How does poor posture contribute to rib and chest pain?

Question

Hello doctor,

I have persistent pressure in my ribs and chest, which makes it difficult to breathe and triggers panic attacks. This happens every day and does not stop interfering with my daily life. I also experience a lump in my throat at times. I have undergone tests for blood vessels, lungs, and heart, all of which came back normal. I also had an allergy prick test, which showed no allergies. At a private clinic, I was prescribed Fluticasone or Vilanterol and Salbutamol due to a weak spirometry test that suggested asthma. However, my family doctor referred me to a health centre for an additional spirometry test, which was normal. The first test may have been weak due to anxiety and a lack of clear instructions.

My doctor suggested that my symptoms might be psychological or anxiety-related and recommended Valerian drops while continuing Fluticasone or Vilanterol. However, after two months of use, I have not seen any improvement. My symptoms persist throughout the day, and I do not believe this is due to anxiety, as they never fully subside.

I have also visited an otolaryngologist, who found no issues with my ears, throat, or nose. My doctor refuses to refer me for further examinations. Who else can I visit for further evaluation, even privately? Is there anything I can purchase from a pharmacy without a prescription that may help alleviate these symptoms?

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

It sounds like you have undergone extensive testing, but you are still experiencing persistent symptoms. Since your heart, lungs, and allergy tests were clear, and your second spirometry test (a lung function test that measures how much air you can breathe in and out) was normal, the pressure in your ribs and difficulty breathing could be due to other underlying causes. Musculoskeletal issues (costochondritis (inflammation of the cartilage connecting the ribs to the breastbone, causing chest pain that worsens with movement or pressure), rib dysfunction, or muscle tension).

Costochondritis: This is inflammation of the cartilage that connects your ribs to your breastbone (sternum), which can cause chest pressure, tenderness, and discomfort.
Rib dysfunction: Misalignment or restricted movement of the ribs can lead to a sensation of chest tightness or difficulty breathing
Muscle tension: Poor posture, stress, or repetitive strain can cause tightness in the chest muscles, leading to discomfort and a restricted feeling in breathing.
Gastroesophageal reflux disease (GERD) or silent reflux (laryngopharyngeal reflux, LPR)

GERD: A condition in which stomach acid frequently flows back into the esophagus, causing symptoms such as chest tightness, a lump-in-throat (Globus sensation), and breathing difficulties.
Silent reflux (LPR): A form of reflux that does not cause typical heartburn but instead leads to throat irritation, postnasal drip, and chest discomfort.
Who to see: A gastroenterologist (digestive system specialist diagnosing and treating disorders) who may recommend a pH test (measures acid levels in the esophagus) or an endoscopy (a procedure using a small camera to examine the digestive tract).
Over-the-counter treatment options: Antacids such as Aluminum hydroxide and Magnesium carbonate, proton pump inhibitors or PPIs, and Omeprazole. It may help reduce symptoms if reflux is the cause.

5. Diaphragm dysfunction or breathing pattern disorders:

Hyperventilation syndrome: A condition in which rapid or shallow breathing leads to sensations of breathlessness, dizziness, or chest tightness.
Diaphragm dysfunction: Poor diaphragm movement due to stress, posture, or underlying conditions can make it difficult to take a deep breath.

Who to see: A respiratory physiotherapist who can assess your breathing mechanics and provide exercises to improve diaphragm function and breathing efficiency.

Immediate relief strategies:

Try gentle stretching, deep breathing exercises, and posture corrections to relieve musculoskeletal tension.
Apply a warm compress to the chest or upper back to relax tight muscles and reduce discomfort.
Use over-the-counter anti-inflammatory pain relievers such as Ibuprofen if an underlying muscle or cartilage issue is suspected. Kindly consult the doctor and take the medicines accordingly.
If your symptoms persist or worsen, seeking a specialist in the relevant field can help narrow down the exact cause and provide targeted treatment.

I hope this information will help you.

Thank you.