Chronic rib and spine pain for 2+ years at my wits end, want support

Note: Below my main post I will attach a list of everything I have tried including how helpful (or not) it has been!

Hi everyone,

I’m in my 30s and have been dealing with chronic rib and spine pain for over two years. The rib pain is by far the worst part of it.

Early in this process, I saw a pain-management doctor who focused heavily on my thoracic MRI findings, including congenital spinal-canal narrowing, and diagnosed me with thoracic radiculopathy. He performed a thoracic epidural steroid injection, which did not help. I had a very poor experience with that doctor and felt like injections were essentially all he wanted to offer.

Later, I saw another physician whom I consider much more legitimate and thoughtful. I underwent a lumbar nerve block, but unfortunately that did not help either.

I also had a thoracic trigger-point injection by that doctor. That one seemed to help one small, localized area of my thoracic spine, but it did not touch the broader rib pain problem.

As I have seen more doctors, the original thoracic-radiculopathy explanation has become less convincing. The newer physicians I have seen generally do not seem to think the thoracic narrowing explains the whole picture. At the same time, my lumbar spine may be a more important structural issue than the thoracic findings, even though the ribs remain what bother me the most.

Over the last couple of years, different possibilities have been raised, including rib or thoracic dysfunction, myofascial pain, costochondritis, and possible central sensitization or nociplastic pain. I still do not have one clear diagnosis that convincingly explains everything.

I have tried a lot.

I have done physical therapy in the past several times and am currently in PT again (aquatic will be involved this time). My current program so far after 1 visit includes hip internal-rotation work, pelvic-clock exercises, thoracic rotation, and other mobility/motor-control work.

I have also seen multiple osteopathic physicians for Osteopathic Manipulation Therapy to fix my supposed Somatic Rib Dysfunction diagnosis. My first OMT doctor helped me a lot, which is one of the reasons I have continued pursuing that route. My current osteopath has been treating multiple thoracic segments and ribs, as well as the diaphragm, head/neck, and other areas. I am still trying to understand what findings are recurring and how OMT and PT should work together.

Other things I have tried include massage, chiropractic-style manipulation, the Activator method, Backpod, foam rolling, stretching, yoga, swimming, walking, reducing soccer and other aggravating activity, heating pads, Biofreeze, Salonpas, lidocaine patches, and a number of medications including vicodin, tramadol, baclofen, methocarbamol, tylenol etc.

Some things have helped, which is one of the reasons this is so frustrating.

An 8-week Mindfulness-Based Stress Reduction program clearly helped me. Backpod has clearly helped at times, although overdoing it can cause flares. My first Osteo's OMT helped a lot. Massage can sometimes give me a couple of better days. Salonpas has been pretty helpful, Biofreeze somewhat helpful, and yoga may have helped somewhat.

Medication-wise, tramadol helps to a point, Vicodin helps with breakthrough pain, baclofen helps, especially at the higher dose I use at night, and Tylenol can help when used in combination with the other medications. None of these has solved the underlying problem.

One of the best periods I have had occurred when I was doing MBSR, using the Backpod, and not playing soccer. I felt substantially better during that period. I cannot say exactly which part was responsible, but it gives me some hope because it shows that my pain is capable of changing.

At the same time, this has taken a very serious toll on me psychologically.

There have been periods when the pain and the uncertainty became so overwhelming that I ended up in the emergency room. At my lowest points, I have experienced suicidal ideation. I am receiving psychiatric care and addressing the mental-health side of this, but I think it is important to be honest about how badly chronic pain can wear a person down when it goes on for years.

There have been stretches where getting out of bed, eating normally, exercising, socializing, working, and just functioning like myself have all become much harder. I have had to take a leave of absence from work. Lately I am hurting every day again, and I am at the point where I am exhausted from constantly trying to manage this.

I also have a positive ANA at 1:320, with homogeneous and speckled patterns. My inflammatory markers and many of the more specific autoimmune tests have been negative, which I understand is somewhat reassuring, but because of the positive ANA and broader (very very occassional) body aches I am going to rheumatology soon. I am hoping that appointment will either uncover something important or at least help clarify whether an inflammatory or autoimmune condition is part of this.

The things I am now considering or starting include acupuncture, Pilates, aquatic physical therapy, TENS, and possibly a more formal pain-reprocessing approach. I have been reading about central sensitization and *The Way Out*, and some of those ideas show promise to me.

What I am really looking for from this community is support and perspective.

Has anyone dealt with severe chronic rib pain for years without one obvious explanation and eventually improved significantly?

Has anyone had a combination of rib pain, lumbar issues, thoracic findings, failed injections, PT, OMT, medications, and multiple competing theories before finally finding something that helped?

Did anyone have a positive ANA that turned out to matter, or turned out not to matter at all?

And most importantly, if chronic pain once brought you to a very dark place and you are now doing substantially better, I would really like to hear your story.

I am not looking for a miracle cure. I just need some hope that it is possible to be this worn down by pain and uncertainty and still eventually get to a much better place.

Thank you for reading.
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