Rib Cage Pain

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I have had CFS/ME for 10 years, and am lucky enough not to have pain as a symptom (other than migraines). For several months now I have had intermittent rib cage pain. It mainly occurs at night, not every night, but is happening more often. The pain occurs when I lie on my side (either side) and wakes me up. When I roll off my side the pain goes. During the day it can be in my whole rib cage, or just some parts of it. It comes and go. Sometimes it feels like a band around my lower ribs. GP doesn't know what the cause is. Is it likely that this could be related to CFS/ME? Seems unlikely given the length of time I've had it. Could it be fibromyalgia? Would be very grateful for your thoughts/suggestions.
 

Mary

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@Fogbound - two possible things came to mind, pleurisy and pericarditis. Pleurisy is inflammation of
a membrane consisting of a layer of tissue that lines the inner side of the chest cavity and a layer of tissue that surrounds the lungs
https://www.mayoclinic.org/diseases-conditions/pleurisy/symptoms-causes/syc-20351863
It can be quite painful.

Pericarditis can be painful too
Pericarditis refers to inflammation of the pericardium, two thin layers of a sac-like tissue that surround the heart, hold it in place and help it work. A small amount of fluid keeps the layers separate so that there’s no friction between them.

A common symptom of pericarditis is chest pain, caused by the sac’s layers becoming inflamed and possibly rubbing against the heart. It may feel like pain from a heart attack.
https://www.heart.org/en/health-topics/pericarditis/what-is-pericarditis

One of my sons had one or the other when he was young (I don't remember which it was) and he had recurrence last year (some 30+ years later). He was told it was probably due to a virus and again he recovered. Part of the treatment was taking lots of advil to reduce inflammation.

So you might try advil and see if it helps. Tylenol won't do anything, it's not an anti-inflammatory.

I had something similar several years ago. Actually I think I had it twice and doctors found nothing wrong the first time so I didn't go to a doctor the second time. But I recall it being most painful at night when I was lying down. It eventually resolved.

Coxsackie B virus can trigger pericarditis.
 
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Thanks to you both for your responses.

I don't have any other symptoms, and my CRP is normal, suggesting no inflammation. I guess neither of you think it's related to CFS or fibromyalgia.
 

BeADocToGoTo1

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For many years I had pains in chest that doctors could not explain. I had MRI, CT, X-rays and ultrasound done. Lying on the side also was more difficult as it felt as if I was putting more weight on the ribs and pain would increase.

In my case it was essentially nutrient deficiencies that caused it (due to exocrine pancreatic insufficiency EPI). My body was using muscles and bone as fuel for amino acids and minerals. Have you ever had any nutritional panels done, for example:

Genova Diagnostics - FMV - Gives a great overall picture of nutrient deficiencies, microbiome dysbiosis, pancreatic enzyme issues, and many more. Biochemistry and metabolomics in practice. This test should be standard for all primary care and family practice doctors as a regular preventative maintenance test, and for anything chronic or hard to diagnose. Great Plains Laboratories has similar tests.

Have you checked whether you are absorbing food properly, or if anything is hindering this?

Have you tried an Epson magnesium salt hot bath and noticed any temporary improvement?

CRP was never elevated with me, even during times where clearly I had systemic inflammation symptoms.
 
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Mary

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@Fogbound - I don't have FM, so I don't know if it could be related to that. But I don't think my CRP has ever been elevated and I'm almost positive I had either pleurisy or pericarditis. You might try Advil for the heck of it. If it helps, then I think it will indicate you have some sort of inflammation.

Also, it could be related to ME/CFS in that ME/CFS can be triggered by coxsackie B, and pericarditis can be triggered by coxsackie B. If you've tested positive for coxsackie B, it could be the culprit.
 
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Sometimes it feels like a band around my lower ribs.
I experience alot of ephemeral or intermittent sudden weird pains, flashes, neurological seizures, and other related mysteries. In this body, they seem to be mysterious, or occassionally recurrent, but chasing these pains has NEVER resulted in getting anywhere. Some of this appears when I am more rundown, then it kinda lapses again.

Bodies can do strange things. Major announcement!:D
 

Shoshana

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Of course I don't know, but I too have periods of time with significant pain similar to your post, @Fogbound

I use heat pads, and I pay attention to my body positions, even when it isn't occurring, to try to help my body (posture/ alignment.)

I do think , personally, that it could possibly very well be from Fibro or CFS. I haven't found any other cause, to date, for myself, and the pain areas from the CFS and/or Fibro do vary in which body areas, and do seem to add some on, at times, that I didn't have prior.
It also might be from lack of ability to exercise, resultant from the CFS. I am just guessing but I have not ruled out that it could be from my overall severe CFS/ME.
 
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msf

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It's also quite likely that it is lymph node pain, I used to get this quite regularly in the side of the torso, particularly about 6 inches below the armpit. Of course, you should first try to see a doctor.
 
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All my blood tests were clear. I'm being referred for an endoscopy and to musculoskeletal. It feels like groundhog day - ie there is no medical explanation for the symptoms I am experiencing.
 

BeADocToGoTo1

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All my blood tests were clear. I'm being referred for an endoscopy and to musculoskeletal. It feels like groundhog day - ie there is no medical explanation for the symptoms I am experiencing.
Please do not forget to rule out malabsorption issues including SIBO, Candida yeast overgrowth and most importantly exocrine pancreatic insufficiency (EPI). You might have to persuade your doctors as they are causes that are sadly often overlooked due to lack of knowledge and experience with doctors.

The following might be good to consider:
  • Standard stool tests for elastase
  • 24 hour fecal fat stool test
  • Genova Diagnostics - Comprehensive Digestive Stool Analysis 2.0 with Parasitology (microbiome dysbiosis indicators), Fecal Fat Distribution (checks if you have issues with different types of fat intake and digestion), Elastase (for EPI, pancreas enzyme marker)and Chymotrypsin (for EPI, pancreas enzyme marker). Doctor's Data has similar tests.
  • Small intestinal bacterial overgrowth (SIBO) breath test, for example, Commonwealth Diagnostics International.
 

2Cor.12:19

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Hi @Fogbound i have had this intermittently over the years at one point I was convinced it was down to my bra being too tight as it was in a band around my ribs but it turned out to be Costochondritis. I don’t have the symptom at the moment but it tends to just start again for no apparent reason.
Sarah
@Sarahloudobby Same here. I suspect it's Cotsochondritis as well. I've had sore points off and on in my upper ribs trading off between left and right and also in the center, for quite awhile. I've also had non-stop tender spots along the muscles on the underside of my arms ever since first getting ME/CFS 34 years ago. I used to think it was due to inflamed lymph nodes, but my doctor said it was the muscle. As for my rib cage pain, I had some extensive chest x-rays not too long ago, so I'm chalking that up to the generalized inflammation that seems to come with the territory.
 
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Said that I didn't find this thread earlier.

Is it likely that this could be related to CFS/ME? Seems unlikely given the length of time I've had it. Could it be fibromyalgia? Would be very grateful for your thoughts/suggestions.
It isn't a cardinal symptom to neither of them, but I think it belongs to the collection of possible symptoms caused by autoimmune diseases and chronic infections.

There is a term in the MS world for this kind of symptom: MS-Hug.

It mainly occurs at night, not every night, but is happening more often. The pain occurs when I lie on my side (either side) and wakes me up. When I roll off my side the pain goes.
Interesting, I had quite the opposite behavior. But I can't sleep on my side, so I've to roll off.

Is the pain caused/increased by any kind of pressure, e.g. through your fist or any other kind of item, against the sides of your rib cage? Or is it better/same if you press your hands against your rib cage.

Sometimes it feels like a band around my lower ribs.
Oh yes, I know. But is it the only kind of band, are there any others at the higher level of your rib cage?

How long does this process take?

Did you have problems to breathe correctly in these phases, mostly breathing out is too short and breathing in too long?

Just to say, I'm equipped with these symptoms 9 years now and have no cure for these symptoms, some things to relieve this:

- Vitamin D
- Selenmethionine
- Opiade
- partly magnesium (just a bit for a short time)
- Aciclovir (only for a short time)
- Gabapentin (recommended for MS-Hug, never tried it)

- Did you tried blood-letting?, it helps, but relapses very quickly.
- Sauna (only a short time)
- deep breathing (only a short time)

IMHO, I think MS-Hug + Allodynia relates to inflammation (and I think also to blood congestion) exactly because vitamin D and selenmethionine influence this process.

I've tried GcMAF (an immune supplement), and it sometimes destroyed these symptoms most completely for a while, but is also unpredictable and worsening the situation in other directions.

Hi @Fogbound i have had this intermittently over the years at one point I was convinced it was down to my bra being too tight as it was in a band around my ribs but it turned out to be Costochondritis. I don’t have the symptom at the moment but it tends to just start again for no apparent reason.
Sarah
Sounds like Allodynia to me. The interesting part of it is that slight pressure worsens the situation more than hard pressure.
 

Pyrrhus

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Could well be something called Chondritis @Fogbound which is an inflammation of the cartilage.
Hi @Fogbound i have had this intermittently over the years at one point I was convinced it was down to my bra being too tight as it was in a band around my ribs but it turned out to be Costochondritis.
Same here. I suspect it's Costochondritis as well.
Costochondritis is quite common in ME apparently...