[vicstir]

Rib pain - is it from strained muscles or a bone lesion?

by vicstir on Sat Sep 12, 2015 9:55 pm

I know it has been asked previously, I have recently had a cold / flu / hayfever. As a result I have been coughing. The last few days I have had a weird pain in my left rib area. It doesn't hurt to touch, but hurts in certain positions and not all the time. Mostly if I try to lie on my back.

The worry is if it could be a lesion or if it would be just muscular pain from coughing. Any insights?

Thanks Vic

[mrozdav]

Re: Rib pain - is it from strained muscles or a bone lesion?

by mrozdav on Sun Sep 13, 2015 6:58 am

Vicstir, I experienced very severe coughing that started with an average head cold last October. Shortly thereafter, I developed a pain in my lower left rib with virtually the same symp­toms you describe. Many months later, after I stopped taking Revlimid, the cough essentially disappeared, but I continue to feel the occasional pain in my rib. My oncologist doubts that the pain is from a plasmacytoma, but we have discussed the possibility of a PET/CT scan. I will decide what to do after a pending consultation with my myeloma specialist.

[Tracy J]

Re: Rib pain - is it from strained muscles or a bone lesion?

by Tracy J on Sun Sep 13, 2015 3:38 pm

Vicstir,

I would think it could be either one, based on what you described. In my own experience it's very difficult to tell the difference. It's awful having to worry about each and every little ache and pain, isn't it?

[Eric Hofacket]

Re: Rib pain - is it from strained muscles or a bone lesion?

by Eric Hofacket on Mon Sep 14, 2015 9:42 am

I have had rib pains that come and go too in the years since I have had myeloma. The rib pain I had for months before I was first diagnosed with myeloma I had thought was from a fall on my mountain bike during the summer, it was myeloma. In later years my rib pains have appeared to be from coughing or other temporary events not related to myeloma. Like Tracy, a doctor herself said it can be very difficult to tell the difference and probably for your doctor too without some imaging done. The advice I would give is that when I get these pains I do not try to put additional stress on myself by trying to self-diagnosis them myself. I do not hold anything back form my oncologist based on my on assumptions on what the pain may or may not be and bring them all to his attention to let him sort out if they are myeloma related or not, that is part of his job. He needs to know everything. He is the specialist that went to 12 years of medical school and had treated myeloma for decades, not me. But when I get rib pain it can be hard not to dwell and be concerned about it.

Best wishes,

Eric

[NStewart]

Re: Rib pain - is it from strained muscles or a bone lesion?

by NStewart on Mon Sep 14, 2015 1:35 pm

I agree with Eric. Tell your oncologist about your new rib pain. If it is a new lesion that is symptomatic, or a fracture, s/he needs to know. A simple x-ray to start might show whether it is a fracture, or not. I had a new severe pain in my left lower leg a few years ago that only bothered me when exercising. An x-ray showed that I had a lesion in that spot and I was referred to a radiation oncologist for treatment with 6 doses of low dose radiation. The lesion was also a sign that I was relapsing.

I hope that it's just a strain, but if you are relapsing it is important to restart treatment soon.

Nancy in Phila

[Kevin J]

Re: Rib pain - is it from strained muscles or a bone lesion?

by Kevin J on Mon Sep 14, 2015 5:42 pm

I have had rib pain on-and-off (once or twice a year) for the past 4-5 years of treatment. It has occurred on both the left and right sides and has coincided with being on Revlimid. The pain is very similar to pleurisy, which I have had previously. The first time it happened, I went through several tests to try and determine a cause, but we were never able to nail it down. I've concluded (albeit with nothing to confirm it) that it probably is an inflammation of the pleura membrane, most likely due to a cold, infection, or something similar, and that the Revlimid amplifies the issue.

[Lev]

Re: Rib pain - is it from strained muscles or a bone lesion?

by Lev on Tue Sep 15, 2015 1:20 am

Hi Vic,

While my m component and all other numbers are still perfect now 9 months after ASCT, every time I feel back pain in my right hip, which was the only real/direct symptom I ever really had, I am thinking "myeloma is back".

This is, I guess a pretty normal reaction?

Now we get to the issue. Do we duck, hide our head in the sand and wait for it to pass. Just one more day, and another?

If you have pain that you can attribute the skeleton/bone and have active myeloma or did have it, you should talk to your myeloma specialist.

And the good thing is that in most cases it probably is just ordinary pain. You are just 39, so one question though; do you usually have this kind of pain?
And what are your numbers. Is your multiple myeloma active?

Yes, have it checked

[FingersCrossed]

Re: Rib pain - is it from strained muscles or a bone lesion?

by FingersCrossed on Tue Sep 15, 2015 12:43 pm

Definitely get some imaging done. That is the only way you will know. I had rib pain off and on from Oct 2014 to May of this year. The severity of the pain did not increase over time, but it was there.

Oddly enough, it started right as I was finishing a particular exercise DVD and it was only on the right side and would move around to different spots. I was doing the cooldown when it started. It would hurt mainly when I moved but also sometimes when I touched the spot. The pain went away after about 3 weeks and I did the workout again as a test. The pain came back. So I decided not to do that workout again.

However, the pain kept coming and going for months even though I never did that workout again. Every time it came back, I would get anxious and start to worry if this was a sign that I was progressing from smoldering multiple myeloma. When I started to feel it on both sides, that's when I really got worried.

My onco had me get an MRI of my ribs and there were no lesions. We think it is costochondritis which is inflammation of the cartilage that connects the ribs to the breastbone. And of course, as soon as I got the MRI done, the pain went way and has not returned since. I think that even if it had been a lesion and was missed by imaging, I would be in an awful lot of pain by now or at least would have fractured my ribs. Costochondritis often goes away on its own, so I think that is what has happened with me.

So get it checked out with imaging. At the very least, it will put your mind at ease if it's nothing serious.

[vicstir]

Re: Rib pain - is it from strained muscles or a bone lesion?

by vicstir on Sat Sep 19, 2015 7:40 pm

Thanks Everyone for your advise and insights.

The pain seems to be going away. So I have decided to give it another week. If pain still there I will go and get it checked out. I have set a reminder in my phone to discuss it with my Heamotologist when I see her in November.

Hope you are all well.

As usual this community is priceless.

Vic

[mrozdav]

Re: Rib pain - is it from strained muscles or a bone lesion?

by mrozdav on Sat Sep 19, 2015 8:58 pm

Vicstir,

Good that your pain has abated. I very recently discussed this issue with my specialist and she was quite confidant that if I had a plasmacytoma (which I guess is what has us worried), there would be indications of it in my blood tests and then a PET/CT would be ordered. Because my myeloma markers have been pretty stable for a number of months, she feels that imagery is not advisable since she has concerns about unnecessary radiation exposure.

My main concern was that my periodic serum analyses would not reveal a plasmacytoma even if I had one, but apparently there would be an unexplained rise in my IgA or urine protein, etc. and these would send up red flags. Comforting to have had this clarified.