Chronic costocondritis?

[Liz D.]

Does anyone suffer from chronic costocondritis?  If so, how do you manage it without losing your mind? 

I have had costocondritis several times over the past 14 years since I've been diagnosed with Sjogrens.  They've lasted a relatively short amount of time and I've taken the necessary treatment......anti inflammatories and heat.  But this past time, it just won't go away.  I've had it for well over a month.  I rest for a couple of days to help it and it calms down.  But as soon as I start living my "normal "life , it kicks in again.  It does not help that I am full chested and wearing a bra adds to the pain.

Is anyone else in this predicament?  Can anyone give me some suggestions?

Thank you,

Liz D.

[cccourt1942]

You rang?     The way I learned to control the attacks was to consciously map everything you do which is extra, heavy, awkward positioning, heavy lifting, awkward lifting, repetitive motion (cooking and stirring something continuously with arm raised ...like a cream based soup, pie etc.  I learned what I was doing. 

Liz...I am a lot older than everyone but Methuzalah.  Some of my attacks I thought just happened generically....and when I paid attention, a LOT of the triggers had to do with something that would bother some older people...physically that is.  So I didn't really make the connection to something I was causing.

Recently I was made aware that my sternum, when examined by firm touch, hurts 24/7.  Not HURT hurt.  Is sensitive to the touch.  I reacted to a sulfa med, and when I pressed at the base of my sternum (which ached) I probably reached about 8 on the 1-10 scale.  I was amazed.  I was extremely bloated..and my rib cage area had just bloated along with everything else.  I didn't go to the dr, but next time I saw her, I told her.  She told me as she's watched my attacks over the years she  could estimate my sternum was swollen all the time.  That is, it didn't take much to blow it from maybe a 1 or 2 to 7 to 9.  She examined me and showed me.  I was surprised.  I'm even more careful now. 

This will be one more limitation, or ....it can be the secret to keeping you out of the ER for a pain shot!
ccc

[Liz D.]

ccc,

Thank you so much for your reply.  Yes, it is distressing that it is yet another limitation, but I wholeheartedly agree with you that I have to watch what I'm doing.  I've been extra busy these last few weeks with many things, one of which is having a lot of company.  That puts stress on me, working harder to make them feel comfortable.

I also love to cook and do laundry (I'm strange that way ?) but again, that puts pressure on my arms and lifting.  I don't want to give up my "life", but I will definitely try to be more weary about what I'm doing.

Also was the doctor you went to your primary or your rheumatologist?  My rheumatologist insists that the costocondritis is due to a virus.  Although I agree that can be true, I don't believe that is why I get it so often.   I just feel it is part of my Sjogrens. She just says to take it up with my primary doc.

Thank you,
Liz D.

[cccourt1942]

That puts stress on me, working harder to make them feel comfortable.

***See?  You already know what is causing it.  You already knew that. Yea you.*****

I also love to cook and do laundry (I'm strange that way ?) but again, that puts pressure on my arms and lifting. 

*** Watch the size & weight of your pots/skillets, etc.  That is..I have Calphalon.  Quite heavy.  I got rid of my  huge skillet and largest pot.  I wash my pots by hand...so I am careful to pay attention to even moving a pot...from stove to sink, and when washing maintain my shoulder level and arm movement.  Sounds silly...but I'll explain in a second.  Also, sit and fold.  I know: I hate that too.  The other thing I do (I live alone) I do small loads.  I never have a lot to wash.  Cuts down on standing/folding time.***

Also was the doctor you went to your primary or your rheumatologist?  My rheumatologist insists that the costocondritis is due to a virus.  Although I agree that can be true, I don't believe that is why I get it so often.   I just feel it is part of my Sjogrens. She just says to take it up with my primary doc.

***Okay...had to remember this one:  my GP diagnosed me and explained the condition.  She explained it as an inflammation condition common amongst SjS BUT NOT limited to it.  I've researched this...and it is stated there's high incidence--nearly 1/2 of SjS and the rest is the general population.  No. She didn't explain it was a virus.  I looked this up and there is one comment about it being a bacterial infection.  That's all I found during a cursory search.  You can research it.  ****

********
NOW FOR THE comment about the 2nd followed by 3rd comment:
My rheumatologist explained to me IF you have costo, your sternum is inflamed.  We do not feel it.  I mentioned this in my first reply.  But now I will tell you how to gauge how tender you are:  Lay down on the bed...and relax as much as you can.  Place your middle fingers on the lowest connecting area of your sternum.  Feels almost like a ball.  It SHOULD be tender if you have costo. If you push harder, you might say ouch. Next,  take both hands and feel the collar ribs and push.  Gently push.  You may be surprised this area is tender too.  Remember---not hurt, but tender.  If your attacks have progressed to the snake like aching at lower left ribs wrapping around your waist, you can touch every rib connection..then follow pressing that lowest left rib and take it around toward the back.  THIS part should NOT be tender.  Or at least, this area is only tender when I am full blown pain/costo/get me to the ER. 

I was flabbergasted to realize my sternum was inflamed.  Then I LITERALLY LOL as I realized I had a chronic, autoimmune anti inflammatory disease.  Of COURSE I hurt in an area which can go from 1 point of pain to 10 points in  a matter of hours.

I wish I could tell you all the misdiagnoses I've had..for decades...not to mention as it progressed to that snake like spreading, the things I THOUGHT it was or what had caused it.  The first 10 to 15 years I felt that side pain, I actually would get on my Pilates Proforma and do twisting exercises thinking I was weak.  Needless to say I would make it worse.  I will say this: it took me decades to progress to the level of pain which required ER.  AND...I believe THAT stage was reached due to my AGE...not the stage of SjS.  Surely, at this age..almost 76...my SjS has topped out.  I believe all my current body aggravations are attributable to age.  To think they are attached to SjS would mean I believed old age was having no effect on my body.  See what I mean?

LAST COMMENT: "Take it up with your primary"  I lived in one city and the GP dxed me.  I moved to another place.  I established with my Internist first.  The internist does an intake--and then says: I don't do this, see in ENT, I don't do that, see a Rheumy, etc, etc.  SO...I get to the rheumy, (this is a diagnostic practice where all drs are linked and can see anything/everything from one another) (I CHOSE that) will repeat:  get to rheumy and see she can see all my intake--we address SjS, meds, etc.  If you go thru everything, it'd take two hours.  So easy in, easy out.  First costo ER attack here, (LONG STORY) am consulting with Neurologist....am rolled over to hospital...and he has read and learned ER won't give me the massive prednisone treatment needed--and he writes the RX before I leave his office.  Somehow, Neuro assigned this "condition" to my internist.  Internist didn't know, understand or care.  After 2 years of begging rheumy to take over the condition, she did.  But I understand your frustration.  AND...glad to hear that situation really is sort of a pecking order problem for all of us.

Sorry so long...Happy Easter,
Good luck,
Courtenay


Thank you,
Liz D.

[Liz D.]

Courtenay,

Thank you, thank you, thank you!  I so appreciate the time you have taken to respond and give me such helpful suggestions.  They are all excellent!

Interestingly, I never had sternum/rib pain until I had my first acute costocondritis attack and ended up in the ER with it thinking I was having a heart attack.  Just to sit back in a chair was excruciatingly painful.  Incidentally it was the exact same month in 2004 that I got diagnosed with Sjogrens.  Hence the reason I always connect the two.

Thanks again for your help!

Liz D.