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I've been working out a lot more lately, I woke with slight…

I've been working out...

I've been working out a lot more lately, I woke with slight pain on lower left side, when I sneeze it becomes very intense pain e

Doctor's Assistant: How long have you had the pain? What seems to make the pain better or worse?

Only noticed this morning. I don't feel any bulge

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I first noticed in bed sneezing, can you pull a muscle laying awkward?

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Answered in 5 minutes by:
2/17/2018
Dr. Arun Phophalia
Category: Medical
Satisfied Customers: 38,452
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
Verified

Welcome to Just Answer.
Answers here are for education and information.
I will respond shortly with an answer, or further information request.

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What is your age?

Do you have pain in lower abdomen / groin?

Do you have increased urinary frequency, urinary burning, heartburn, diarrhea/constipation, nausea, vomiting, fever, loss of appetite, bloating, gas, tenderness on abdomen?

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Customer reply replied 4 months ago
I'm 42. no pain in the groin. I haven't noticed any increase in urine. My stool is not soft, seems to be normal. I've gone twice today no pain. No vomiting or appetite loss
Customer reply replied 4 months ago
The pain is right on my lower rib

Thanks for the additional information. I am writing the answer for you and will get back to you in 4-5 minutes. If you get a phone call request, you may ignore it as that is an automated site trigger. Thank you.

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Am intense pain on sneezing is indicative of abdominal muscle strain. This is not likely due to abdominal viscera and abdominal wall can be responsible for this pain. ACNES (abdominal cutaneous nerve entrapment syndrome) can be a possibility and the diagnosis can be confirmed by the subcutaneous infiltration of the local anesthetic like xylocaine. If the pain disappears completely, this substantiates the diagnosis. Abdominal wall pain can occur from nerve entrapment syndrome, irritation of intercostal nerve roots, anterior cutaneous nerve entrapment, rib-tip syndrome, myofascial pain and trigger points. You should consider these abdominal wall problems for your pain (especially in the absence of the visceral symptoms).

Following would help you;

Warm compresses.

Abdominal brace / binder.

Motrin / Advil / Tylenol.

Local analgesic cream.

Avoid exertion, lifting weight etc.

A soft tissue ultrasound can diagnose the muscle strain.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

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The other possibilities of the diagnosis are;

1) Myofascial trigger point

2) Costochondritis. Please read about it

https://www.medicinenet.com/costochondritis_and_tietze_syndrome/article.htm

Myofascial trigger point may develop after an initial injury to muscle fibers. This injury may be a noticeable traumatic event or repetitive microtrauma to the muscles. The trigger point causes pain and stress in the muscle or muscle fiber. As the stress increases, the muscles become fatigued and more susceptible to activation of additional trigger points. When predisposing factors combine with a triggering stress event, activation of a trigger point occurs. Myofascial trigger point is a hyperirritable spot, usually within a taut band of skeletal muscle or in the muscle fascia which is painful on compression. The treatment is following;

1) passive stretching of the affected muscle after application of sprayed vapocoolant

2) physical therapy

3) deep electrotherapy; iontophoresis, phonophoresis, short wave diathermy, electrical stimulation

4) local analgesic patch / ointment / spray

5) anti-inflammatory analgesics; Ibuprofen (Motrin / Advil)

6) ischemic compression therapy; pressure on the points

7) massage

8) steroid shots.

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Dr. Arun Phophalia
Category: Medical
Satisfied Customers: 38,452
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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