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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Persistent Pain On Top Of Rib And Lower Back Causing Stiff Body?

62 year-old male, retired. I have psoriatic arthritis, diagnosed some 15? years ago. Take methotrexate, 6 per week. Controlled, basically. Maybe 8? years ago I had a shingles attack on chest and shoulders I remember. Truly hateful episode. I have for some years had a constant dull/mild pain which seems located on top of a single rib on my right, at side, one of the bottom ones. If I press anywhere the skin on top of the rib, and along it for several inches, it is sensitive. My rhumatologist links the pain to some light degeneration of a d6/d7 spine joint, seen on x-ray, but I am unconvinced. I cannot provoke any pain by spine movement. The pain in this rib has been very constant, until recently when it has been increasing in intensity. Sleep, which was not easy before, now starts to be difficult. I am now wondering if I have the symptoms of a postherpetic neuralgia (PHN) case. This increased rib pain is occurring simultaneously with some lower back pain, which makes me especially stiff in the mornings. I see myself becoming more and more immobile, and it frightens me. Can you help by giving me the title/description of the specialist in these matters, that I should see, please? What kind of test could prove it to be PHN?
posted on Sat, 3 Oct 2015
Twitter Tue, 7 Apr 2020 Answered on
Twitter Mon, 13 Apr 2020 Last reviewed on
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General Surgeon 's  Response
Hello,

As per my clinical experience, the post herpetic neuralgia does not provoke inability to move and more immobility, stiffness in the morning. The issue sounds to be more in concern with age related degenerative changes with exacerbation of symptoms from possible firbomyalgia or other auto immune issue affecting neuro-muscular junction or motor end plates. A sports physician is best person to evaluate the issue with thorough evaluation of range of movements of different joints and guide accordingly, which can be a need of MRI of the thorax.

Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Bhagyesh V. Patel, General Surgeon
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What Causes Persistent Pain On Top Of Rib And Lower Back Causing Stiff Body?

Hello, As per my clinical experience, the post herpetic neuralgia does not provoke inability to move and more immobility, stiffness in the morning. The issue sounds to be more in concern with age related degenerative changes with exacerbation of symptoms from possible firbomyalgia or other auto immune issue affecting neuro-muscular junction or motor end plates. A sports physician is best person to evaluate the issue with thorough evaluation of range of movements of different joints and guide accordingly, which can be a need of MRI of the thorax. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon