1.5 years later

It has now been about 1 and 1/2 years after my initial experience with Costochondritis. At this point I consider myself fully healed. I still have occasional discomfort in my sternum area mostly at night when I arch my back or stretch in certain ways. But in general the Costo no longer affects my life like it did a year ago. In some ways I'm grateful for the experience because it taught me some things about the healthcare system and when to trust (or not trust) doctors and other healthcare providers, and how important it is to do some of your own research about health problems affecting you or people close to you.


What would I recommend to people experiencing Costochondritis?


(1) Be Patient - In my opinion, this is the most important part of the healing process. It can take a year or more to heal, so be prepared to deal with the pain and discomfort for a long time while still trying to enjoy life. Try to reduce the amount of stress in your life as much as possible, and do something like yoga or Tai chi which will provide some movement to the area (ribs and sternum) without further damaging it.


(2) Don't be afraid of the pain - During normal day to day life, I think we become accustomed to living in comfort and many of us have forgotten that pain is a natural response to various conditions in the body. Doctors tend to reinforce this belief that any amount of pain or discomfort needs to be eliminated, but I think this can be counter-productive. A certain amount of pain is normal to the healing process. The fact that you feel can still feel pain means your body and nerves are working correctly. Your body is changing and adapting all the time and even healthy kids feel "growing pains" which are completely normal.


(3) Enjoy the good things in life - When I had a significant amount of pain in the first few months, it was sometimes hard to keep a positive attitude. You can be glad that costochondritis is not a life threatening condition. If you need/want support from other people suffering in the same way there are a lot of resources on the web, including a costochondritis yahoo group.

Finally healing

I'm finally feeling like my Costochondritis is going away. Over the past year it has been a very, very gradual recovery, and I think that's where the main problem is. The various doctors I went to see all seemed to believe they had an immediate (~1 month) solution to the problem. I'm amazed that they must not have been taught in med school (or maybe they forgot) that cartilage takes a very long time to heal. A quick review of the wikipedia page for Cartilage and one can learn that cartilage does not have a blood supply and therefore takes a very long time to heal. It can take your body 6 months to 2 years to fully repair damaged cartilage, and this seems consistent with my experiences. Where muscle damage can be healed in a matter of days, the process for healing damaged cartilage should be measured in months. This means it can be difficult to tell that the damage is healing at all.


This whole experience has left me a bit disenchanted with mainstream Health care. It seems that many doctors and other healthcare providers don't spend the necessary amount of time to properly diagnose, understand, and care for less common injuries. I've read numerous other stories about Costochondritis and the related Tietze's syndrome and most doctors seem to have a hard time dealing with these problems.


I think when dealing with any type of inflammation it's also important to realize that inflammation is the body's natural healing response. If part of the body becomes damaged, the body automatically responds by sending blood and nutrients to the damaged area. However most healthcare providers automatically respond to any inflammation by trying to reduce or remove it. But for many conditions, the best choice is to just let the body do what it needs to. Primitive man for thousands of years didn't have easy access to ice when they were injured. Instead of the old adage "use (R)est, (I)ce, (C)ompression, (E)levation", how about just (R)est? I have a feeling that in many cases the I.C.E. parts are just to help our minds feel like we are actively doing something for the healing process. Anyway, that's just my two cents.

Rolfing Results

I decided to give Rolfing a try for my Costochondritis, and these are the results. The first session went very well. It was not more painful than any normal massage. I learned that Rolfing uses basically the same technique as Myofacial Release, but Rolfing systematically works the entire body in a specific order to produce more complete results. After the first session I felt pretty good and relaxed and made another appointment. It was hard to tell if there was any benefit to my chest though. The second session was less confortable, there were a few spots on my feet that were very painful and I came out of the session feeling a bit worse than going in. The third session, a few days later, was similar to the second and I didn't feel like I was really benefiting from this therapy. The therapist also said that there was some inflamation in different parts of my body and suggested that I "google 'inflamation'". I was a little annoyed by this because I had just spent the past 6 months using google to search for any information related to costochondritis and other problems related to inflamation. So I decided to stop the Rolfing sessions because I didn't feel like they were really helping.


Would I recommend Rolfing to other people suffering from Costochondritis or other similar problems? I don't really see much benefit to Rolfing over finding a decent massage therapist. But for me what works best is Yoga. It's like a massage where you can control the intensity and duration of each part and improves your fitness, flexibility, and coordination at the same time. After a session of yoga, I feel about as relaxed or maybe more relaxed than I do after massage. And with yoga, I don't feel the stress of losing money. But a massage is a nice for an occasional treat.

Rolfing and Skilled Relaxation

I came across Dr. Stoll's website while doing some Costochondritis information browsing. He seems very confident that Costo is caused by "bracing" which is basically accumulated tension over time caused by stress and other factors. The best way to relieve this bracing is with the practice of skilled relaxation. What is skilled relaxation? Basically anything that can get you into a very relaxed state for at least 20 minutes twice a day.

For more immediate relief of Costochondritis Dr. Stoll strongly recommends Rolfing. This is a series of deep tissue manipulations/massage that is supposed to re-align the body and relieve tension. Since reading the information on Dr. Stoll's website I've been trying to practice my own skilled relaxation, and I've been considering trying Rolfing. The drawbacks are that it's expensive, and it's supposed to be pretty painful according to several people I've talked to.

Update

After taking the Meloxicam for a little over a month, I decided that while it was helping some of the symptoms, the core problem didn't seem to be getting any better. So I decided to stop taking it and see how it goes. After the third day I think the medication completely wore off, and I was feeling a lot more pain and discomfort in my chest. But to my pleasant surprise the next day I felt a little better and the day after that a little better to the point where I basically felt the same as when I was on the medication. It was kind of like my body just had to adjust to find the right balance again after going off the medication.

I also decided to see a sport's medicine doctor to get some other ideas about what I should be doing. She believes that my Costochondritis is due to bad posture and poor ergonomics at work sitting at the computer all day. So tomorrow I start physical therapy to improve my posture and hopefully relieve some of the tension in my tight neck and shoulder muscles.

Back to the Doctor

So now I have taken my entire 30 day supply of the medication. I feel ok for normal daily activities but I still really can't do anything strenuous without some pain. Forturnately my job (software engineer) doesn't require anything strenuous, but it sucks not to be able to play tennis or do my normal activities with the kids.

Tomorrow I go back to the doctor to find out if she has other ideas and maybe do some x-rays or other tests. I want to make sure that what I have is Costochondritis or Tietze's and not something more serious with my heart.

Costochondritis 2

After doing a little more reading, I think I actually have Tietze syndrome and not costochondritis. The difference according to wikipedia and other sites seems to just be whether you have swelling, and I have some swelling that seems to be controlled by the Meloxicam that the doctor prescribed. Anyway, the difference doesn't matter too much because the treatment is the same: anti-imflammatory meds and rest.

I've been taking the meloxicam for a little over two weeks now. My doctor recommended I take it for 10 days, but felt I needed more so I checked and the doc said it was ok to keep taking it. There's no doubt it helps control the pain and swelling in my sternum area. I also seemed to be recovering until today. Our office had a boat party in the afternoon, so like an idiot I went there and jumped off the boat, swam in the lake, and pushed myself harder than I should have.

So now I'm back in pain and remember what my chest felt like a couple weeks ago. I'm a pretty active person, running, tennis, yoga, swimming with the kids, etc. And I'm finding it's difficult to resist the urge to push myself and do the stuff I like to do. Hopefully by writing this I will help to remind myself to be more careful. I keep reinjuring myself and as a result I'm not healing.

So my plan today is to really try to not do anything strenuous for at least one month. The first two weeks of which I will take the remaining medicine. I'm also going to keep a log so that I have a better idea of my improvement. Without a log it can be hard to remember how I felt 1 or 2 weeks ago, and then I get frustrated because I feel like I'm not getting any better.