Tietze syndrome

At the front of the chest, the ribs connect through cartilage to the breastbone in the center of the chest. Tietze syndrome is swelling and pain at these cartilage junctions. It usually affects only one side, most commonly near the second or third rib from the top.

A condition with a similar name is Costochondritis. The two conditions cause pain in similar locations, but the main difference is that Tietze syndrome involves swelling that can be seen and felt. Pain at the front of the chest without swelling is generally called costochondritis.

The exact cause has not yet been clearly established. There are reports of it occurring after prolonged coughing, repetitive use of the upper body, or a minor impact to the chest. However, many cases occur without an identifiable cause.

• One spot at the front of the chest has a stabbing or throbbing pain.
• That spot is swollen and hurts when pressed with a finger.
• The pain is more noticeable when taking a deep breath, coughing, or sneezing.
• There is a pulling sensation when making large arm movements or twisting the upper body.

Some people feel as though the pain spreads toward the shoulder or arm, which can understandably cause anxiety.

It commonly settles gradually over a few weeks to a few months, and it sometimes returns later. There is considerable variation between individuals, so it is difficult to give a definite timeframe.

Integrative Manual Therapy (IMT) views this syndrome as having a pattern similar to restricted movement at the joints where the breastbone and costal cartilage meet. In this approach, these joints are considered to have small movements, bending during inhalation and straightening during exhalation, even though they normally move very little. IMT explains that restriction of this movement in one direction may cause severe pain and make breathing feel constricted, as with asthma. Problems involving the ribs can also be found in Rib dysfunction. IMT practitioners use their hands to feel whether the joint surfaces move closer together or farther apart with breathing, while also assessing Breathing and tension around the Diaphragm. This is IMT's way of viewing the body and does not replace medical diagnosis or treatment of Tietze syndrome.

• Do not rub or tap the painful spot forcefully. This may make the area more sensitive.
• While it is painful, try temporarily reducing exercises that involve substantial twisting of the upper body or lifting heavy objects.
• If deep breaths hurt, try breathing slowly within a comfortable range. Rather than deliberately holding your breath, it is better to keep breathing, even if the breaths are shallow.
• Many people say that applying warmth makes them feel more comfortable.
• When receiving hands-on care, first tell the practitioner where the pain is, whether there is swelling, and whether other causes of chest pain have been checked. You can also ask them to assess the surrounding areas first without pressing directly on the painful spot.

Chest pain needs to be distinguished from other causes, such as heart or lung conditions. Tell a healthcare professional right away if the pain is new, if you have shortness of breath and cold sweats, if the pain spreads to your arm and jaw, if you also have a fever, or if the swelling increases rapidly. The cause of the pain needs to be determined through an examination by a healthcare professional.