Costochondritis and scubadiving ?

[DocVikingo]

Hi Monica, Costochondritis (tietze's syndrome) is quite common.

Speaking about these two conditions as if they are synonymous is incorrect.

- Tietze’s syndrome causes inflammation, tenderness & swelling, while swelling is absent with costochondritis.

- Tietze’s syndrome affects men & women equally & typically occurs in the 20-40 year-old age range bracket. Costochondritis tends to affect women >40.

- Costochondritis affects the 3rd-5th joints between the sternum & ribs. Tietze’s syndrome tends to affect only one joint, although the pain may radiate outward.

- Costochondritis is usually short-lived, whereas Tietze’s syndrome can last for many, many years.

"Everything should be made as simple as possible, but not simpler." (Albert Einstein).

Regards,

DocVikingo

---------- Post added February 5th, 2013 at 06:34 AM ----------

Hi zugbug,

You may find Table 1 in the following article to be informative --> Costochondritis: Diagnosis and Treatment Costochondritis: Diagnosis and Treatment - September 15, 2009 - American Family Physician

Regards,

DocVikingo

 

[scubamonica]

Actually, zugbug, costochondritis and Tietze's syndrome are not quite the same.

Both costochondritis and Tietze's syndrome involve localized pain and tenderness in the same area of the front of the chest (sternum), but the former is not commmonly associated with swelling, while in the latter swelling is characteristic.

Regards,

DocVikingo

Hi Doc

Still not well, more than 3 weeks with this and Im still in pain. Is like on and off. I think a little bit better but not clear yet how this is going to end. And if will end. Im in a state of panic.

Im in Bali and I'll go to the dr again. I'll try to book an appointment with a GP because I dont want ER again and again. I already know my heart
is well and is very healthy.

I need to know if this is going to end some day (im in a state of depresion at the moment) and I need to know if I have to be in the bed all the time, or if I can walk. If yes, how long. If i have to sleep in some particular position, etc etc ... what to do in the daily basis to fix this problem asap.

Our holiday is a nightmare now. The depresion is present.

Any comment will be appreciate.

Thanks
Monica

 

[DocVikingo]

Major bummer, Monica. No doubt this is not what you had in mind for this trip.

However, there appears no reason for panic & depression. What will serve you best now is a cool head, positive attitude & methodical approach to the issue. As has been said, costochondritis, while almost always resolving, can take weeks or months to do so.

It is unclear how religiously & aggressively you carried out the earlier suggestions for resting the affected area, taking
anti-inflammatory meds and applying local heat/ice, but these actions definitely are the place to start. Down the road other meds might be considered, including duloxetine (e.g., Cymbalta) or local anesthetic & steroid injections, at your physician's discretion.

BTW, as regards your heart, while it's unlikely to be the cause of your complaints, an "...X-ray, another ECG and a blood test. All to check my heart which is working very well and is very healthy one due my healthy life style," is not sufficient to rule out cardiac/cardiovascular issues. You would need to undergo several other more sophisticated diagnostic procedures before you could be solidly confident.

Concerning sleeping position, try to sleep on your back. Avoid positions that compress/constrict the affected area.

Again, diagnosis is key here and the physician you may wish to seek out next is either an orthopedist or a rheumatologist. There are some in Bali & you might contact the U.S. Consulate there for further info --> Home | Consulate General of the United States Surabaya, Indonesia. If you wish to spend the time & money, Singapore is the nearest location for world-class medical treatment. It's about a 2 1/2 hr flight.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

 

[scubamonica]

Major bummer, Monica. No doubt this is not what you had in mind for this trip.

However, there appears no reason for panic & depression. What will serve you best now is a cool head, positive attitude & methodical approach to the issue. As has been said, costochondritis, while almost always resolving, can take weeks or months to do so.

It is unclear how religiously & aggressively you carried out the earlier suggestions for resting the affected area, taking
anti-inflammatory meds and applying local heat/ice, but these actions definitely are the place to start. Down the road other meds might be considered, including duloxetine (e.g., Cymbalta) or local anesthetic & steroid injections, at your physician's discretion.

BTW, as regards your heart, while it's unlikely to be the cause of your complaints, an "...X-ray, another ECG and a blood test. All to check my heart which is working very well and is very healthy one due my healthy life style," is not sufficient to rule out cardiac/cardiovascular issues. You would need to undergo several other more sophisticated diagnostic procedures before you could be solidly confident.

Concerning sleeping position, try to sleep on your back. Avoid positions that compress/constrict the affected area.

Again, diagnosis is key here and the physician you may wish to seek out next is either an orthopedist or a rheumatologist. There are some in Bali & you might contact the U.S. Consulate there for further info --> Home | Consulate General of the United States Surabaya, Indonesia. If you wish to spend the time & money, Singapore is the nearest location for world-class medical treatment. It's about a 2 1/2 hr flight.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

thanks for your reply. i went to see a gp here in bali and after she press my chest and ribs which didnt hesrt she said this is more likeli to be muscle and anxiety problem. she gave me muscle relaxant and alprazolam and i feel better. next week i'll come back home, london, and ill go to see my dr. hopefully the indonesian dr was right. just one week to go. uuuufffff ! thanks for your answers !

 

[DocVikingo]

Hey, scubamonica. Glad your condition seems to be resolving. Make sure you follow up.

Cheers,

DocV

 

[tracydr]

What medicine do you take? How did your doctor rule out the blood clot? An EKG does nothing to rule out blood clots.
please PM me if you'd like some more in-depth information on blood clots and diving. I'm going through some issues related to a coagulation problem and diving.

 

[DocVikingo]

BTW, as regards your heart, while it's unlikely to be the cause of your complaints, an "...X-ray, another ECG and a blood test. All to check my heart which is working very well and is very healthy one due my healthy life style," is not sufficient to rule out cardiac/cardiovascular issues. You would need to undergo several other more sophisticated diagnostic procedures before you could be solidly confident. Regards, DocVikingo

This seems to be getting overlooked & repeated in the two threads we have going on costochondritis.

Regards,

DocVikingo