Hi, I’m a 26 year old female…had 3 pregnancies, one miscarriage…
I’ve had a sharp, stabbing pain behind/in the center of my right breast for a LONG TIME (like, maybe a couple to several years?). There’s no lump… It happens just about daily – sometimes several times a day. Sometimes the pain is very sharp & painful, other times it flares up just a bit… Possible it happens most after meals?
The pain just under my right ribcage is also sharp & stabbing, but sometimes also
feels like a burning pain – feels like it’s just under the skin. Had it for several years, too. Can’t feel anything abnormal there either. I asked the doctor about this once, and she just said it was probably a pinched nerve (I was very pregnant at the time), but it had happened before my pregnancy, and it’s going on now 6 months after my son’s birth.) Possible it happens most after meals?
The pain on the right side of my pelvic bone (okay, I don’t know a whole lot about my anatomy down
there – it’s the top right “corner”/edge of the bone, closest to the hip bone, if that makes any sense) is also a sharp, stabbing pain. This occurs the least frequently, but still often enough (and on the SAME SIDE) that it scares me to death!
Has anyone else ever had this happen before? What did you do? What happened? What was your diagnosis? Thanks so much!
A very frightened, Sarah
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Overview
Costochondritis (kos-toe-kon-DRY-tis) is an inflammation of the cartilage that connects a rib to the breastbone (sternum). Pain caused by costochondritis might mimic that of a heart attack or other heart conditions.
Costochondritis is sometimes known as chest wall pain syndrome, costosternal syndrome or costosternal chondrodynia. Sometimes, swelling accompanies the pain (Tietze syndrome).
What causes costochondritis is unclear. Treatment focuses on easing the pain while waiting for the condition to improve on its own, which can take several weeks or more.
Symptoms
The pain associated with costochondritis usually:
- Occurs on the left side of your breastbone
- Is sharp, aching or pressure-like
- Affects more than one rib
- Can radiate to arms and shoulders
- Worsens when taking a deep breath, coughing, sneezing or with any chest wall movement
When to see a doctor
For chest pain, seek emergency medical attention to rule out life-threatening causes such as a heart attack.
Causes
Costochondritis usually has no clear cause. However, costochondritis might be associated with trauma, illness or physical strain, such as severe coughing.
Risk factors
Costochondritis occurs most often in women older than 40.
Tietze syndrome usually occurs in teenagers and young adults, and with equal frequency in men and women.
May 11, 2022
- Ferri FF. Costochondritis. In: Ferri's Clinical Advisor 2022. Elsevier; 2022. //www.clinicalkey.com. Accessed Jan. 20, 2022.
- Phillips K, et al. Management of isolated musculoskeletal chest pain. //www.uptodate.com/contents/search. Accessed Jan. 20, 2022.
- Frontera WR, et al. Costosternal syndrome. In: Essentials of Physical Medicine and Rehabilitation. 4th ed. Elsevier; 2019. //www.clinicalkey.com. Accessed Jan. 24, 2022.
- Wise CM. Major causes of musculoskeletal chest pain in adults. //www.uptodate.com/contents/search. Accessed Jan. 20, 2022.
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1. What is chest wall pain?
2. Symptoms
3. Diagnosis
4. Treatment
5. Coping with chest wall pain
1. What is chest wall pain?
Chest wall pain may feel as though it’s coming from the breast, but really it comes from somewhere else. It’s also known as extra-mammary (meaning outside the breast) pain.
Chest wall pain can have a number of causes, including:
- pulling a muscle in your chest
- inflammation around the ribs, caused by conditions called costochondritis or Tietze's syndrome
- a medical condition such as angina or gallstones
Breast pain can have a number of other causes, but on its own is not usually a sign of breast cancer.
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2. Symptoms of chest wall pain
The pain can be on one side, in a specific area or around a wide area of the breast.
It may be burning or sharp, may spread down the arm and can be worse when you move.
This type of pain can also be felt if pressure is applied to the area on the chest wall.
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3. Diagnosing chest wall pain
See your GP if your breast pain is new and carries on.
Your GP will examine your breasts and take a history of the type of pain you have and how often it occurs. To check how long the pain lasts for, how severe the pain is or if the pain may be linked to your menstrual cycle, your GP may ask you to fill in a simple pain chart.
If your GP thinks you may have chest wall pain, they may ask you to lean forward during the examination. This is to help them assess if the pain is inside your breast or in the chest wall.
Your GP may refer you to a breast clinic where you’ll be seen by specialist doctors or nurses for a more detailed assessment.
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4. Treating chest wall pain
Treatment for chest wall pain will depend on what’s causing it.
If it’s found that your breast pain is caused by a pulled muscle in your chest, this is likely to improve over time and can be treated with pain relief.
Chest wall pain can also affect the area under the arm and towards the front of the chest, and this may be due to:
- costochondritis – inflammation of parts of the ribs (called costal cartilages)
- Tietze’s syndrome – inflammation of the costal cartilages and swelling
Your GP or specialist may be able to tell that the costal cartilages are painful if pressure is put on them. Sometimes this inflammation can feel similar to heart (cardiac) pain. You may feel tightness in the chest and a severe, sharp pain. The pain may also spread down the arm and can be worse when you move.
You may find it helpful to rest and avoid sudden movements that increase the pain. Pain relief such as paracetamol or a non-steroidal anti-inflammatory such as ibuprofen (as a cream, gel or tablet) may help.
Your specialist may suggest injecting the painful area with a local anaesthetic and steroid.
Smoking can make the inflammation worse, so you may find that your pain lessens if you cut down or stop altogether.
The NHS website has more information about costochondritis and Tietze’s syndrome.
Pain caused by other medical conditions, such as angina (tightness across the chest) or gallstones, may be felt in the breast. Your GP or specialist will advise you on the most appropriate treatment.
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5. Coping with chest wall pain
Any type of breast pain can be very distressing, and many women worry they may have breast cancer. However, in most cases pain in the breast isn’t a sign of breast cancer.
Having breast pain doesn’t increase your risk of breast cancer. However, it’s still important to be breast aware and go back to your GP if the pain increases or changes, or you notice any other changes in your breasts.
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