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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does Severe Pain Under The Breast Bone Indicate?

i have severe pain everyday under breast bone on the right side to my back and it bothers me to sit long and when i eat it feels the food is entering to the area its just uncomfortable i had a scat scan done and was told nothing was seen pain pills no help was told not to lift anything over 5lbs.it stiffens me and hard to turnover when lying down have to sleep with a pillow under my right side
posted on Fri, 23 Mar 2018
Twitter Fri, 1 Jun 2018 Answered on
Twitter Tue, 5 Jun 2018 Last reviewed on
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Ayurveda Specialist,  's  Response
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

1. Since the symptoms are present and the CT scan report of the affected region is not indicating any abnormality, I recommend the following symptom wise approach:
i. In absence of injury, pain could be a pleural pathology [ask for chest X-ray to exclude pleuritis].
ii. As the pain is on the right side, in addition to X-ray, ask for ultrasonography of HBR [hepatobiliary region] for amoebic liver abscess and cholecystitis.
iii. Consult a chest specialist, who will go for systemic examination and if any chest signs are present, he will ask for imaging scans of the chest with Hb%, WBC, ESR and then provide proper management [as they can ask more detailed questions on associated symptoms].

Since symptoms are still persisting and as chest pain is related to the chest wall, the following should be the symptom wise approach:
i. Think of fracture rib, new or old.
ii. Think of costochondritis, very common anteriorly.
iii. Think of muscle sprain.

If by adopting
- hot water fomentation
- rest with minimal movements
- chest strapping
- intercostal nerve block
- taking an analgesic, anti-inflammatory enzymes, and muscle relaxant, the pain goes away, continue with the same, however, if the pain is not relieved ask for Hb%, WBC, ESR and X-ray chest

PS. Although most of the times, pain may be the result of minor injury or postural changes, however sometimes there may be an underlying medical condition/situation which needs appropriate treatment.

Hope I have answered your query. Let me know if I can assist you further.
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What Does Severe Pain Under The Breast Bone Indicate?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. 1. Since the symptoms are present and the CT scan report of the affected region is not indicating any abnormality, I recommend the following symptom wise approach: i. In absence of injury, pain could be a pleural pathology [ask for chest X-ray to exclude pleuritis]. ii. As the pain is on the right side, in addition to X-ray, ask for ultrasonography of HBR [hepatobiliary region] for amoebic liver abscess and cholecystitis. iii. Consult a chest specialist, who will go for systemic examination and if any chest signs are present, he will ask for imaging scans of the chest with Hb%, WBC, ESR and then provide proper management [as they can ask more detailed questions on associated symptoms]. Since symptoms are still persisting and as chest pain is related to the chest wall, the following should be the symptom wise approach: i. Think of fracture rib, new or old. ii. Think of costochondritis, very common anteriorly. iii. Think of muscle sprain. If by adopting - hot water fomentation - rest with minimal movements - chest strapping - intercostal nerve block - taking an analgesic, anti-inflammatory enzymes, and muscle relaxant, the pain goes away, continue with the same, however, if the pain is not relieved ask for Hb%, WBC, ESR and X-ray chest PS. Although most of the times, pain may be the result of minor injury or postural changes, however sometimes there may be an underlying medical condition/situation which needs appropriate treatment. Hope I have answered your query. Let me know if I can assist you further.