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Sent to February 15, 2007 3:50 p.m.
I started a cold on Monday 2/12/07 and it was going how my colds normally go, but then I came into work this morning, Thursday, 2/15/07, and one of my co workers made me laugh. I noticed an uncomfortable feeling around my sternum when I laughed....not a sharp pain or burning sensation like heartburn, but a tight, bruised, and sore feeling. It only seemed to hurt when laughing, even the slightest, but now throughout the day it's progressed to where I can feel pressure/pain even just sitting here. I can move for the most part without it hurting. The lower right side of my ribcage is sore if I stretch or twist too much, and on occassion the discomfort happens in my sternum if i move my arm up too high. I have not had any frequent coughing throughout having my cold, and am not coughing up any mucus--coughing hurts so I have been doing it very very lightly when needed. Please let me know if I should advise my physician or what it could be. Thank you!
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Answer
February 15, 2007 4:37 p.m. (46 minutes and 24 seconds later)
BBF84,

At this point there are three main possibilities:

1. You have injured a rib or its attachment to your sternum by the costochondral cartillage.

2. You have developed inflammation of the pleural lining of the chest, pleurisy.

3. You have an inflammation of of the costochondral cartillage, costochondritis.

If you have fractured a rib or detached it from the sternum, you can be helped by strapping your chest if either of these shows up on X-ray.

With the other two, there is no specific treatment.

If the situation does not interfere with the activities of daily living, and/or those at work, i suggest that you use generic Tylenol (don't pay the price for the brand name) as directed on the label and keep well hydrated. The more fluid you drink, the thinner will be your secretions and the less the force needed to cough them up. As an elderly pediatrician told me 40 years ago when I asked him to recommend a syrup for my son, "Water is the best expectorant."

Your decision about seeing a physician now has to depend upon your comfort level and the duration of the episode. The question is whether or not a hands-on evaluation will be outcome-effective and cost-effective, and I'm afraid I can't answer that one.

Let me know if you want to discuss this. I teach medicine, so I am not on line regularly. However, I do check this site several times a day, Please be patient. I will answer.

Dr. Nash


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