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Doctor Nash
Doctor Nash,
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Why does my chest hurt when I sneeze?

Customer Question

When I sneeze the middle of my chest hurts. I have to put my hand over my chest to help me as I sneeze.
Submitted: 9 years ago.
Category: Medical
Expert:  Doctor Nash replied 9 years ago.

Do you have the same or similar pain when cough or you take in a deep breath rapidly or forcefully expel a deep breath?

How long has this been going on?

Customer: replied 9 years ago.

No, I do not have similar pain when I cough or take in a deep breath rapidly or forcefully expel a deep breath. This has been going on months.
I have seasonal allergies that cause me to sneeze quiet often during the day. But I never had this chest pain in the past years. I don't smoke or drink alcohol.

Expert:  Doctor Nash replied 9 years ago.

Is there anything beside sneezing that brings on the pain?

Does pressing firmly directly on your sternum cause pain/discomfort? Does it ease the pain?

I'm searching focused and appropriate questions, but right now I'm at a loss.

From the beginning, I thought you could have costochondritis, but with the pain restricted to sneezing alone, well, ....

But, I won't give up easily. I'm supposed to be able to handle the tough problems.

Customer: replied 9 years ago.

Thank you so much . But, no, pressing on the sternum does not cause pain, but it does somewhat seem to ease the pain of the sneeze.

Expert:  Doctor Nash replied 9 years ago.

Okay, next step.

Locate the xiphoid process, a small piece of cartilage attached to the lower end of the sternum. Is it tender?

Customer: replied 9 years ago.

Oh, wow, yes it is tender.

Expert:  Doctor Nash replied 9 years ago.
Very good! Now we know what to do!

The condition is called xiphoidynia or xiphoidalgia. It is a self-limited problem, and most of the time there is no known cause. I suggest using an anti-inflammatory agent such as ibuprofen (generic, don't pay brand name), but if you have been doing that, then tell your doc what the problem is and that this old man has recommended your having someone inject the region with a mixture of a local anesthetic and a cortisone-like agent.

If you don't mind a story, within the last year, an eldrly gentleman posted a question here regarding his wife. She had been having constant pain in the lower chest and upper adbomen . After all sorts of expensive and time-consuming studies, mainly of the digestive system, she was no better off.

In frustration, he went to the web, site after site. Then he found JA, but his question sat and ended up in the tough question file. That's where I like to look. Indeed, she had what you have.

The problem is that young docs rely too much on technilogical magic, and your condition is sort of rare and generally overlooked. I go back to the 1950s when we didnt have much more than a history and physical examination. I was doing surgery, and our best imaging tool was the scalpel. One of the things we considered when a patient had upper abdominal pain but wasn't really at death's door, was xiphoidynia. What good would it do to cut open someone with that condition? The cure would be worse than the disease.

I don't do surgery any more, but at 75 years, I'm still teaching.

Please let me know how things work out . You might want to print this message thread and show it to your doctor.


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