Question
Hello!

For 4 weeks now I've been having this strange chest pain on and off, below the 3rd rib on the right side of the chest (close to the sternum).

It's rather mild, a burny dull ache that's occasinally more pulsing. It sometimes feels deep inside the chest, other times just on the underside of the ribs and it radiates to the back near the spine. It comes and goes and doesn't seem to be triggered by anything obvious that I can repeat.

Sometimes a movement or posture can trigger it, other times pressing on the ribcage. Often when I press on base of my neck (1cm above the collarbone, basically on the muscles) a diffuse pain radiates down to my chest and can flare up that pain also. It's never triggered instantaneously, it just slowly becomes more noticeable/unpleasant.

One time when I vomited (had a stomach bug) I forced myself quite a bit and then it hurt more intensely for a minute and then faded.

Overall it's dull and mild, nothing intense.

It's also triggered by stress and effort - breathing heavily, becoming tense. I suffer from strong anxiety and I worry about something very bad like a tumour or something - but on the other hand I read about costochondritis and maybe this is more likely?

I can't have an X ray because I might be pregnant, so I just worry... Does this sound like costochondritis or fibromyalgia?

I've had strange pains before, in my lower abdomen, above my stomach, etc. but they all seemed to be unrelated to any obvious source.

I also had a case of costochondritis before, on the lower ribs at the base of my ribcage, but that time I could reproduce the pain when I grabbed (hooked) my ribcage and it was huring on the underside. Now I can't physically try that.

Thank you for any help!

Answer
Rebecca,

THis could be a stuck or dysfunctional rib in the front of your chest, or at its attachment at the thoracic spine vertebra, or both.  It could also be the second rib, and what attaches to the 2nd rib is a muscle group called scalenes.   If the scalenes get irritated and develop "trigger points" they will refer pain into the chest area you described;  the stuck rib front or back will also cause pain in the chest.   To me, what you described does not sound like costochondritis or fibromyalgia syndrome.    Don't get any x-rays, regardless.   It is not appropriate unless you are looking for a broken bone or other big problem.    Try to massage the scalenes, and see if you can find a chiropractor to adjust the thoracic spine and ribs.  

'Hope this helps.

Dr. G'