Question
QUESTION: Hello,  I think my ribs are out of alignment.  My doctor says costochondritis.  I feel like everytime I move My diaphram is getting irritated or punched-like feeling.  I don't want it to rupture.  I am getting scared to move.  When I move the pain can get to an 8-9. When I lay still it is like a 5, sometimes less.  I try to do movement everyday so I dont develop further problems.  I did use my upper body and arms more strenously prior to this.  I was trying to hold my body weight up while I was going down the stairs. I have a herniated l1 l2 disc and thought going up and down the stairs was aggravating it. I usually go up and down about 10 times a day to use the restroom. I used the stair railing as parallel bars to get down.  Then the rib pain started and keeps increasing.  Please advise.  I need to get this diaphragm pain to stop.  It is really hard to do anything.  Holly

ANSWER: Hi Holly,

That is quite a burden you are living with.  As you can imagine, it is difficult to fully advise you at a distance like this.  Let's see what we can do.

First, costochondritis is a general term.  It means the area that the rib and cartilage meet is inflammed.  It does not speak to the cause or any specific treatment.

It seems a sensible theory that the disc herniation will directly effect the diaphragmatic attachments and the increased upper body stress caused the inflammation.

Rest, antiinflammatory meds and ice may help a bit.  Direct treatment to the muscles and joints, if needed, would insure optimal healing.

Chiropractic doctors will examine and treat this with manipulation, physical therapy, exercise, posture advice, and so on.  

I have treated (and had) a lot of rib troubles with great success.

You are correct that continuing to move is important.  A stretch that I often recommend is to take a towel and roll it up into a tube shape.  Then put it on the floor and lay on it longways from the base of your neck down.  Let gravity stretch you over it for 3-4 minutes.  

It shouldn't hurt.  Adjust the diameter to fatter and cushier or longer and thinner so that it feels like a stretch, not a pain.

Hope this helps.

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QUESTION: One more quick question.  Can Cauda Esquina Syndrome happen at a l1 l2 level.  I've read about it and I am nervous to move. I don't want my herniated disc to get worse.  Thank you, Holly

Answer
The short answer is yes.  Usually the doc will not give you the costochondritis diagnosis unless they have done some diagnostic testing.  Have you had the area xrayed?  MRI?  NCV?  

If there is any reason to worry about CES those test should be done.  Run this by your doc for their reasoning on why you need to worry about this or not.

Grace and peace, Dr P