How and why there are pains in the ribs, which they can testify to and whether they can be eliminated, explains Alexander Nevsky, specialist in the center of neurology and pain treatment at Atlas Medical Center.
- It’s more correct to speak not about pain in the ribs, but about pain in the chest. Usually this pain we feel in the ribs - pain in the anterior chest wall.
Most often, unpleasant sensations appear due to muscle pain in the back - thoracalgia. This is a peripheral nerve disease.
If you look for deeper causes of pain that comes from bone tissue or the costal-cartilaginous joints, it is worth recalling Titz syndrome - this is the so-called costal chondritis. It is associated with inflammatory processes in the cartilage, at the site of the cartilage of the rib and sternum. Such pain can appear spontaneously, have a pronounced character. Due to localization - it is felt on the left - it may resemble an attack of angina pectoris (heart pain). Often patients just turn to chest pain with a therapist or cardiologist.
But during the diagnosis, it often turns out that this is a pain of a different nature associated with the muscular-rib structures. Then the patient is referred to a neurologist.
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If we are not talking about the muscular nature of the pain, we can distinguish the pain as a result of a mechanical effect on the nerve endings. In this case, the pain will be slightly different from a dull aching and will be more neuropathic.
The patient may have a burning sensation, a burnt surface, a feeling may appear, as if something is baking.
There are also serious pains, which are less common, but require more attention - these are pains in the chest. Of the "red flags" - the most dangerous causes - cancer associated with damage to bone tissue, and other malignant tumors in this area. In the same category - lung diseases. This includes, for example, diseases of the pleura - leaflets that cover the cell tissue and line the chest cavity.
With pleurisy - inflammation of the pleural sheets - the pains are aching in nature, can limit the movement of a person.
Pain from injuries can be distinguished, but in this case the causal relationship is obvious: bruises, minor bone injuries, fractures of the ribs. Sometimes, as practice shows, a person who is injured does not attach any importance to it, but it is this that causes acute pain.
Diagnosis depends on the type of pain. Most often, doctors do computed tomography of organs, computed tomography of the chest - the ribs of the chest and organs located in the chest cavity.
When it comes to pain associated with cardiology, differential diagnosis is most often needed - doctors collect a medical history, make an examination, rule out inappropriate diagnoses and come to a diagnosis.
We can say that pain, not directly related to the pathology of muscles or ribs, in most cases refers to cardiopathology or diseases of the gastrointestinal tract. A separate type is pain due to cancer. It has a growing character - the tumor can progress.
To prescribe treatment, of course, you need consultation with the patient.
If during a conversation it is possible to establish that a person associates the appearance of pain with physical work, the doctor may prescribe certain drugs. In this case, analgesics, non-steroidal anti-inflammatory drugs, muscle tone-reducing drugs, muscle relaxants will help reduce symptoms (before use, you should study the instructions and consult a specialist. - Approx. Ed. ).
Sometimes doctors recommend limiting physical activity. In some cases, it’s useful to visit an osteopathic doctor who can manually identify failures, displacements, or injuries. An osteopath will correct a muscle imbalance that is associated with a particular posture.
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In some cases, prescribe anti-inflammatory and analgesic patches (for example, "Voltaren"), drugs based on lidocaine (patch "Versatis").
Doctors also recommend physiotherapy - it has anti-edematous and anti-inflammatory effects (magnetotherapy).
When it comes to more serious diseases, one cannot limit oneself to analgesics or other drugs - you need a special treatment plan for the underlying disease. In general, the treatment of pain that is associated with the chest is the work with the reflected symptoms, that is, with the pathology of other organs located nearby. Often the main treatment is directed at them, and not at the place where the pain is felt.
Non-specific pains are often associated with physical activity.
To prevent them, we recommend that a person prepare for physical work before embarking on it. That is, if you have a load, for example, weight transfer, you need to stretch your shoulder girdle, warm up your muscles, do a light workout - and only then take heavy objects.
Sometimes exacerbation is associated with a cold factor. In this case, the recommendation is simple: avoid hypothermia, do not work directly under the air conditioner.
Often you have to spend a lot of time in a static position - sit at a table, work at a computer.
In addition to the negative impact on the shoulder girdle, neck, and collar region, there is an additional load on the thoracic spine. The key to minimizing such pain is to sit correctly: without distortions, without turning the body.
If a person regularly performs physical exercises, his muscles are kept in good tone, which means he is less prone to various pains.