Confused Not Sure Of Diagnosis4weeks on Sunday I was looking out of the window into the garden when WHAM it felt like a wrecking ball had hit me in the chest. To cut a long story short I spent the Tues-Weds of that week in and of hospital having tests. They ruled out heart conditions, clots, infection, breaks and didn't think there was any inflammation or that it was muscular reasoning for theses 2 being ruled out is because when they pressed on the costochondral joints it wasn't tender and the pain didn't get any worse, also with having a chronic pain condition called CRPS (Complex Regional Pain Syndrome) I'm on very very strong Transtex patches. I was sent home with some Oramorph and that was the end of the hospitals involvement.
I’ve been back and forth to the GP since then looking answers and help with pain control. This morning a saw a different GP and I had to explain yet again, pain down sternum, hurts to cough sneeze laugh breathing deeply move and at time when I’m sat doing naff all, a couple of times is felt like top of my chest was on fire (put was cool to the touch this is a classic CRPS symptom), leaning forwards makes it worse as does laying flat, twisting my body into odd shapes helps but aggravates the lower back (CRPS area). The GP said he thought it could be Tietze Syndrome.
He takes me into the examining room and presses along my costochondral joints now today 1 of them was a little tender but hasn't been when checked before. He then did some physical tests 1 was for me to put my fists together knuckle to knuckle so my elbows pointed out <> . He then put his hands under each elbow and asked me to push down. WOW this was great no pain but the Dr was shocked when I told him and had me do it again which again took the pain away. Still puzzled he next had me stand up with my left arm out stretched touching the wall with my hand and then asked me to keep touching the wall keeping my arm straight and to twist my body towards the right. This had no effect apart from aggravate my ankles (another CRPS site). He was surprised by this.
We go back into the consultation room and he says he’s sure its Tietze Syndrome, prescribed me anti inflammatories give me another sick note for a week and sends me home to look up the condition.
Which I have. Ok my sternum kills, I now have 1 tender area which I didn't have before at least 5different people have prodded that area between the pain 1st coming on and today and it wasn’t tender then so I’m a little puzzled why it suddenly is today, I've got no swelling non I Drs have even said that there’s no swelling so it’s not a case of me not been able to it coz I’m looking at a different angle. I don’t feel any tightness or crushing sensation. People have said that putting their arms around themselves and squeezing (hugging yourself) helps. Not for me I find it best to push my shoulders back and my chest forwards but is a killer to my back. I also find pushing down on the sternum helps especially when I get the sudden sharp pain which can happen at any time (including while sat watching a film doing nothing). People have also mentioned using heat and that laying on their back helps. Heat on my chest makes me very hot and uncomfy though the warm shower helps as does the steam in the air, cold is a big big no no. No matter which way I lay it hurts like hell I'm having to sleep upright laying back only slightly. I find using my crutches to walk with painful moving my arms up down in out and holding them out for any length of time painful as is lifting. Sounds and environmental changes can make it worse. Like I've said before I've had a burning sensation, I also get redness and skin can look mottled (not inconjuction with the burning)
So I'm now left wondering if the GP was right. It was obvious my body didn't react in the way he thought it would if it was Tietze. From what I've read I've only a few symptoms match and as swelling is what differentiates Tietze Syndrome from Costochondritis and I don't have and never have had swelling, it makes Costochondritis more likely than Tietze. My chest is acting more like my CRPS areas but my pain consultant won't comment on it or even see me.
I have had chest pain before the 1st time was as a teenage I kept getting sharp crushing pain to the chest which made breathing difficult that went on for about 6-8months with it coming and going, was put down to growing pains. The other time was about 3yrs ago, again it was pain to the sternum which came on gradually I had tender points but the pain was tolerable but got in the way a little. GP said it was muscular and it would go slowly. It did in a way but I've always had a slight niggle there (1-3 on pain scale).it would get worse when the CRPS flares big time. I mentioned this to pain consultant and asked if it could be a spread. She said it was possible nothing more was said. Now when hospital Drs or GPs contact her she says it can’t be CRPS and 'can't comment on this acute pain' (a direct quote from a 2line email she sent to GP).
So now I'm totally confused not sure if GP is right or if he's got confused with Costochondritis, also as it's displaying the same symptoms as my CRPS areas in the back of my mind I’m thinking could it be spread.
Sorry for the big long rant. Is there anyone out there who can please help me sort things out in my mind or shed some light on why the GP thinks the pain is Tietze?
Alchemist79 31-35 1 Response 0 May 16, 2013