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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Pain Below Sternum On Right Bottom Of Ribs. Lump On Right Back Rib. Hurts To Breathe. Took Morphine For Ehlers-danlos Syndrome. Is It Serious?

I have intense pain below my sternum to the right and towards the bottom of my right side ribs. Chiropractor felt a lump on right back 10th rib and felt it was broken 2 weeks ago but this sternum and side right pain has happened in the last 2 days. Hurts to breathe and pain under both armpits and tingling down both arms. I take morphine for Ehlers-Danlos syndrome but it's not touching this pain. I can't cope any longer (it has been 36 hours of it). Please help as I'm worried something is seriously wrong. Thank you
Mon, 29 Apr 2013
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General Surgeon 's  Response
Hello!

Thank you for the query.

Your pain can be caused by broken rib, however after 2 weeks, the pain should rather get less intense. Rib nerve irritation due to inflammation or spine disc herniation can cause such pain.
However, if the pain is in the lower right rib cage area, upper right abdomen, and radiates to the back, gallstones can be also a reason of such symptoms. You should also have nausea, however not necessarily. Acute pancreatitis should be also ruled out.
Gallstone problem is more probable as morphine causes smooth muscles spasm and in case of gallstones, it aggravates the pain. So that is why it does not help with it.
I suggest you have some tests. Abdominal ultrasound, blood work, liver tests (AST,ALT,GGTP,AP), amylase, urine amylase, bilirubin, urine analysis should be done. Rib X-ray and chest x-ray (to rule out pneumothorax) should be also done.
Temporal relief from the pain should give Metamizole, Buscolysine and hot bath. Avoid fatty foods, spicy foods, fried foods and alcohol intake.

Hope this will help.
Regards.
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Cardiologist Dr. Anantharamakrishnan's  Response
Hi friend,
Welcome to Health Care Magic

You need examination -
It could be irritation of the nerve root at spinal level - need to check neck and thoracic spine.
It could be diaphragmatic irritation...
CT chest may be necessary...
See thoracic surgeon...

Take care
Wishing speedy recovery
God bless
Good luck
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Pain Below Sternum On Right Bottom Of Ribs. Lump On Right Back Rib. Hurts To Breathe. Took Morphine For Ehlers-danlos Syndrome. Is It Serious?

Hello! Thank you for the query. Your pain can be caused by broken rib, however after 2 weeks, the pain should rather get less intense. Rib nerve irritation due to inflammation or spine disc herniation can cause such pain. However, if the pain is in the lower right rib cage area, upper right abdomen, and radiates to the back, gallstones can be also a reason of such symptoms. You should also have nausea, however not necessarily. Acute pancreatitis should be also ruled out. Gallstone problem is more probable as morphine causes smooth muscles spasm and in case of gallstones, it aggravates the pain. So that is why it does not help with it. I suggest you have some tests. Abdominal ultrasound, blood work, liver tests (AST,ALT,GGTP,AP), amylase, urine amylase, bilirubin, urine analysis should be done. Rib X-ray and chest x-ray (to rule out pneumothorax) should be also done. Temporal relief from the pain should give Metamizole, Buscolysine and hot bath. Avoid fatty foods, spicy foods, fried foods and alcohol intake. Hope this will help. Regards.