Question
Hi Shawn,

I was hoping you could help me out. I am in dire need of some advice. I hurt
my chest somewhere around two years ago. The strange part is that it started
to hurt when I stopped working out.  I have this horrible pain in my chest by
the sternum area. When I pull my shoulders back I can hear a crack and there
is a slight reduction in pain. It is a horrible pain that I can feel when I cough
and sneeze as well. It hurts when I put pressure on it. I've gotten x rays and
have gone two different doctors. One of which told me it was a virus and
there was nothing that could be done. The x ray didn't have anything. When I
start to work out after about a week it actually feels better. As of recently I
have been traveling and have not been able to stay in the gym and my chest
has been hurting like never before.  It's been hurting if I lay on my right side
and almost any motion with my right arm gives it a lot of pain. If I raise my
hands too fast or go down to pick something up, my chest just shoots up
with pain. Is there hope? Or is this a lifetime thing now??

Thanks,
Nathan

Answer
Dear Nathan,

The dysfunction is obviously connected to the rib cage articulations such as the rib heads and sternum.  What may have occurred is that the joints became fixated when you stopped working out, and getting back into the gym helps them to become unrestricted due to the increased movement and muscular activation.  The pain most likely originated from inflammation in the joint capsules which are ligamentous structures (innervated with pain fibers), and respond to stress, strain, and movement.  Often this is termed chostochondritis when no visible inflammation is found, or Tietse's syndrome when inflammation is present.

Restriction of the anterior chest cage generally does result in chest pain worse with deep breathing or pressure over the rib/sternal articulation.  These cases are often seen in chiropractor's offices due to the fact that medical physicians mostly do not understand these fixation/inflammation/pain transmission issues, and do not treat them.  However unfortunate, it is almost comical that you were diagnosed with a virus for chronic sternal pain.

What I would recommend is that you first and foremost use ice packs for 20 minute intervals over the sternum when in pain to reduce inflammation...you can repeat this process every two hours as needed.  Then seek out the care of a local chiropractic physician to address the sternal joints, to allow for proper established motion.  These cases can be very tender to treat, however you should see appreciable improvements in 4-6 visits.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net