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#197620 - 02/11/11 12:07 PM Rib pain
outlier Offline
Registered Visitor

Registered: 08/22/10
Posts: 370
Loc: Brooklyn, NY
How many of you get rib pain? and where on your ribs?

My rhemy seems confused about what's causing my rib pain, which is mainly on the sides of my ribs, under my shoulder blades, and where my the bottom of my bra would hit. She says it might be nerve pain.

It actually has led to me making the comment why did you think i was here? to her. I like her a lot, and she is friends with my eye doc which in my case good communication between between them is very important in my case. But now I am confused.

This also lead to the question of i know back pain get's less when you fuse does that happen also with your ribs?
is the pain going to go down if I stop flaring?
Thank you
_________________________
Diagnosed: ankylosing spondylitis Feb '10, Crohn's Nov '09, GERD Aug '09, Scleritis May '08, Scoliosis '92
HLA-b27 negative
Surgery: Scoliosis Spinal fusion July '99
Current Meds: Humira, Asacol, Reglan, Dexilant, Tramadol, Maalox, and Xibrom (Bromfenac).
No more sulfasalazine and Iron

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#197621 - 02/11/11 12:10 PM Re: Rib pain [Re: outlier]
JenInCincy Offline
Registered Visitor

Registered: 05/19/08
Posts: 13278
Loc: Cincinnati, OH
Costochondroitis is a pretty standard type of inflammation associated with AS... it's disheartening that this should confuse your doctor. If you search these forums for threads with "rib" or "rib pain" you will find LOTS of history.

There is no guarantee of fusion and for some folks on here, their pain did not improve with fusion. I don't recall having seen any statistics about rib fusion ... may not be all that well studied/documented.

The definition of the end of a flare is pretty much, the pain is greatly diminished. So yes, if you can get the inflammation under control with your meds this pain should improve.
_________________________
Jen, 42, happy partner of James and Moma to Evan, 14, & Lucy, 12.5 (Crohn's dx @ age 3; on Remicade since April 2010.) I take piroxicam, Flexeril, & Nucynta ER nightly. 3 anti-TNFs didn't pan out for me.

"Science is the father of knowledge, but opinion breeds ignorance." -- Hippocrates

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#197626 - 02/11/11 12:44 PM Re: Rib pain [Re: JenInCincy]
ljohnsy Offline
Registered Visitor

Registered: 11/17/09
Posts: 302
Loc: Washington, D.C.
I get rib pain, exactly where you have described. I hope you get some relief soon!
_________________________
Laura -- age 36, diagnosed with AS 11/09. Mom of 2. Currently taking Humira.

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#197627 - 02/11/11 01:20 PM Re: Rib pain [Re: JenInCincy]
Beth Offline
Registered Visitor

Registered: 07/13/10
Posts: 684
Loc: Northern CA
Oh yes, I get the rib pain and it actually varies from day to day where it hurts. Sometimes I get it in the back where you talked about and sometimes in the front right under the breasts. It varies from just being sore to the touch, to throbbing to actual pain that feels like the ribs are stabbing into the lungs. Not fun! I agree with Jen - my rheumy said it's definitely the AS...

So sorry you're having this too! It's no fun!
_________________________
Beth

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#197632 - 02/11/11 01:46 PM Re: Rib pain [Re: Beth]
avonldy Offline
Registered Visitor

Registered: 12/14/09
Posts: 2466
Loc: N. Sacramento Valley
Most of my rib pain is near the breastbone, where the ribs join and also in the middle of the breastbone, there is a joint there where they meet.
_________________________
Donna
Suffering since a teenager.Dx with AS Dec 2009. Dx with ulcerative colitis 1998, both knees replaced 2006. GP said I had "some kind of inflammatory arthritis" 25 years ago. It has taken 50 years to get a Dx.

Mobic, Nexium, Naproxin, Lipitor, 6-MP, Nexium, Miacalcam, MSContin and 2 Norco for break through pain

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#197641 - 02/11/11 02:23 PM Re: Rib pain [Re: JenInCincy]
seekonk Offline
Registered Visitor

Registered: 12/06/10
Posts: 1254
Originally Posted By: JenInCincy
Costochondroitis is a pretty standard type of inflammation associated with AS... it's disheartening that this should confuse your doctor.


The problem is that chostochondroitis is supposed to occur in the rib joints, which are in the front of the chest, not in the back where the OP was describing it.

But I also get pain around my back ribs, also under the scapula as well as the lowest little short rib, which is exquisitely painful to palpitation. I haven't been able to figure out what this pain really is, but not in my understanding the classical chostochodroitis. Maybe enthesitis of the muscle attachments?


Edited by seekonk (02/11/11 02:40 PM)
_________________________
Spondylitis since '08, finally diagnosed Feb '11.
Enbrel 50mg/week.

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#197645 - 02/11/11 03:12 PM Re: Rib pain [Re: seekonk]
Aim Offline
Registered Visitor

Registered: 02/07/11
Posts: 177
Costochondritis, as it was called back then, was my first symptom as a young adult. It took the doctors a while to figure out that I had inflammation in my lower rib cage that was causing all the pain, and they didn't know how else to diagnose it other than costochondritis. It seems now, over 20 years later, that it was a symptom of USpA and most likely due to enthesitis. The pain and swelling were under my left breast, where the ribs connect to cartilage. I actually could press down on the swollen mass and it would click in and out. At times, the clicking was even audible! Friends in college thought it was pretty cool how I could pop my ribs in and out. After a while, though, the pain became unbearable and I couldn't touch the area because it was so tender. In college, a medical resident injected cortisone into the area a couple of times, which gave me considerable relief, but then it would flare up again after a while and I had to stop. I understand now it's not good to inject too much steriods into an area. After college, a chiropractor told me that my thoracic spine was all messed up in the areas where the lower ribs connected to the vertebrae. She did what she could to gently ease everything back into place, but I remember she told me I was going to have pretty bad arthritis some day. I should have listened to her! Instead I went to a medical doctor who said it was most likely fibromyalgia. I learned much later that the costochondritis associated with fibromyalgia is mainly pain in the area of the sternum and shouldn't have been the explanation for inflammation in the area where the ribs connect to the cartilage in the front or the vertebrae in the back. Up until I found my new rheumy, whenever I told doctors I had costochondritis, they just assumed it was the type common with fibro. After all these years, it's been flaring up again recently and the new rheumy was a little surprised with the presentation being mistaken for costochondritis, because it was so low, but it being caused by enthesitis totally makes sense now that I've been diagnosed with spondyloarthropathy.
_________________________
Amy, 42, officially diagnosed finally with PsA, on MTX and just starting Remicade. Also have Hashimoto's hypothyroidism, secondary FMS (?), IBS, GERD, and possibly endometriosis. Have had various symptoms since teens. Married for 17 years to college sweetheart; we have one amazing 8 year old son.

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#197648 - 02/11/11 03:41 PM Re: Rib pain [Re: seekonk]
JenInCincy Offline
Registered Visitor

Registered: 05/19/08
Posts: 13278
Loc: Cincinnati, OH
Originally Posted By: seekonk
Maybe enthesitis of the muscle attachments?


Enthesitis, yes - either the tendon or ligament whichever is found in that part of the anatomy.

A lot of women on here have rib pain that is attributed to costo but is not front and center... more off to the sides as the OP described. So maybe it's not really costo but is lumped in under that designation, dunno. I think inflammation can also occur between the ribs but can't remember where I read/heard that.
_________________________
Jen, 42, happy partner of James and Moma to Evan, 14, & Lucy, 12.5 (Crohn's dx @ age 3; on Remicade since April 2010.) I take piroxicam, Flexeril, & Nucynta ER nightly. 3 anti-TNFs didn't pan out for me.

"Science is the father of knowledge, but opinion breeds ignorance." -- Hippocrates

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#197697 - 02/12/11 08:46 AM Re: Rib pain [Re: JenInCincy]
outlier Offline
Registered Visitor

Registered: 08/22/10
Posts: 370
Loc: Brooklyn, NY
hmm... enthesitis. how is that dealt with?
Does a Rhemy deal with that?

Funny enough i tried to google enthesitis and ribs and i got this post. The one place that does not hurt is the breast bone.
But i am as i describe body blind. I am not very good at locating where pain hurts. For awhile i was describing the rib pain in my back as shoulder pain. and famously called a ovarian cyst as pulling a muscle.

One thing else that i haven't told my doc and i sort don't know how this fits in but when I was young 12-17. I wore a back brace that caused a lot of rib pain and bruises all over my ribs and back. I sort of wonder if damage from that is causing pain and it is sort of the inflammation is attracted to where damage is?
_________________________
Diagnosed: ankylosing spondylitis Feb '10, Crohn's Nov '09, GERD Aug '09, Scleritis May '08, Scoliosis '92
HLA-b27 negative
Surgery: Scoliosis Spinal fusion July '99
Current Meds: Humira, Asacol, Reglan, Dexilant, Tramadol, Maalox, and Xibrom (Bromfenac).
No more sulfasalazine and Iron

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