Fibromyalgia: costochondritis
I have been having severe fibromyalgia–related chest pains.
The way I can tell it is fibromyalgia is that a) they are enduring and b) my sternum is extremely tender to the touch and so it is quite inflamed. I am going to the doctor to discuss it. At the moment using anti-inflammatory creams and a heating pad
What is costochondritis anyway?
It is swelling in the cartilage between the ribs and the sternum and the pain can radiate through the chest often feeling like a heart attack. It varies from mind to severe. It can be stabbing, aching, burning and it can be in one location specifically or just all over. It can come and go. At the beginning of this bout, I had just short bouts at night. But then, now, it is all day.
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The reproducible tenderness you feel when you press on the rib joints (costochondral junctions) is a constant feature of costochondritis. Without this tenderness, a diagnosis of costochondritis is unlikely.
This is a good test for costochondritis… pressing right on those rib joints and if they hurt like hell it is costochondritis. Or if you breathe in deeply and it hurts more, also a good sign. Just things I do to help assure me that is in fact what it is.
It can get worse with:
- Exercising and reparative motions (as I learned as a baker by ignoring it and continuing work until it was quite severe)
- If you take a deep breath due to the chest wall expanding, you will feel it get worse. So that is why it is better to have shallow even breathing.
- And yeah, don’t cough ( I have learned with this cold) or sneeze.
- It can begin in one place, like the sternum, and radiate outward so it can just get worse on its own. In general it is seen to be worse on the left side of the breast bone. But may radiate to your back or even your abdomen.
- Bending, twisting that sort of deal. I find laying on my side can make it so much worse.
Now it is a condition in its own right. And it actually can be comorbid with other conditions. And it can occur by itself.
The causes are:
- Viral infection
- Fungal: Fungal infections are rare causes of costochondritis.
- Bacterial: Costochondritis may occur after surgery
- Repetitive overuse or trauma (my first horrible bout was when I was a baker and lifting bags of flour all the time as well as repetitive stirring) This also includes injury due to actually lifting something too heavy for you.
- Chest trauma– I mean like a car accident where you can that seatbelt to the chest… can trigger this condition. Anything like that.
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So why it is so common with fibromyalgia is a bit of a mystery. But common it is. (60-70 percent of us)
*** WARNING: If you are experiencing chest pains for the first time or there is anything different about them from your fibromyalgia ones or you have any doubt whatsoever… go to the ER. Better safe than sorry. And I am saying this not because it may be a heart attack, but it may, but other things like severe acid reflux. We cannot know sometimes. And reviewing the pain intensity and duration with your doctor is a very good idea.***
No one is exactly sure whether it is true costochondritis or why it occurs with FMS. One hypothesis is that FMS involves inflammation of the fascia, which is a thin layer of connective tissue that runs all through your body. If that’s true, it may explain why costochondritis is so common in this condition.
The fibromyalgia tender points just beneath the collar bone may play a role as well. (Tender points are 18 spots on the body that are used to diagnose fibromyalgia.) Myofascial pain syndrome, which is common in people with FMS, also could be a cause.
Treatment
Okay, so the most common treatment for inflammation like this is NSAIDs. Since I cannot have them I am in a bit of a spot. I do try ice and menthol topical creams. Others recommend a heating pad. But ice or hot you want to go for about 20-minute treatments. My doctor recommends ice since it is inflammation and she said that is best for that sort of pain. ( Recommend an ice hot reusable pack that way you get either one you want. And I also prefer a multi-pack that offers a few sizes. The back size… works great for the chest by the way.)
- Ice
- Heat
- NSAID anti-inflammatories
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