Read about the journey that ended my 20 years of suffering with Tietze's Syndrome »Common Causes of Tietze’s Syndrome
Filed under: Causes | 10 Comments »What Causes Tietze’s Syndrome?
The answer might surprise you; although researchers have yet to figure out exactly what causes Tietze’s Syndrome, they have some pretty good ideas, from as benign as coughing to as frightening as cancer. More than one of the following conditions in combination may cause Tietze’s Syndrome and it’s often hard or even impossible to pinpoint an exact cause.
Trauma, Recurrent Microtrauma, or Intercostal hematoma.
A fast, unexpected movement could cause a pool of blood—a bruise—to form in the costal cartilage. Bruises (hematomas) in the cartilage joining the ribs to the breast bone (the intercostal area) have been seen in baseball players, but it could be cause by something as simple as shaking a rug. Recurrent episodes of microtrauma to the chest wall; boxing, karate and other martial arts, severe vomiting and/or coughing, are examples of where the chest could experience continuous trauma, but it could be as simple as lifting heavy objects in an awkward fashion over time.
Fibromyalgia.
Fibromyalgia is a chronic, disabling disorder that occurs in about 2% of the population, and is seen more in women that in men. The causes of fibromyalgia is not known, but significantly higher levels of substance P (a neurotransmitter responsible for transmitting pain signals) have been found in the spinal fluid of patients with fibromyalgia. The inflamed costochondral margins that are commonly associated with Tietze’s Syndrome are the same as two of the pressure points associated with fibromyalgia; it’s therefore important that all of a patient’s symptoms are taken into account when making a diagnosis of Tietze’s syndrome.
Arthritis and related diseases.
Rarely, patients with psoriatic arthritis have reported Tietze’s Syndrome; psoriatic arthritis is a condition where arthritis is accompanied by red patches of inflamed skin. Other arthritis related diseases (i.e ankylosing spondylitis, reactive arthritis and Reiter’s disease) might also produce Tietze’s Syndrome.
Ulcerative colitis or Crohn’s disease.
Patients with inflammatory bowel disease such as ulcerative colitis and Crohn’s disease often report costochondritis and Tietze’s Syndrome.
Cancer
An Italian study led by R. Cocco found that several patients who were diagnosed with Tietze’s syndrome actually had tumors. The patients all had the classic signs of Tietze’s Syndrome—swelling of the costal cartilage, pain–and they were all treated with a standard treatment for the disease: anti-inflammatory drugs and an injection of cortisol. When symptoms didn’t improve, the patients sought answers: three of the cases were later found to have Hodgkin’s disease and one person had non-Hodgkin’s lymphoma. All four patients made a complete recovery after the cancer was diagnosed.
Heredity factors.
No one knows exactly what causes Tietze’s syndrome, but there could certainly be a hereditary factor. It could run in families—perhaps because of a genetic abnormality.
Radiation Therapy
If you have had radiation therapy to the chest or breast area, there is a chance you will experience Tietze’s Syndrome sometime down the road (it could be years after the therapy!).
Viruses
A virus caused my Tietze’s Syndrome; could it have caused yours? You can read more about my experience with the virus in this blog post.
Syphillis
Some studies have linked syphilis to outbreaks of Tietze’s Syndrome. You can find one of those reports here in the British Medical Journal.
Stress
There’s no definitive research to suggest that stress causes Tietze’s Syndrome, but it can worsen an underlying condition. For example, people with fibromyalgia should avoid stress, because it worsens the condition.
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References:
Cocco, R. et al. Lymphomas presenting as Tietze’s syndrome: a report of 4 clinical cases. Ann Ital Med Int. 1999 Apr-Jun;14(2):118-23.
Gill, G. Epidemic of Tietze’s Syndrome. Br Med J 1977;2:499 (20 August)
McCarty, D. & Koopman, W. Arthritis and allied conditions. NY, New York: Williams & Wilkins. 1993
Martino, G. et al. Tietze’s syndrome in the elderly: description of a case and review of the literature. Il Giornale di Chirurgia. 1994 Mar;15(3):119-23.
O’Neal, M. Complex strain injury involving an intercostal hematoma in a professional baseball player. Clin J Sport Med. 2008 Jul;18(4):372-3. Pappalardo et. al, Reflexions on the Tietze syndrome. Clinica Terapeutica. 1995 Nov;146(11):675-82.
Russell, J. et. al. Elevated cerebrospinal fluid levels of substance p in patients with the fibromyalgia syndrome. Arthritis and Rheumatism. Volume 37 Issue 11, Pages 1593 – 1601. Published Online: 9 Dec 2005
Shiel, W. Costochondritis & Tietze Syndrome. Article posted on website medicinenet.com. Retrieved June 10, 2009 from http://www.medicinenet.com/costochondritis_and_tietze_syndrome/article.htm
Starlanyl, D. Reactive Hypoglycemia (RHG): FMS&MPS Complex Perpetuating Factor. Article posted on website Fibromyalgia Information. Retrieved June 9, 2009 from http://fibromyalgia.ncf.ca/dshypogl.htm.
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about eighteen months ago i started having almost like electric shock type pains in my upper left chest almost as though i had been stung or ‘zapped’ , very frightening, these continued off and on for several months, on one occasion i was admitted overnight into hospital, i have family history of heart disease but have had all the heart tests over years, these are all ok, also have soreness in the area and tenderness, the pain ‘progressed’ to a deeper dull pain on occasions, which hurts if i try to take a deep breath, it seemed to ease up slightly for a few weeks in the summer, but came back again about 6 weeks ago and is an almost constant ‘feeling’ interspersed with severe sudden attacks , i was diagnosed with fibromyalgia several years ago but this pain has only started about 18 months ago, the doctors tell me ‘they don’t know what to do, it is a mystery’!! when the sever pain comes it stops me in my tracks, i recently sarted Tai Chi, thinking of it as a gentle excercise but am now wondering if all the arms movements are aggravating the condition, i am quite desperate here as to know what to do, it is affecting my life enormously, please can you help
Mary,
Have you got a firm diagnosis of Tietze’s? If you do, then yes–upper arm/chest exercise can exacerbate it. Myself, I stuck to walking and jogging with a very well-fit exercise bra. My rheumatologist told me that yoga can help with chronic pain…but tai chi? I’m not sure.
Good luck!
Stephanie
no i have not had a diagnosis, this is what i was wondering, could it be Tietzes, i had never heard of this before i came accross your site, the doctors say it is costacdondritis but i feel it is more than this and was hoping you could make a suggestion as to what i could do? thanks for your reply
mary. have had pain on the right side of my chest third rib down six weeks . there is a small bump near where the rib attaches to the sternum. Dr. says it is costochondritis. The pain radiates to my back and also down the back of my right arm. could it be teitze. had a cat scan today 12/2/09 will this tell if i have teitze and what should the Dr. be looking for. Please help i am a very active 60 year old man and feel like i am going backwards.
Ray: It sounds like Tietze’s: that bump is a hallmark sign. The CAT scan is probably to rule out something more serious, but some physicians use it to diagnose Tietze’s.
Best of luck,
Stephanie
Mary,
My first step would be to see a rheumatologist for a firm diagnosis.
There’s a lot of info here on the site: I hope you find it helpful.
Also, make sure you are following a good diet (I suggest one in my book).
Stephanie
[...] many causes of Tietze’s syndrome like genetics and viruses (you can read a full summary of known causes of Tietze’s syndrome here). But “stress”? It just doesn’t seem likely to me that stress can cause a joint [...]