Help please

[megan175]

I am 18 years old and a woman who has been experiencing a series of pains for over 7 months now.  They differ in severity, but are usually fairly bad.  They begn at my upper left rib cage and wrap around to the left portion of my back.  It is very difficult and usually hurts to breathe as if there is something sharp lodged in my lungs.  My heartbeat will increase and I get exhausted from fighting to breathe.  It hurts worse when I stand during these pains, but sitting doesn't help very much either.  They can last from ten minutes to hours.  I can have them just sitting down or especially when doing some form of physical activity such as running.  

I have had an ultrasound, chest xrays, EKG, blood lab test, biopsy, nuclear stress test, and echocardiogram test.  Everything has turned out normal.  I am still suffering from pains and I have been having them in bouts of a few days.  Now that it is getting colder, I find myself in more pain than usual.  Nothing seems to help and my doctor has told me she has no idea what is wrong with me.  

If anyone has or has had these symptoms or could help me, please let me know.  I don't know where to go from here.  By the way, the pains always start on the left side and on the front and then wrap around to my back.  

[megan175]

No, I haven't had a chest CAT scan...I don't think so.  I know in my nuclear stress test before and after running on the treadmill, I had to lay on a table while a huge machine took pictures of my heart.  

I have looked into Fibromyalgia a little bit and it seems really severe.  I'll be sure to mention it to my doctor the next time I see her.  Thank you very much!  

[Tuckamore]

I have done some research on your symptoms, at least what I know of them. And the next to last paragraph in my previous post talks about other conditions that this pain could be contributed to.

Have you had a chest CAT scan with contrast? I would certainly suggest that if it hasn't been done.

In my searching I also came across several articles that claimed your pain may be the beginning of Fibromyalgia. I hope that is not the case and that they will soon be able to determine the cause of your pain. Again best of luck to you and keep us updated. Take Care, Tuck

[megan175]

Thank you.  I was actually diagnosed with costochondritis by a different doctor a few months ago and he put me on anti-inflammatory steriods.  These medications made the symptoms twice as severe and I had to be taken to the hospital because I couldn't breathe and my heart was racing.  The hospital said it was defintely not costochondritis.  I apologize for not including that in my original post.  Also, costochondritis only lasts a few weeks and I've had these pains for months.  Helpful info though and thank you.  Today was a really bad day for me; probably the worst I've had in a while.  

Yes, Otis, it does seem to come from one area and deep within the chest wall.  I do try to have patience with my doctor because I understand my symptoms are not very specific, but it's difficult when nothing helps the pain go away and I'm always hurting.  Your thoughts and comments have helped me and thank you.

[Tuckamore]

Hello Megan,

Welcome to the Pain Management Forum of MedHelp. I am glad you found us. I am sorry you are experiencing such pain. I am not a physician either so the following is only my suggestions or opinion.

Otis has offered a good opinion. Your condition could be costochondritis but it could be other things also as he suggested. The following are symptoms of costochondritis:
Costochondritis causes pain and tenderness in the locations where your ribs attach to your breastbone (costosternal joints). Often the pain is sharp, though it can also feel like a dull, gnawing pain. Pain associated with costochondritis occurs most often on the left side of your breastbone, though it can occur on either side of your chest.

Other costochondritis symptoms may include:
Pain when taking deep breaths
Pain when coughing
Difficulty breathing
Costochondritis is the most common cause of chest pain originating in the chest wall. It occurs most often in women and people over age 40. However, costochondritis can affect anyone, including infants and children.

There is also a condition called Begin Chest Wall Pain: Benign chest wall pain is most likely a transient and fleeting irritation of the pleura, the slippery membrane that lines and protects the lungs. The pleura are very sensitive to pain, and for reasons that are usually not clear, some momentary irritation causes a painful sensation that can be quite severe, but that quickly subsides. This condition has no medical significance whatsoever. It is very common. Most people will experience these symptoms at some point in their lives.
Characteristics of pain:
The pain is usually a sharp "catch" that interrupts a breath, and that returns with each breath for a few moments - then it subsides. It is usually not relate to exercise.

The gallbladder, gastroentestional system or the pancreas can also produce chest wall pain. There are so many conditions that could be the cause of you pain that you need to continue with tests and work-ups through your PCP. If your PCP is unwilling to continue to investigate your symptoms than please seek a second opinion.

Good luck to you. Please keep us posted and let us know how you are doing. Take Care, Tuck

[OtisDaMan]

Hi,

Before we begin, I am not a doctor and cannot therefore give a diagnosis. But I can perhaps throw up some ideas for checking out with your doctor. Have patience with your doctor; she has eliminated the nastiest reasons for pain in the chest area.

It is good to see that the echocardiogram is clear; that, combined with your young age, makes the pain less likely to be heart related. This is good news.

Pain like this is sometimes a referred pain: this is a pain that feels like it is coming from one spot but is actually caused by a different part of your body. A classic example of referred pain is sciatica: pains in one or both legs which is in fact caused by damage to the back and/or spinal cord. A different example is where referred pain may come from an internal organ: appendicitis has a typical sequence of referred pain locations as it progresses. This is one reason why it may be difficult for your doctor to determine the cause.

Because your pain specifically starts on the left side (and wraps around to the left side of your back), it might be due to injury to a particular rib or where it attaches to the sternum (the bone running down the middle of your chest) - this might also compress a nerve intermittently, which would probably cause sharp and even severe pain.

Has your doctor asked where *exactly* the pain starts up, ie where on your chest, and whether it feels like it is close to the skin or deep inside ? If not, then next time you have a bout, if the pain is fairly localised when it starts up on the left/front side, mark with a texta where you think the source is, and for that matter, where on your back it seems to go to, and then see your doctor with that information. It mightn't be possible, but if it is, identify whether the pain emanates from a particular rib (or the gap between two particular ribs) each time a bout happens.

My guess, on the information that you have provided, is that you have a case of costochondritis, a painful affliction due to injury of soft tissue which holds a rib in place. Have a look at the following web site for more information:

http://www.mayoclinic.com/health/costochondritis/DS00626

All the best.