Increasing Pain in the Sternal Area
A 26-year-old female, standing 5 feet 2 inches tall and weighing 150 pounds, is seeking insights into her health condition. **Current Medications:** birth control and Allegra. **Past Medical History:** includes irritable bowel syndrome with constipation (IBS-C), bilateral cubital tunnel syndrome that required surgical intervention at ages 17 and 18, and minor kyphosis. For the past year, she has experienced considerable stiffness, along with clicking and popping sensations, accompanied by mild discomfort located at the costosternal junction, particularly around the second to fourth ribs, with greater intensity on the left side. Recently, during the last three days, she noticed a notable increase in pain on the left, to the extent that it occasionally causes a sharp sensation that temporarily immobilizes her. However, once she changes her position, the pain becomes more bearable. Notably, she is not experiencing any shortness of breath. The pain appears to be triggered by movement and can be replicated, leading her to believe that cardiac or pulmonary issues are unlikely. Attempts to alleviate the discomfort with a lidocaine patch have been largely ineffective, although she has found some slight relief with ibuprofen. This situation appears to align with typical presentations of costochondritis; nonetheless, she acknowledges that such symptoms typically resolve within a few weeks, while hers have persisted for an entire year. She has encountered information suggesting that chronic costochondritis might point to rheumatoid disorders, and she is uncertain about the validity of this claim. Given her earlier struggles with ulnar nerve entrapment, which occurred during her teenage years, she is contemplating whether this pain warrants further medical evaluation. Currently, she lacks comprehensive health insurance, and she wishes to avoid any extensive diagnostic processes if they are unlikely to yield actionable results. However, if there is a possibility that her symptoms could indicate a more serious condition, she is prepared to follow through with recommended evaluations. Thank you for your assistance!
Answers (1)
2/7/2026, 11:20:33 PM
OpenHealth AI
You're experiencing increasing pain in your sternal area, likely stemming from costochondritis, but you're right to consider other possibilities given its persistence over a year. Let's address your concerns about this pain, its potential causes, and effective management strategies.
Key Points:
- Possible Diagnosis: Your symptoms suggest chronic costochondritis, which is inflammation of the cartilage connecting your ribs to your sternum. This condition often causes localized pain and discomfort, especially during movement but can also cause sharp sensations.
- Associated Concerns: Persistent pain over a year warrants consideration of other causes, including musculoskeletal issues, rheumatological disorders, or costosternal syndrome. Nonetheless, cardiac or pulmonary causes seem less likely given your symptom profile.
Explanation:
Your pain's specific location, its reproducibility with movement, and the relief when changing positions are strong indicators that it is likely muscular or related to costochondritis. Chronic forms of this condition can occasionally be associated with systemic issues like rheumatological disorders, but this is less common, especially if there are no additional systemic symptoms (like swelling, stiffness in other joints, or fatigue).
Next Steps:
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Self-Management:
- Pain Relief: Continue taking ibuprofen as needed, but be cautious with prolonged use; a guided dose (e.g., 400-600 mg every 6-8 hours) can help reduce inflammation.
- Heat Therapy: Applying heat to the affected area might provide relief from stiffness and discomfort.
- Gentle Stretching: Incorporate gentle stretches for your chest and shoulders, avoiding any movements that exacerbate your pain.
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Monitor Symptoms: Keep a symptom diary noting:
- The intensity and nature of your pain
- Activities that trigger your pain
- Any changes over a week
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Evaluate Triggers: Identify any postures or movements that worsen your pain. Adjusting activities that exacerbate discomfort can help prevent exacerbations.
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Consideration for Medical Evaluation: If pain worsens significantly, becomes persistent day-to-day despite self-care, or if you experience new symptoms (like swelling in your joints or full-body symptoms), it would be wise to seek further evaluation.
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Explore Low-Cost Health Resources: Since you mentioned lacking comprehensive insurance, look into community health clinics or sliding-scale payment options for low-cost evaluations if symptoms persist or worsen.
By focusing on these steps, you can manage your current situation more effectively while remaining vigilant for any changes that would necessitate medical attention. If you need further clarification on any points, feel free to ask!
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