Sensitive area on ribs. Worried about lung problem.

[nickc]

Hi, I’m hoping you may be able to help me with a diagnosis or provide advice. About 6 months ago I developed a sensation on the left side of my lower chest. I say sensation because it’s not really a pain. The area it covers it about the size of my hand. The skin feels sensitive and dry. The sensation is more pronounced when touched lightly. If I poke my fingers around I sometimes get a sharp pain that my doctor has described as a trigger spot below the 7th rib. My doctor suspects it’s an intercostal neuroma but subsequent ultrasound and chest X-ray came back normal. He has told me to come back in 6 months or if it gets worse. My one worry is that it may be lung related. I’m 42 and have smoked a pack a day for 25 years. I gave up the day I had the chest X-ray. I have no cough and my breathing feels fine. The sensation has become slightly more pronounced over the last 6 months. It does not change when exercising, but feels more pronounced when I am lifting something with my arms outstretched. I occasionally have a slight feeling of breathlessness but I figure this is to be expected with the amount of smoking over the years. The fact that it is always there and I don’t know what is causing it has made me anxious until now it’s affecting my sleep. Any idea what it may be?
Is there anything I can do to help it go away? Exercising, physiotherapy or application of cream? I have tried an anti-inflammatory cream for a week with no difference to symptoms. Is it worth going for a CT scan?
Thank you for taking your time to read this email and helping me.
All the best to you.

[National Jewish]

Your description suggests a peripheral neuropathy.  That is inflammation that involves a peripheral nerve(s) causing the sensation.  It could be of no consequence to your health or a sign of a more serious problem.

Please share your concern that it might be "lung related", with your doctor.  I would assume that your doctor has reason to believe this is of no consequence to your health; a nuisance rather than a sign of serious problem.  If, however your doctor cannot provide assurance about this, you should ask about having a CT scan.  If the problem is a neuroma, it might still be too small to be detected by chest x-ray.

You have made a wise decision to stop smoking!  Stick with your decision to quit smoking.  Everyone in the United States has free access to telephonic counseling for quitting tobacco at Quitline (800) QUIT NOW.  You may want to look at our giving up smoking information at http://www.nationaljewish.org/disease-info/wellness/smoking/index.aspx for ways to stay smoke free.  Check with your doctor for other quit smoking resources in your area.