OpenHealth Q&A

Sternal Region Bone Inflammation without Bacterial Origin

For the past several months, I've been experiencing persistent discomfort and tenderness centered around my sternum, radiating towards the upper left rib area. This began in October. I am a 26-year-old woman with a history of hypothyroidism since 2016, currently on a regimen of levothyroxine (75) and liothyronin (15). Additionally, I deal with IBS and overactive bladder, for which I take tolterodine daily, alongside a battle with chronic hives. I have access to health services in two different countries, and both medical professionals suggested that my symptoms might be linked to tightness in my back, with one speculating that it could be Tietze syndrome or costochondritis. Initial tests, including an X-ray and EKG, yielded no significant findings. After consulting a physiotherapist who noted my excellent range of motion and could not identify any issues that could be addressed, I was prescribed pain relief that proved ineffective. During a recent trip to Brazil, I sought the expertise of a thoracic surgeon, who ordered an MRI. While his investigations ruled out conditions like Tietze syndrome and SAPHO, he did identify "bone edema and inflammation in the sternum area." He prescribed me pregabalin for 30 days and a short course of prednisolone (7 days), also allowing me to use dipyrone as needed for pain relief. He advised me to follow up with a rheumatologist upon returning home. Despite adhering to the prescribed medications for several weeks, my discomfort has only intensified. I've chosen not to take the painkillers regularly, reserving them for acute episodes. I have an upcoming appointment in three weeks with a doctor who may refer me to a rheumatologist. I've been informed they might request another MRI to compare findings, although I still possess the imaging and notes from Brazil. Despite nearly nine months of enduring this issue, I have yet to experience any improvement. Initially, the pain was severe and felt akin to a heart attack; it later transitioned to a more constant soreness, with sharp pain episodes occurring sporadically. Currently, it feels as though my sternum is being compressed in a v-shape, causing immense discomfort that often leaves me on the verge of tears, particularly in the mornings, although the pain’s intensity varies throughout the day. I attempted to take a break from physical activities, but that did not yield any positive changes. While I still engage in couple's dancing—an activity that doesn't provoke pain—upper body workouts and my practice in Japanese jiu-jitsu do trigger discomfort. I’ve taken a hiatus from martial arts but fear returning due to the growing severity of my pain, which I desperately miss. I'm grappling with apprehensions regarding whether my condition will improve or be acknowledged seriously. I worry about potential spread or persistence of the pain. Are there effective treatment options or relief strategies I can implement? I feel somewhat isolated in my situation, and my understanding of bone inflammation is limited. The thoracic surgeon hinted at the possibility of an autoimmune disorder but deemed it more plausible that it stemmed from an unrecognized trauma. He suggested that arthritis is unlikely since that condition typically involves migratory symptoms instead.

Answers (1)

7/21/2025, 1:31:05 PM

OpenHealth AI

I'm sorry to hear about the persistent discomfort you're experiencing in your sternum area. Living with ongoing pain can be really challenging and isolating. It’s important that you actively seek ways to manage your symptoms and support your well-being.

Main Points:

• Pain in the sternum area can stem from various causes, including musculoskeletal issues or inflammatory processes.
• It’s important to manage your symptoms while waiting for further evaluations by specialists.
• Several lifestyle modifications and self-care strategies may help alleviate some discomfort.

Explanation:

The inflammation and bone edema noted on your MRI suggest that there may be underlying issues contributing to your discomfort. While autoimmune disorders or previous trauma could be potential causes, your symptoms might also be related to musculoskeletal stress or inflammation. Addressing pain management, lifestyle adjustments, and mindful practices can help improve your quality of life while you await further evaluations.

Next Steps:

1. Pain Management Techniques: Consider using heat or cold therapy to manage pain. Applying a warm compress or heating pad can help soothe soreness, while an ice pack may reduce inflammation during painful episodes.

2. Activity Modification: While you enjoy certain physical activities like couple's dancing, listen to your body and avoid exercises that exacerbate your pain. Gentle stretching or low-impact exercises such as walking or swimming might be more tolerable and reduce discomfort.

3. Mindfulness and Stress Reduction: Chronic pain can be exacerbated by stress. Practices such as mindfulness meditation, yoga, or deep breathing exercises might help reduce your sensitivity to pain and improve your emotional well-being.

4. Dietary Considerations: Since you have IBS, pay attention to your diet and any triggers that may worsen your symptoms. Consider anti-inflammatory foods, such as omega-3 fatty acids (found in fish and walnuts), turmeric, and green leafy vegetables, which may help to reduce inflammation.

5. Symptom Diary: Keep a record of your symptoms, noting their intensity, triggers, and timings. This can provide valuable insights for your healthcare providers when you see them again.

6. Stay Engaged with Healthcare Providers: Continue to follow up with your doctor regarding your condition. If your current pain-management strategies and lifestyle changes aren’t yielding improvements, ask about additional options, such as physical therapy focused on pain management or further evaluations for potential underlying conditions.

Lastly, it is vital to remain connected with support networks, whether friends, family, or online communities, to help alleviate feelings of isolation. Remember, advocating for your health is essential, and your concerns about persistence and acknowledgment of your symptoms are valid. You're doing important work by being proactive about your health. Please reach out if you have more questions or need further guidance.