TherapyTreatmentWhat helps?
Due to the inflammatory process, many patients experience pain during movements, sports or sometimes even during breathing. The use of analgesics (painkillers) and anti-inflammatory drugs can reduce the pain and also the inflammatory process. Ibuprofen and diclofenac (Cox inhibitors) are the drugs of choice here.
However, these should not be taken in high doses over long periods of time, as they can lead to dangerous bleeding in the stomach. In acute pain, light muscle relaxants (drugs to relax the muscles) can also be used – this reduces the tone (tension) of the muscles and thus the pulling at the points affected by Tietze syndrome. Furthermore, for acute pain relief, the respective joint can be treated locally with an anesthetic.
This involves injecting a local anesthetic (medication for local anesthesia) into the affected rib cartilage. In the application of manual therapy/osteopathy, it is possible to relieve the pain by correcting malpositions of the ribs, vertebrae and sternum (breastbone) in relation to each other.The idea behind this is that blockages in the joints between the ribs and vertebrae cause an unnatural posture and movement of the upper body. Through targeted removal of these blockages using various techniques of Manual Therapy, the incorrect load is removed or reduced and the pain should become less or ideally disappear.
Since the incorrect posture has often been present for long periods of time, it often takes time for the inflammation to subside and for the body to adjust to the original posture. Strengthening the muscles in the course of physiotherapy or targeted training is helpful for long-term stabilization and prevention of further cases. As a rule, no special therapy is necessary for Tietze syndrome, as the disease and thus the pain disappears by itself.
In some cases, the doctor may prescribe anti-inflammatory painkillers to accompany the treatment and refer to various very simple exercises for use at home. To sit down consciously once for 5 minutes and concentrate on the breathing and the respiratory movement is a possibility to contribute to the improvement at home. Since the breathing movement can often trigger pain in the thorax/chest, conscious “counterbreathing” against the pain is beneficial to counteract the flatter gentle breathing that often occurs automatically.
A posture correction while sitting can also be consciously performed several times a day: Straighten the back, pull the vertex slightly towards the ceiling, move the chin slightly towards the chest, move the lower back slightly into the hollow back, bring the shoulder blades together so that the chest moves forward. Finally, a stretching exercise for the middle back and chest can also be performed: in a four-footed position, first move into the hollow back (with the head resting on the neck) and then make a cat’s back by moving the chin towards the chest. Alternate both positions several times in a row.
Surgery in the presence of Tietze syndrome is usually not a therapeutic component of the possible treatment approaches. The reason for this is, on the one hand, that it has been proven that the symptoms often recede on their own and patients would be “over-therapied” with surgery. Even the chronic form of the disease is not treated surgically, since in many cases there is no clear reason for it and thus no therapeutic point of attack for surgical treatment.
On the other hand, there are far more effective and less invasive treatment options (e.g. medication, physiotherapy and acupuncture), which usually do not require surgery. Finally, generally speaking, the lack of the need for an operation can be seen as a reason for the decision against surgery for Tietze syndrome, with too few symptoms and the lack of clarity of the origin. Only rarely is a visit to a physiotherapist recommended by the treating physician in the case of Tietze syndrome, which usually recurs on its own after some time.
Physiotherapy can only make sense in this clinical picture in the sense that it is used to counteract a relieving posture in the trunk caused by the pain. A relieving posture often leads to the trunk musculature becoming tense and does not allow free movement, so that additional pain can result from hardening of the muscles. We use loosening, relaxing massages of the back muscles, trigger point treatments, manual therapy, proprioceptive neuromuscular fascilization (PNF) and craniosacral therapy.
The above mentioned exercises for home use can also be taught by the physiotherapist. For the homeopathic treatment of Tietze Syndrome, various preparations for injection can be used. Mainly the two preparations Zeel® and Traumeel® are used. They are injected into the affected joint for several weeks. However, their main area of application is in the treatment of arthroses in joints.
