anyone can get HIT, but it often arises, or gets worse, during the menopause due to the hormonal changes.

Histamine release is an immune system response, caused by external or internal mechanical, chemical or biological agents.  Most people know about histamine overload in the context of allergens like pollen or nuts. These can over-stimulate the immune system, which in some cases can start to interfere with the body itself (auto-immune disease). Anti-histamines are required. and if none are available, people thus affected may die. Antihistamine drugs act by blocking histamine action on nerve endings.

Normally, histamine levels are kept at a healthy level by our own organism  through a number of metabolic reactions. One is the intervention of an enzyme called diamino oxidase (DAO).  This enzyme is produced in the small intestine and is missing in people with histamine intolerance like me. Eating things that contain histamine, liberate histamine or inhibit the enzyme will increase my load and can make me very ill.

What I should have known and watched out for:

In hindsight, I can say that, due to exhaustion and stress, my histamine levels would have been very high already. The inflammation caused by a non-healing injury added to the load, which pushed me over the edge.  What I only understood recently is, that when histamine levels are too high, mast cells can start to over-react too, particularly at a place of injury on in an event of sudden injury - like my sneeze. Latest research has found out that "once activated, mast cells secrete numerous vasoactive and pro-inflammatory mediators.  These include pre-formed molecules such as histamine, serotonin, TNF, kinins and proteases stored in secretory granules... Proteases released from mast cells could act on plasma albumin to generate histamine-releasing peptides. That would further propagate mast cell activation and inflammation. Proteases could also stimulate protease-activated receptors (PAR) inducing microleakage and widespread inflammation. 

https://www.sciencedirect.com/science/article/pii/S0925443910002929

Excessive histamine release can stimulate neurons local to the injury. The neurons get the brain to send more mast cells to the site. Those  release, yet more histamine and other pro-inflammatory substances, thus  setting up a spiral of escalating pain that will spread far beyond the location of the inflammation. As it did in my case.

Histamine intolerance is a condition that is not well understood, but seems to become more and more common. Google it! You may be surprised. It can make you very ill unless you stick to a very restrictive diet. Eating things that contain histamine, liberate histamine or inhibit the enzyme DOA will increase the histamine load causing all sorts of symptoms. It can make me quite ill. And like with allergies, there is always the chance that something is hidden in the food I am  is not aware of.

And now I have found out, that mast cell activity can also be driven by intake of certain food; for example beef! And I had eaten a lot of beef the two days before the pain got completely out of hand, because I thought it would be good to have more protein intake. Beef, I hasten to say, is not contraindicated for histamine intolerance.

What are the secondary symptoms: Because of the way an over-alerted  immune system works, all sorts of other events in the body can suddenly attract more attention  than they normally would. With all that pain, I could not sleep well. I lay mostly on one side. The ribcage is involved in so many movements, I would not have thought it possible. The muscles in my upper body became quite tense. Stiffness of the neck and back, blockages under the shoulder blades, achjng ribs all over. Shallow breathing made my energy go flat. I lost my appetite etc. etc. By the time the nervous system is so alarmed, mast cells seems to be running all over the place turning every bit of discomfort into a major injury event. This is not something that can be sorted out with paracetamol.

As you can see from this post, there maybe a variety of reasons, why one get  Tietze syndrome or costochondritis, and why it will not got away.

If anybody found this post helpful, they can respond and I will write up what I find helps me to get better and what does not.

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