recurring pain in lowest right rib with arm motion

[chalknpens]

Hi Susan,
I've had a pain in my lower right rib, definitely triggered by using my arms (sitting at a desk and writing, brushing my teeth, hanging laundry outside on overhead lines, and sometimes just swinging my arms while walking.)

I've had ribs x-rayed: nothing. I've gone to physical therapy twice a week for eight weeks (and have benefited in strength and posture) but no change in pain.

I can best relieve it by sitting in a recliner, feet up, and arms at my side. It takes about 15 minutes of rest, and then I can get up and continue whatever I was doing. But within ten or fifteen minutes the pain is so strong that I have to sit again. Needless to say, any chore is suffering from one step forward, two steps back! Sometimes I give up and just stay in the recliner for a nap. I retired this year, after 30 years of teaching... two years earlier than I'd planned. Pain and fatigue were the reasons.

I've begun to wonder whether this is something bone related rather than MS fatigue, etc. I have osteoporosis, spine and hips, and recently learned i have scoliosis (age-related? I'm 61.)And of course, relapsing remitting ms, undiagnosed until I was 57 (and now on a DMD). The pain became very noticeable shortly after I started the DMD, in 2007, and has never faded (no remission).

Your thoughts for my next steps? Thank you for being here.

[SusanD]

Thank you for sharing your information with me.

Have you ever had your cervical spine looked at recently by bone density test or MRI -not MS related? I ask because as I started to read your post, I thought about possible shoulder/neck issue. Then as you mentioned osteoporosis and scoliosis, I wonder if it may be the target area of concern.

With issues of bone and spine, and normal aging on top of that, we get a narrowing of the spinal cord. There are issues that may result in change of cervical spine position that could cause pain and change of function from the neck down.
I have seen upper body problems result from neck issues as a clinician and actually had problems after whiplash last year.

Think about your body position when you do things. The position of your head - (i.e. are you looking); is your arm(s) supported, at shoulder height or higher? Length of time you can do things....
Take note of all that you can to see if there are certain positions that aggravate it. Journal as much information as you can and see what information you gather.

I would like to know what some of the results are. Perhaps I would be able to help by giving you suggestions for posture and biomechanics to help you do the tasks you want and need to do.

[chalknpens]

Thank you, Susan. I did learn on my MRI this spring that I have a new lesion at C1, (it was a brain MRI but they could see that much of the spine) and I have lesions at several T's (if i remember right, most of them, 2 through 11, but they have been there since the first MRI five years ago)

I also have long term lesions at C4,5,6 (or two of those three). The longest I've walked is 2.5 miles (half of the 5 mile MS walk this spring,) and I pedal on our recumbent stationary bike for ten to fifteen minutes each day, (which reads out at about 2 to 2.5 miles, and I stop when I start feeling overheated.)

I'll see my MS neurologist this fall, and ask about the connection between lesions, bone scan, etc.

To answer your question about head position, I do generally walk looking down at the space ahead of my feet, and if I'm alone I use a cane to be steady. If, while walking, I try to look up at something high (a helicopter, a bird) my body immediately spins and tilts, and without my husband's hand, I would fall. Every time! So I no longer try to walk and look at things ... just walk and talk with him. Stop walking and hold onto him before turning or looking up to see something. He's a good guy

When I was still trying to work this winter (I'm a teacher) I used a walker in the corridors for balance in crowds. (My husband called it my cow-catcher, like the front of an old locomotive, to keep the kids from crashing into me !
I retired at the end of the year, finishing it on sick leave.

Thank you for your response. I'm currently doing follow up exercises recommended by the PT this past winter...because I lose balance and fall easily, I work sitting or lying down for most of this: with 2 pound hand weights, arm stretches, slow hip rock side to side, leg stretches and lifts (with 2 pound ankle weights) and the stretchy rope for shoulder pulls. In all it takes about a half hour, plus the bike time.

I should also tell you, I lost 50 pounds four years ago by changing my menu - now a vegetarian with very little dairy (Yogurt, some grilled cheese) and nothing fried, no additives, oil, etc. I eat "heart healthy" nuts, lots of vegetables, fruits, whole grain bread and oatmeal, take vitamin D, B, and calcium, and eat pasta with tomato sauce, and rice with nuts and craisins. I've kept the weight off for four years, and am a comfortable size ten now, instead of size eighteen. And I've kept my Dove dark chocolateOh, and I cut my long hair short, as it was hard to keep my arms raised to wash and dry it. It was thinning anyway.

Be well, and thanks again.

[SusanD]

Wow, you are amazing! Your exercise and diet plan is terrific.
Congratulations on your achievements!
Continue with the exercises you are doing and see if there are any triggers.


I hope things go well for you and please have a Dove chocolate for me! Yum