Expert: Dr. J. Shawn Leatherman - 12/24/2008

Question
Hi !
I am a healthy 38 year old female that has been suffering from chest pain for the past 4 years. I am at my wits end dealing with the pain. I have been to my doctor and had a CT scan done that showed nothing. Nothing showed up on xray either. I have been to the ER for it and all they did was xray and EKG. My back in the same area is uncomfortable all the time as well. THe chest pain is 24/7. Nothing relieves the pain. I have also been on two trials of Proxicam. I am desperate for an answer or maybe something I can bring up to my doctor to check out. Any ideas????????

Answer
Dear Shannon,

Forget your medical doctor on this one...they will never find the problem because they are looking for the wrong things. That sounds harsh, let me explain: your doctors have done what they needed to do, which is rule out tumor, infection and heart pathology, so they have exhausted their primary concerns...they are looking for serious pathology not subtle conditions.  However, the fact that you have been suffering for 4 years and no one has referred you out for a chiropractic opinion only proves my assertions that they will not get you the answers you need.

You need to go to a chiropractic physician, this is a musculoskeletal problem of the anterior rib cage where the ribs meet the sternum as well as posterior rib cage with vertebral dysfunction.  This is actually more common than you would believe and the medical physicians almost never figure out the cause.  This is often termed costochondritis or Tietse syndrome.  Basically the joint capsule that surrounds the rib/sternum is inflamed and is the cause of the chest pain...and yes is happens in the back as well because the rib attaches at both sites...both sites will need to be addressed as well.

The best thing you can do right now is put ice directly over the chest for 20 minutes and repeat this every two hours.  Find a good local chiropractic physician to examine the skeletal system and adjust the rib articulations at the sternum and the back.  Note:  you will be very tender on the sternum where the rib dysfunction is found and you may actually be able to feel a small tender nodule..this is swelling and scar tissue at the site of involvement and can contain some minor muscle spasm as well.

I have seen this actual presentation about 4-5 times a year in my clinic and the presentation is almost always the same. Primary complaint is chest pain that can be constant or intermittant and feel like a heart attack, but with no radiation to the shoulder, neck, jaw or arms, back pain, pain upon deep breathing, and soreness to the touch...sound familiar?

The last patient I saw with this condition was a 12 year old boy who went through EKG, blood testing, CT scans of the chest, esophageal and gastric scopes, and spent three days in the hospital on medication and constant monitoring.  Total bill was over $45,000 for his care and they never figured out what the problem was...their diagnosis at release was acute pancreatitis even though all the pancreatic enzymes and blood tests were normal  His mother was a patient of mine and decided to have me look at him.  After examination, I saw him 4 times the first week and 2 times the second week and the pain was eliminated.  Total cost of care was just over $700.00.  So, you can see why I may have had a harsh tone with this response.  Have a chiropractor check it out.  Good luck Shannon.

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