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Rib stabbing pain

Medical history for the past 3-4 years explaining how its related to my current health problem:

February 2008:

At first I felt a twist in my right upper back. It started getting painful. The pain became persistent. I also started to get recurring headaches. The doctor gave me different painkillers for my pain – ibuprofen, codamol and some others along with paracetamol.

March 2008:

Following this I felt sudden sharp pains around the body at which point it became painful to breathe. The painkillers gave 2 hours of pain relief and the pain kept coming back in the right upper back.

April 2008:

I started getting high fevers/temperatures and sweating very frequently at night. The paracetamol helped clear the temperature but it kept returning along with the sweating.

May – June 2008:

Admitted in hospital with pleuretic chest pain. A sputum and urine sample was taken over a few days and the results were normal. After being discharged from hospital about 3 weeks after I had persistent sharp pains in my right ribcage/. I played football and when I kicked the ball I felt a crack in my right ribcage. Over the next few days I felt my whole ribcage from back to front move with every breathe I took. The ribcage was moving and it felt cracked and out of place. When I woke up the next morning I stretched my arms up to yawn and as I took a full breathe I felt my ribs crack inwards. After this happened if I tried to breathe it was impossible to breathe fully as the ribcage felt stuck and I could not expand my right ribcage when I try to breathe. Since that happened it ha been impossible to breathe as my ribcage feels stuck before I can take a full breathe. It’s just like a stabbing pain.
        A blood test or skin test for TB (Tuberculosis) was taken and it showed sings of minor TB. There was also a fluctuant mass over the left clavicle (on left collar bone below the neck) which had grown bigger over the past 2 months. A sample was taken from this at the ENT clinic at Royal Berkshire Hospital and I was diagnosed with 6 month TB treatment from July –Dec 2008.

July – Dec 2008:

Tuberculosis 6 month treatment.





Dec 2008:

A CT scan was taken at Royal Berkshire hospital which showed concavity of right inferior costal cartilage in the thorocoabdominal region possibly giving rise to mechanical right-sided chest pain.

Feb 2009:

Doctor gave me tramadol tablets and I collapsed fainted after 2 hours of having taken just 1 Tramadol tablet.

March 2009:

Referred to orthopaedic specialist who examined me and suggested I be referred to pain clinic for nerve injections to numb the pain.

April 2009 – Dec2009:

Referred to pain clinic and was given amitriptyline tablets by the pain consultant which didn’t help. I had a couple of pain injections after this which also didn’t help remove my right upper back persistent pain. I also had injections directly in the right ribcage where I was getting the stabbing pain. But the injections didn’t give any pain relief.

June 2009:

I had a private MRI spine thoracic scan done at a private hospital which showed no significant abnormality identified.

May 2010 – Jan 2011:

Referred to Cardiothoracic consultant in St Barts London Hospital. After examining my pain symptoms, he suggested operating on the rib to find out what’s wrong. During the procedure a fractured lower costal cartilage was found. So they proceeded to an excision of right costal cartilage.

Current situation:

• The stabbing pain in my right ribcage and pain in my right upper back is still persistent. I can’t breathe properly as I feel the stabbing pain before I can breathe in. I’m not able to sit or stand for a short period of time. When in the sitting position the rib feels stuck in right ribcage and stabbing pain is worse. And at this same moment in time the right upper back starts feeling sore and persistent pain comes.

• Last year I also saw an osteopath and chiropractor who gave me over 2 months of sessions to treat the pain. But it wasn’t helpful for me. The doctor continuously prescribes me with different painkillers and medication and they absolutely don’t help the pain at all and actually instead cause severe side effects including occasional headaches and severe digestion problems.

• The right chest/ lung area feels like its being pulled down by the stabbing pain that I feel in my right ribcage. The stabbing pain remains persistent which stops me from breathing in my right ribcage and right lung.

• So basically I still have the right upper back pain which always comes when sitting down and the stabbing pain in right ribcage is always there in my right ribcage because I can hardly breathe on that side. It’s affecting my life and I've tried explaining into the doctor but they think it’s not that serious. The stabbing pain is upper ribs and just below the right chest and it’s not where I had the operation. The operation was done in lower ribcage costal muscles.

Questions:

1. Who is the best kind of consultant to see for the stabbing pain and nerve pain?
Because I've seen a few consultants and the only thing that points to the fact that the right ribcage is gone in permanently is the CT scan which was taken quite a while ago in 2008. Would it be necessary to take another CT scan to look into the stabbing pain? As it’s been a long while since the last CT scan. Is there a CT consultant that I can see?

2. I’m considering getting a check up at the international hospital abroad to investigate my persistent back and rib pain. But if I could find someone here in the UK to look into my case than that would save the trip. What do you advise best in regards to investigating this pain here in the UK or abroad? As I'm not able to live with my pain.

3. I was told that they do RIB scans (radio isotope bone scans) which help identify where the pain is originating from.

4. Would it be okay to operate on the rib to find out where the rib has permanently gone inwards? And could it be pulled outwards or cut out if it has to be? Because where the rib has permanently gone in it doesn’t let me breathe in my right ribcage and it always feels sore. When I’m sitting down it feels like the rib stuck the same way when I try to breathe.

5. It’s been over 3 years now with this persistent stabbing pain and it feels like it has become a permanent damage to the ribs. But before I continue I want to mention to you I’m not trying to investigate the ribcage myself as I’m not a doctor. The main issue being is that how it came about and how I felt it push inwards when I took a full breathe and ever since it has felt stuck and blocks me from breathing in. Basically it’s affecting my life.

I would like your help and advice with my health problem.
9 Responses
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547368 tn?1440541785
Thank you Dr. Cummings.

I did request that this detailed post receive some attention and your "House Call"  is very much appreciated. You are always welcome in our community.

Regards,
~Tuck
Helpful - 0
936016 tn?1332765604
MEDICAL PROFESSIONAL
Good Morning Koolboi,

The powers behind MEDHELP have been watching your post and have asked me if I can help you with your problem. I'll do my best.

You've asked:-

1. Who is the best kind of consultant to see for the stabbing pain and nerve pain?
Because I've seen a few consultants and the only thing that points to the fact that the right ribcage is gone in permanently is the CT scan which was taken quite a while ago in 2008. Would it be necessary to take another CT scan to look into the stabbing pain? As it’s been a long while since the last CT scan. Is there a CT consultant that I can see?

I don't know that seeing a "CT consultant" = specialist radiologist would be helpful. I think it might be useful to have a comprehensive review with a pain specialist - so to gather and take along copies of all your images and scans etc to see them. There are very many good pain specilaists in the UK. I use the pain specialists at the Wellington Hospital = a private Hospital in North Central London http://www.thewellingtonpainunit.com/team.asp. So you could try them. I think to be fair to them this is a complicated issue and so you should explain that if you do book and that you probably need a double appointment to go through all the detail etc. Clearly the Wellington being a private hospital will charge you.


2. I’m considering getting a check up at the international hospital abroad to investigate my persistent back and rib pain. But if I could find someone here in the UK to look into my case than that would save the trip. What do you advise best in regards to investigating this pain here in the UK or abroad? As I'm not able to live with my pain.

I think my suggestion above answers this for you.



3. I was told that they do RIB scans (radio isotope bone scans) which help identify where the pain is originating from.

These are possible - again though I would take sensible and specialist advice before "random" images are taken because it may wel be that that is not the appropriate course for you and that some thing else might be better.


4. Would it be okay to operate on the rib to find out where the rib has permanently gone inwards? And could it be pulled outwards or cut out if it has to be? Because where the rib has permanently gone in it doesn’t let me breathe in my right ribcage and it always feels sore. When I’m sitting down it feels like the rib stuck the same way when I try to breathe.

Personally I'm keen to avoid "exploratory" procedures or surgery until all other avenues have been properly exhausted. Surgery even when done by the very best surgeons does entail a controlled injury and associated damage. Surgery to the chest is tricky.


5. It’s been over 3 years now with this persistent stabbing pain and it feels like it has become a permanent damage to the ribs. But before I continue I want to mention to you I’m not trying to investigate the ribcage myself as I’m not a doctor. The main issue being is that how it came about and how I felt it push inwards when I took a full breathe and ever since it has felt stuck and blocks me from breathing in. Basically it’s affecting my life.

Yes, I can see that it is affecting your life. I think trying the Wellington or a similar good unit might be useful. There are similar units dotted around the UK - typically more are clustered in London.

I hope some of that is helpful? Very best wishes, Sean

Helpful - 0
Avatar universal
Hiya suggapie.

Thanx for your message. My friends and family have told me to change doctors have told me to change to another GP but im not sure if thats the right thing to do as my health condition has become complicated.

Helpful - 0
1733706 tn?1310345602
I cannot phantom a Dr. telling you that you must live with your pain!! Can you get another Dr.? Seriously, you have described something I have had, it may have been an anxiety thing for me, I even thought it was a heart attack, and this was ages before my accident and the real true chronic unrelenting constant pain I suffer day and night. But when I had the pain in my back I thought if it lasted another second I would have died. Then like you stated it did end up under my rib cage, and this still happens to this day. I can only pray for it to go away! once they did an EKG right when it happened and nothing to do with the heart they said. The pain is horrible, and if I had to have that each time I had to inhale, well, I could not bear it. You deserve to have relief, you can get relief, first get a Dr. who does not say live with it but says we will stop this pain for you!!
Helpful - 0
Avatar universal
Your very welcome, Koolboi!!

Please keep me updated on what you find out.  I'm very concerned about this pain that you are having to suffer with.

I'll let you know after I search some more on Monday and I definitely will be looking for your updates after you see your Doctor and after your RIB Scan.  I truly feel that is what will give you your answers to your problem............Sherry  :)
Helpful - 0
Avatar universal
Hiya,

Thats okay. I'm very grateful for your help.
Helpful - 0
Avatar universal
If I were you, I'd begin with the RIB Scan first and then go from there.  After you get the result have your Doctor (depending on the results of the Scan) direct you to the Specialist that you would need to see for your Surgery.  

I'm sorry that I can't give you any more information than that as I haven't been able to find out anymore about it than that today.  I will try again on Monday for you, if that's alright with you.  OK?  Please keep in mind that none of us on here are Doctor's.  We are all CP (Chronic Pain) Patients such as yourself.  

I hope that you have a wonderful and pain-free week-end.  :)

I'm wishing you the very best...........Sherry  :)
Helpful - 0
Avatar universal
Hi Sherry,

Thanks for your message. I very much appreciate your concern. The procedures here in the UK are very long winded and the doctors make you wait quite a while for each test that is carried out. For example I was supposed to be referred to a dermatologist for my chest rash which is  another health condition of mine but not as sever as the stabbing pain in my ribs. I had to phone the local hospital 3 or 4 times even though they stated they would contact me to refer me to a dermatologist. And i rang them for the 5th time last thursday and they put me on hold while they booked the appointment for august 10th which is quite a while away. This is always the case whenever waiting for a referral or anything. I would come to the states if i knew who to see for my condition but there still is no sense for me to take a leap ahead if I dont know who I need to exactly see for my condition. Health insurance is out of the question because they dont deal with ongoing conditions. I have spoken to my doctor about getting me referred to someone who could help me out but the doctor doesnt think my condition is serious or life threatening. They have told me i might have to live with my pain. I havent asked him to refer me for a Radio isotope scan (RIB). IM going to try and ask him and see what he says. Thanks for your help. Let me know if you find someone who can help me out. You have my medical history. I dont mean I would have to come to the states but at least I can find someone who has dealt with my kind of condition. And so I would find the same consultant in the UK.  Im very grateful for your help.
Helpful - 0
Avatar universal
Hi koolboi2009,

My goodness, you can't get a break no matter what!! :(  I'm so sorry this just keeps building up for you.  

I'm sure that you remember that there are no Doctor's on the PM Forum but we will try to give you whatever ideas we might have.

I do know of people that have had ribs removed before so in some cases that is a possibility.  Only your Orthopedic Specialist could tell you whether or not you are a good candidate for that procedure.  If it were me and everything else failed, I'd weigh the pros and cons and make an informed decision.   I can udnerstand how this is affectign every aspect of your life.  

I can't believe that they haven't sent you to a Specialist before this for this RIB (Radio Isotope Bone) Scan.  It seems to me that should have been long before now!!  You need to immediately ask to be sent for this procedure.  Whether it's quicker for you to schedule it yourself or for your Doctor to do it, I wouldn't have a clue as I'm here in the States and not in the UK.  I'm very sorry but I have no knowledge of how they proceed over there. I have seen on MH where it seems to be much more difficult to be referred for procedures over there than here and it takes a much longer period of time.  I wish I had answers for you as to whom you should see in the UK but I don't.  Have you asked your Doctor for his/her help in finding you the proper Specialist?

Please don't hesitate any longer to get all of the testing and procedures that need to be done for you to get relief from this agonizing and prolonged pain that you are having to endure!!

Please keep us updated as I can't fathom how difficult this is for you to have to endure!!

I'll be looking for your updates..........Sherry  :)
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