Question
I have had chronic sinus drainage and subsequent cough for 3 months.  I am being followed over the last 2 weeks by a ent md.  During a coughing spell, i heard a pop and severe pain in my left side. The pain was particularly severe with coughing and sniffing hard.  Three days later during a coughing episode, I had the same type incident, but the pain  was excruciating during coughing and sniffing.  My chest xray was negative, however I've been told I could have a hairline fx that the xray did not reveal.  My cough is resolving and the pain with coughing, but I continue to feel this clicking in my lower left rib cage area with coughing sniffing.  how can this heal if it is a fracture?  should i be concerned with this clicking?

Answer
Hi Lori,
I'm sorry you are having a lot of pain. Hairline fractures are possible with forceful coughing as well as cracked costal cartilage. Cracked cartilage occurs where the rib attaches to the sternum. The cartilage attachment is flexible and allows movement of the rib with chest expansion. This cartilage has a limit to excursion and often during hard coughing the cartilage bone junction will crack. This heals however it takes a couple weeks. The first consideration is to keep breathing as deep as you can without pain. Usually very slow inhalation may not be as painful. Rib pain and shallow breathing problems can lead to lung infections and pneumonia. I have had quite a few patients with severe rib pain have substantial relief using class 4 laser therapy. This is different than cold laser. Many chiropractors have class 4 laser therapy devices however, you will need to inquire or check the Doctor's web site. Cold laser works as well although not as fast.

Do not lift or exert too much this only causes reinjury.