Strange pain in rib cage

July 4, 2011 9:19 PM

Help needed for a friend who is experiencing intermittent pain in his rib cage.

I'm asking this for a friend who is not on Metafilter - the following is in his words. I can follow up with him for more info if anyone has any follow up questions:

First, I know you are not my doctor (or a doctor) and are not giving me medical advice.

I am a 34 year-old male in good health, exercise 4-5 times a week, haven't had any recent changes to my diet or anything. About a month ago, I started having this odd pain in the left side of my rib cage, about an inch or 2 below the nipple. It isn't overbearing, it doesn't last long (usually just a few seconds), but it does come multiple times a day. It feels like a burn or tiny needles - it's hard to describe. It seems to be random and I can't think of any kind of pattern in my diet or activities that brings it on.

Prior to this pain, I was having a strange tingling sensation in my back almost directly across from where this chest/rib cage pain is. I have no idea if they are correlated - the tingling sensation in the back doesn't happen nearly as often anymore.

I recently read about Precordial Catch Syndrome which does sound similar, but I think I know what that feels like (I think I experienced that when I was a kid) and it's different from the strange pain I'm experiencing now - what is happening now is not nearly as painful as how that is described. I also think I can rule out heartburn due to its location and my diet/history, and I don't think these are anxiety attacks.

Has anyone experienced this and do you have any idea what could be happening? Does this sound serious enough to warrant a trip to the doctor or can it wait until my next checkup? I know that chest pain in general is usually met with a "see a doctor NOW" response but as this has been happening for awhile now, it doesn't strike me as an immediate emergency. Am I wrong to wait on this?

posted by katy song to health & fitness (7 answers total)

I think this is a NOW situation, especially since the pain seems to be felt on both front and back and/or has progressed. It could be lots and lots of things, many of them harmless, but this is definitely a case where X-rays and MRIs are pretty much called for.
posted by dhartung at 10:17 PM on July 4, 2011

Urgency is probably not really required - young people with chest pain tend to drop dead if it's serious and left for a month so you can probably rule out something major. What you're going to get when you see a GP is a referral to a cardiologist and a 24-hour halter monitor to see if there's any detectable arrhythmias - provided that you get a clear chest x-ray. Respiratory stuff is generally not transitory however so that's unlikely.
posted by Silentgoldfish at 12:16 AM on July 5, 2011

Actually, on re-read that doesn't sound like cardiac chest pain at all, so you may not get a monitor if you have a clear ECG.
posted by Silentgoldfish at 12:17 AM on July 5, 2011

IANYD but your next checkup could be a long time away if you're a healthy young person, and I would be remiss if I did not tell you to seek help urgently for chest pain, even if it has been going on for a month and hasn't killed you yet.

I agree that it doesn't sound like cardiac chest pain, but usually chest pain will be met with at least an x-ray and an ECG, to look for anything unusual (not usually MRIs as suggested above). It could still be something like reflux or gastritis, your diet does not dictate whether you get these things and your gastro-esophageal junction is around the area where your pain is. Other benign possibilities would include costochondritis and pleurisy. In any case, it's most likely not something dangerous, but the way you should look at it is that even if there's only a 1% chance that it's something life-threatening, is that a chance worth taking when seeing a doctor is easy? The decision is yours, but I know what my answer would be.
posted by treehorn+bunny at 6:11 AM on July 5, 2011

Could be a rib fracture or tear in the cartilage. I've had both, and minor damage can cause intermittent burning pain. You should probably get an x-ray to find out. They can't do much, but you might also have some kind of infection, so it's best to find out.
posted by catatethebird at 7:29 AM on July 5, 2011

This sounds exactly like the feeling I had when I developed shingles - particularly the "mirror" pain in the back. However, that develops into a rash and the pain becomes worse. It could be a lot of things. This has been going on for a month: he needs to get it checked out.
posted by Decani at 11:32 AM on July 5, 2011

Thanks for the advice, all. Turns out he had a realization "I'm having chest pain - should see a doctor NOW!" last night so he was able to get it and see his doctor this morning. Tests so far are inconclusive but it doesn't seem serious, and he has a doctor monitoring.
posted by katy song at 11:51 AM on July 5, 2011