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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18427
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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pain upper left side of torso, below breast - in rib cage area.

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pain upper left side of torso, below breast - in rib cage area. Worse on physical exertion ie housework - rest helps but doesn't cure. Age 63. Have for years whilst doing anything - even just a little strenous. Can't stand it sometimes and find having friends for a meal a real task. Please help me. Makes me very cross at times as I dont's have musch energy with this and don't feel like exercising. just lying down.
Thank you XXXXX

Could you describe the pain? Sharp? Dull? Burning? Squeezing?

Is it tender in this area when it is bothering you?

Have you had any evaluation for this?


Customer: replied 6 years ago.

Pain - more like squeezing


Not tender


My doctor evaluates this as intercostal myalgia.


So sore to do anything physical like simple housework and bending.




Did the doctor prescribe the amitriptyline when the diagnosis of intercostal myalgia was made?


Customer: replied 6 years ago.

Yes. He said that painkillers didn't really help this condition as it is a nerve problem.


Please help with an answer soon. I am very tired and am going to bed.


I don't disagree with my doctor but the treatment doesn't really help. If I lean backwards I have temporary relief. By the way I have have a partial tear in my shoulder which I have for about 3 years + but this is on the other side. I had the pain long before the shoulder accident.



Thank you for the additional information.


There are several possible approaches to this problem. There are many possible causes of chest pain. It is important that anyone with chest pain that occurs with exertion should be evaluated to be certain that it is not due to heart disease. Since you have had an evaluation and intercostal myalgia diagnosed, it would be appropriate to treat that condition more aggressively. It is true that amitriptyline can help with a variety of chronic pain syndromes, including nerve irritation in the chest wall, although it may require a higher dose. It may help to try an over the counter anti-inflammatory medicine, such as ibuprofen or naproxen. Anti-inflammatory medicines can help ease pain, even if there is no inflammation present. It also may help to apply an over the counter cream of capsaicin, which has been found to help with nerve irritation pain, such as occurs with shingles, although it takes a few weeks for the medicine to build in the system There are several other prescription medicines that can also help calm the nerves in this condition. There are several antidepressant medicines, in addition to the amitriptyline, that can help. There are also several seizure medicines that may help, such as gabapentin or pregabalin. If the over the counter interventions are not helpful, then you can discuss the other options with your physician.


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