Understanding Persistent Rib Pain Despite Negative Imaging Results
A woman in her late 40s is facing a perplexing issue with lingering discomfort in her ribs. Here's a summary of her situation: Two months ago, she experienced a tight embrace from a friend, which she believes initiated her pain. That night, she woke up with significant discomfort while shifting in her sleep, prompting her to visit urgent care the following day. During that visit, X-rays were taken, revealing what the urgent care doctor initially thought were about seven broken ribs. She was prescribed a combination of over-the-counter pain medications and scheduled for a Dexa scan the next day, which showed a bone density reading of -2.1. However, a few days later, a formal review by a radiologist contradicted the urgent care findings, indicating no signs of fractures on the X-rays. Consequently, her primary care physician (PCP) concluded that she was fine and advised against further investigation into osteopenia given her bone density results. Still concerned, she insisted on having a CT scan, which was conducted three weeks after the initial injury. Yesterday, she received the results, revealing again that neither the PCP nor the radiologist had found any fractures, lesions, or other abnormalities that could account for her ongoing pain. Her primary concern now is understanding the persistent pain she feels in three specific areas of her left rib cage: the lower front, the upper back near her spine, and the lower left side toward the back. While she began tapering off the acetaminophen and ibuprofen that she had been taking since week three, she still occasionally uses a lidocaine patch on the upper back area. She describes the pain in that spot as sharp, in contrast to the other regions where the sensation is more of a dull pulling. Although it's evident that she is improving, she does not feel completely healed. Given that her imaging tests have shown no clear issues, she is left wondering why the pain persists.
Answers (1)
8/7/2025, 10:20:48 AM
OpenHealth AI
It sounds like you’re experiencing ongoing rib pain that is frustrating, especially after multiple imaging tests have shown no obvious cause. Your situation is not uncommon, and there are several potential factors that could contribute to your persistent discomfort. Let's break this down and focus on managing your symptoms and enhancing your recovery.
Main Points
- Understanding Persistent Pain: The absence of fractures in your imaging does not discount the possibility of muscular, ligamentous, or nerve-related issues near the rib cage.
- Pain Management Strategies: There are effective strategies to help manage and reduce your discomfort.
Explanation
Even if imaging studies show no fractures or abnormalities, it's possible that you might be dealing with muscle strain, costochondritis (inflammation of the cartilage connecting the ribs to the sternum), or irritation of the nerves in the area. Over time, injury signals can result in lingering pain, even after the initial cause appears to resolve.
Actionable Next Steps
-
Continue Gradual Pain Management:
- Continue using the lidocaine patch on areas where you feel sharp pain as needed. This can help alleviate localized discomfort.
- If the over-the-counter medication is being tapered off, consider using it intermittently for flare-ups only, while monitoring its effectiveness.
-
Gentle Stretching and Strengthening Exercises:
- Start with gentle stretching exercises specifically focusing on the thoracic region (mid and upper back).
- Incorporate breathing exercises to help stretch and relax the muscles around your rib cage. For instance, deep diaphragmatic breathing can also alleviate tension.
-
Physical Therapy:
- Consider engaging in physical therapy to establish a tailored rehabilitation program that might include guided exercises for strengthening the surrounding muscles and improving mobility.
-
Monitor Symptoms and Reassess:
- Keep a symptom diary for a few weeks, noting what activities seem to flare up your pain and any improvements. This can help identify patterns and effective management strategies.
-
Posture Awareness:
- Pay attention to your posture throughout the day. Good posture can reduce strain on your ribcage and surrounding muscles. Ergonomic adjustments at your workspace may be helpful if you work at a desk.
If you notice any changes in your symptoms, or if your pain worsens despite these steps, it might be worth discussing this again with your healthcare provider, particularly regarding further evaluation of your musculoskeletal health. Remember, recovery can take time, and it's important to be patient with yourself as you navigate this.
Related Questions
Concerns Over Organic Charcoal Toothbrush
Greetings, I am a 26-year-old male experiencing significant anxiety. Recently, while brushing my teeth, I encountered something unusual—what appeared to be a bristle lodged in my mouth. I'm uncertain whether I managed to spit it out or if it accidentally went down the wrong path. I had also been using Anbesol to relieve cavity discomfort, which adds to my confusion. Despite my attempts to rinse thoroughly, I still can't be sure if I ingested the bristle. It seems quite brittle and has sharp edges, as it originated from a low-cost organic bamboo charcoal toothbrush. This has left me particularly anxious about the possibility of gastrointestinal perforation should I have swallowed it. I appreciate any guidance on this matter.
Suspected Hernia?
M32 I've observed a slight irregularity in the area around my groin. It remains unchanged in size during physical exertion, and it’s difficult to determine if it diminishes when I lie down. Having undergone surgery for an inguinal hernia in my childhood, I can't recall the specifics about its appearance or which side it was located on. I find myself uncertain whether what I’m noticing could signify a recurrence of a hernia. It does not resemble the images of hernias I’ve come across online, though there seems to be a lack of photographs featuring actual people as opposed to illustrations.
Dealing with Pinworm Infestation
In our household, we are currently addressing a pinworm infestation and have implemented a comprehensive cleaning routine. This includes morning showers, frequent laundry sessions, extensive vacuuming, and thorough disinfection. However, my struggle with obsessive-compulsive disorder (OCD) complicates our efforts. I experience contamination OCD, which heightens my perception of dirtiness in everything around me. I'm particularly anxious about potentially inhaling pinworm eggs while emptying the vacuum cleaner, and the inability to wash our dog every day adds to my stress. Even touching my hair prompts an immediate hand wash for me. It’s quite overwhelming, and we’re only on the third day of our treatment. I would greatly appreciate any advice on effectively eliminating these pests so that I can restore a sense of normalcy in my life after we finish our treatment.
Dislocated Shoulder - Day 7 Update
Age: 39, male, generally fit and active. While on a solo expedition, I had a mishap and slipped down an outdoor iron staircase that had become slippery. This unfortunate incident led to my left shoulder being dislocated for the first time and my left ankle fracturing in three places. Upon reaching the emergency room, medical professionals managed to realign my shoulder after approximately three hours post-injury. They advised me to keep my arm immobilized in a sling for one week. Initially, I adhered to this guideline, keeping my arm in the sling for the first two days. However, I soon found it necessary to remove the sling to maneuver with crutches and to type. Living independently on the second floor of an apartment without an elevator posed additional challenges, so I took extra care not to raise the injured arm above shoulder level or position it behind my back, ensuring it remained as close to my side as possible. Upon consulting another physician after returning home, I learned that it would be better to keep the arm in the sling for a total of three weeks without any exceptions. I also reached out to two other doctors for additional insights, and their advice varied to some extent. Overall, the consensus among the professionals seems to suggest: - Maintain the sling on my shoulder for three weeks. - While removing it occasionally to navigate with crutches and to type is not preferred, it should not result in long-term harm. - A follow-up MRI and physical therapy evaluation is scheduled for two weeks from now, at which point the arm may be released from the sling. Throughout the day, I experience mild tenderness in my arm, scoring about 1 or 2 out of 10 on the pain scale. Despite this discomfort, I feel that I am managing well. I am eager to ensure the best possible recovery. However, the practical aspects of daily life make it challenging to remain completely immobile. What actions can I take safely during this healing period? Is it permissible to apply 75% of my weight on my uninjured arm while using crutches? Have I caused any irreversible harm to my shoulder? I welcome any advice or recommendations on how to proceed!
Is High Ketosis a Concern for Non-Diabetics? Understanding Low Blood Sugar in the Context of Ketones
Hello, I am a 38-year-old female weighing 99 pounds with a BMI of 17. For various personal reasons, I've been steering clear of carbohydrates lately, despite understanding the potential health ramifications. This change in diet has coincided with a resurgence of my previous eating disorder symptoms; I have a history of severe anorexia and have experienced a significant weight loss recently. My ketone levels, as measured by a blood monitor, are at a striking 7.3 mmol/L, while my blood sugar consistently hovers under 54 mg/dL. It’s obvious that I am in a state of ketosis. However, considering that I am not diabetic, I wonder if this poses any real risk to my health. Can my elevated ketone levels offset the dangers associated with low blood sugar, especially since it dropped to 36 mg/dL last week? In addition to this, I also have several health concerns, including rheumatoid arthritis, osteoarthritis, anemia, obsessive-compulsive disorder, a history of severe anorexia, and post-traumatic stress disorder. My current medications include Benepali (etanercept), tramadol, gabapentin, amitriptyline, fluoxetine, an estrogen patch, omeprazole, and propranolol.