Definition Introduction
The Tietze syndrome describes a change in the rib cartilage at the base of the sternum. It presents with pain and swelling of varying intensity and appearance. More detailed knowledge about the development of chondropathy (cartilage damage) in the course of Tietze syndrome has not yet been found.
Symptoms
The symptoms that patients describe in the course of the Tietze syndrome have very different characteristics. The main symptom of Tietze syndrome is pain in the sternum. In some cases the pain radiates to the back, neck, shoulders or arms, and can be provoked and intensified by coughing, sneezing or deep breathing in and out.
These pains can sometimes cause an oppressive feeling in the chest, although it is not uncommon for initially frightening thoughts of heart problems to arise, which are ultimately the reason for going to the doctor. The pain is caused by an inflammatory process in the area of the sternum cartilage. In most cases, people complain of rib pain in and around the joint transitions from the ribs to the sternum.
This can be the case at rest. However, the pain often occurs during movement. The onset of the pain begins, for example, after a new or unfamiliar activity (somewhat heavy lifting).
After that, the problem persists for days to weeks or even longer and restricts the affected person in the exercise of their daily activities. Furthermore, in some cases the affected joints become overheated, reddened and swelling that is visible and palpable from the outside. Very often the ribs 1-3 are affected by the problem described above.
However, the symptoms can also be seen on the other ribs attached to the sternum (up to the 7th rib). Due to the sometimes high position of the first ribs, the pain may radiate to higher regions of the body. Some patients complain of pain in the neck region and a radiation of the pain into the shoulder and arms.
Accordingly, an adequate examination is indicated to exclude any other causes for the symptoms. Taking a relieving posture to avoid pain can result in pain in other areas, such as muscle cramps in the chest, shoulder and back. When breathing in and out, the movements of the thorax (chest) can cause pain.
During the breathing process there is a movement of the entire thorax with joints and muscles. The simple breathing movement comes from the diaphragm (diaphragm), which contracts due to its contraction and creates a negative pressure that expands the lungs – this process takes place during inhalation. On exhalation the diaphragm slackens again and the air is pressed out.
In addition to the diaphragm, other muscles are involved in the breathing process – e.g. the inner and outer intercostal muscles (Musculi intercostales interni and externi). These muscles have their origins and insertions at the ribs. Consequently, during a breathing movement, tension is exerted on the ribs, which can lead to pain in the presence of Tietze syndrome.
Pain often limits the ability to perform the breathing movement adequately – there is a risk that the patient will develop a feeling of breathlessness due to pain avoidance. It is essential to clarify this shortness of breath and to make sure that no heart or lung disease (pneumonia, metastases, COPD, edema etc.) or psychological reasons are responsible for it.
Furthermore, the shortness of breath must be treated symptomatically. If it is an acute event after a wrong movement (i.e. newly appeared Tietze syndrome), an improvement should be achieved with analgesic (pain-relieving) therapy or with orthopedic possibilities. In the case of prolonged respiratory distress, the same means can be used – however, more attention should be paid to other reasons and causes.
The Tietze Syndrome is actually defined as a painful disease in the area of the cartilaginous parts of the ribs, which are connected to the sternum. The occurrence of back pain can therefore be described rather less as a symptom of Tietze syndrome. Rather, back pain can occur as a secondary, i.e. subsequent complaints, when affected persons take relieving postures due to the severe pain in the sternum area.The relieving posture is usually equated with a bad posture, so that the symptoms of ailments tend to shift to the back and shoulder area.