costochondritis

Moderators: kwyss, Sillevis

costochondritis

Postby kwyss » Sun Oct 02, 2011 9:49 am

Patient works assembly performing most activities at chest/head level. She has recently been experiencing
pain in the costo sternal area bilateral. She can not stop working, what treatment options do I have.What other info needed?
: minimal kyphotic, hypertone R vs L in paraspinals, Decresed thoracic SB with contralat. pain. Chronic neck pain and HA's. (-) for intercostal pain.
kwyss
 
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Re: costochondritis

Postby cpendo » Mon Oct 03, 2011 8:47 am

I would try MFR to the TSA/CSA/ along with mobs to the TSA and costosternal area, rib spreading, pec stretching and release, scapular atabilization exercises focusing on extension and retraction with the least pec involvement, posture correction for while performing activities at home. I would also check and make sure if there was any other conditions that could mimic the pain in that area as well, such as heart, lungs, stomach, esophagus, etc. Anything that could radiate pain in that area.
cpendo
 
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Re: costochondritis

Postby Paula » Mon Oct 03, 2011 11:26 pm

How old is the patient? Costochondritis is a common dx of chest pain in young people up to mid 20's. Is the costosternal pain at all rib levels or 2nd and 3rd levels or 4th through 6th levels? Is there any hx of viral respiratory infection as this could cause costochondritis. If the patient is older than mid 20's...is there any heart disease hx and has heart disease been ruled out by an MD as costochondritis is chest pain. Also with patient's work activities at chest level is she obtaining appropriate posture to endure chest/head level activities that require increased rib/lung expansion. Does her work activities make it worst?
Paula
 
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Re: costochondritis

Postby kwyss » Thu Oct 06, 2011 8:11 am

Patient is in mid 40th otherwise in good health. Family history of arthritis only. No recent illness or infection.
Dysfunction: decreased thoracic extention T3-7 with most pain 3-7th costosternal connection.
Patients hight is an issue 5'4" working for that reason with arms elevated, no adaptations possible at the
work station based on safety regulations. Work definet a factor in pain.
kwyss
 
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Re: costochondritis

Postby Paula » Thu Oct 06, 2011 9:51 pm

If patient is experiencing same level of chest pain at the costo sternum joints at same area of decreased thoracic mobility, I would suggest thoracic mobilizations to improve extension. Additionally, I would assess the costovertebral joints as well. If she has increased tone on right paraspinals... I would expect SB to be limited to the left and would perform STM and MFR. Additionally, the rhomboid major origin is at the t2-t5 level and may exhibit some dysfunction as well. It would be ideal for patient to rest(avoid aggravating factors such as her job) however it sounds realistically that she is unable to and secondary to this may interfere with how quickly she progresses with the therapy.
Paula
 
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Re: costochondritis

Postby matt » Thu Oct 20, 2011 10:23 am

Would wrapping or taping be an option? Although it is typically no longer done for rib fractures, the compression of taping or wrapping with an ACE bandage might give some relief.
matt
 
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