Recurring rib injury/pain?
April 8, 2016 11:49 PM   Subscribe

Since mid-December -- and never before that -- I've had three instances of very sore ribs or sprained intercostal muscles. Twice on the left, once on the right. What's going on?

The first time I sprained my intercostal (rib) muscle was in mid-December. That healed. Then in February -- and now again -- I again have been dealing with very sharp, difficult rib pain. It has now appeared on both sides of the body, so it can't just be a re-injury to the old spot (left side before, right side now).

I went to a clinic for the second instance; the MD found it inexplicable that I'd injured my rib twice in 2 months, and said maybe it was because I was carrying myself differently due to the original injury. That didn't seem right, since the first had healed completely by the time of the second.

The first injury was from a sharp move in Pilades. The second two both seem to have occurred during sex when my partner might have crushed me a bit. But it's gotten much worse in the last week since it came on, and the pain has spread to my back. also worrying is that the sex wasn't really unusually crushing or rough -- it seems like it would never have hurt me before my original rib injury.

Can anyone tell me what might be going on with these now chronic rib/upper back pain? I can barely breathe.
Again, I've already gone to the doctor for the second injury; they just said to rest and take Advil.
posted by flourpot to Health & Fitness (6 answers total)

One injury can lead to others due to something called "guarding" or "reflex guarding." The muscles in the injured area will tighten up due to pain or pain avoidance, which leads to unconscious but unusual adaptive behavior in other muscle groups. This can lead to weakness or uneven strengthening which can make the whole area prone to new injury.

Another possibility is that you don't have an intercostal muscle strain at all. Depending on where you feel the rib pain, it could be costochondritis.
posted by xyzzy at 1:07 AM on April 9, 2016

I have rib pain that took the doctors 3 years to diagnosis. Turns out I have a herniated disk in the thoracic spine that presses on the nerve roots that innervate the intercostal muscles there. Because of the location of the hernation, it should theoretically only be on my right side, but it presents with pain on both sides.

I don't know if that could be your issue, but it was apparently one of those things doctors don't see much so they didn't figure it out for far too long.

Sorry you are going through this, it's truly awful. You have to breathe so you can never truly let it rest and heal.

You might want to try icing your mid back for 20 minutes at a stretch and see if it helps with the rib pain. It does for me, likely reducing the swelling of the hernation just enough to provide some relief. If it does though, then I'd start to worry and speak to your doc about this possibility specifically.

I suppose the good thing is that for me it presents on Botha sides fairly equally. Every once in a while one side hurts more than the other, but mostly it's bilateral.
posted by [insert clever name here] at 3:06 AM on April 9, 2016

Did the pain emerge quickly after the incidents that you think are triggering it? Did you get x-rays when you saw the doc in February? I ask in part because I experienced a pulmonary embolism about 10 years ago that felt exactly like a rib fracture, and about a month prior to getting that diagnosis I'd had a similar episode of back pain that felt like a fracture and was never adequately diagnosed because it resolved after a few days.
posted by drlith at 9:02 AM on April 9, 2016

"But it's gotten much worse in the last week since it came on, and the pain has spread to my back..."

Do you have a fever?
Advil will suppress fever, so you might have to stop taking it in order to check.

My partner had similar symptoms in the week before her kidney infection became acute.
Do you have a UTI or any symptoms thereof?

"I can barely breathe."

Because of the pain, even on Advil? See a doctor for this.
posted by the Real Dan at 11:29 AM on April 9, 2016

A rib sprain should not get worse over time. My biggest concern would be that you are assuming this is the same thing as it was before, despite having no injury, but it may not be. I would see the doctor again to explain that your symptoms are different than they were before and that you don't have adequate pain control.

Depending on what they determine they might want to do additional workup. I'm not saying that this is likely to be something bad, in fact I see a lot of people who end up with a diagnosis of a rib sprain who don't remember any particular injury, but chest wall pain is still chest pain and if it's atraumatic it deserves more careful consideration. One thing I like for chest wall pain is a Lidoderm patch (it's non narcotic, a topical anesthetic patch), so if your doc still feels this is a muscle strain you could see what they think would be other good pain control options. Not being able to take deep breaths due to pain actually can lead to complications (see the "Deep breathing" section on this patient information handout).
posted by treehorn+bunny at 12:15 AM on April 11, 2016

Update for anyone who walks around with a self-diagnosis of a pulled muscle: had Xray, it is a fractured rib. I appreciated all the comments, which made me decide to get myself back to the doctor.
posted by flourpot at 10:00 AM on April 12, 2016

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