Dear Ask The Doctor: I have been experiencing pain on the inner left side of my left rib area, below the armpit, for 2 weeks now. It is painful to breathe, shortness of breath, wheezing at night, causing headaches, had pneumonia a month ago, no known trama to the rib area, and it's now radiating down my left arm. I am a 37yr old female and have smoked since I was 18. Could I have cracked a rib from coughing so hard and so much? Or could this be something more severe?
Dear Melissa: In the view that you recently had pneumonia, I suggest a reevaluation including X-rays for follow-up. Possibly you did an extreme movement, coughing repeatedly for example, that produced a muscle sprain in your back. A muscle strain is associated with the tearing or excessive stretching of the muscle and can be painful. All symptoms of muscle injury and muscle pain can range from mild to severe. Any muscle strain or muscle pull or even a muscle tear implies damage to a muscle or its attaching tendons. The time of healing varies from patient to patient and also depends on the severity of the injury. The conservative treatment consists of: initially, rest, ice can help the affected muscle and also maintaining the strained muscle in a stretched position. Heat can be applied when the swelling has lessened, anti-inflammatory medication (i.e.: “Aleve”), rest the strained muscle and avoid the activities that caused the strain and other activities that are painful. It is very important that you allow time to heal. The other condition that may produce the pain that you described is a Intercostal neuritis, which is not a serious condition but very annoying indeed and slow healing. By a spasm or a direct trauma the intercostals muscles and nerves got injured, and that’s why you are feeling that stabbing pain every time you take a deep breath, lean over, sneeze or cough. The suggested strategy would be: please, try to be patient and do not expect an overnight improvement, take anti inflammatory medication and also Vitamin B12 supplement. Local moist heat helps to ease the pain. An again, try to avoid activities that worsen the pain.