Psychological Stress and Tietze’s Syndrome

Filed under: Causes, Tietze's Syndrome Facts | No Comments »

Can Stress Cause Inflamed Cartilage?

Yesterday, I had the first twinge of pain in my ribs that I’ve had in about a year. Immediately I laid down and meditated for about a half hour. I also took a couple of Tylenol. The pain went away later in the afternoon and I realized that the previous day I had been under a lot of stress. I began to wonder how much the stress had to do with my sudden attack of chest pain.

Breast Bone Pain Caused by Insurance Company?

The cause of my stress was an insurance company. To be more precise, I’d had a small grease fire in 2002. It’s funny how in some stressful situations, the brain seizes up; I couldn’t remember for the life of me how to put out a grease fire. So I called 911 and asked them. “Ma’am,” the operator said. “You should get out of the house and let the firefighters deal with it–grease fires can explode without warning.” Well, I exited the house and lucky for me I did, because the pan exploded after I stepped out of the kitchen. The resulting fire caused $8,000 worth of damage. The insurance company paid for the damage and that was the end of the story. Or so I thought.

Fast forward a few years. In the meantime, the insurance company sold the claim to a subrogation company who sued me for the $8,000 for “negligence,” which of course wasn’t true (I’d done all the right things, including calling 911). To cut a long story short, they sent all of the notices of the court hearings to an old address and received a default judgment against me for $14,000 (including lawyer’s fees and court costs) because I didn’t show up for court. Of course I didn’t show up: I never received a notice! I only found out about the judgment when I checked my credit report.

Perhaps you can imagine why I felt a little stressed–I am now on the hook for $14,000 only because a law firm sent notices to an old mailing address and didn’t give me the opportunity to appear in court.

“Psychological Stress is a Cause of Tietze’s Syndrome”?

Wikipedia stated that psychological stress is a cause of Tietze’s Syndrome:  “Preceding stressful events such as relationship problems, family issues or work related stress are very commonly associated with this syndrome.” I’m always skeptical of anything I read on Wikipedia–I think because it got drummed into me in grad school that I could not, under any circumstances, list Wikipedia as a resource for anything–not even in a paper debating the merits of Wikipedia. So I decided to do a little research to find out why that statement on Wikipedia might be true.

Now, I’ve got no doubt that stress can worsen Tietz’es Syndrome. But cause it? That’s like saying that stress can cause arthritis (because Tietze’s and arthritits are closely related). I am fully aware that I have to avoid stress, because tension in my chest is going to affect my costal joints and cause pain. But I’d hate to think there are people out there with Tietze’s syndrome who are living with debilitating pain because of a little stress fifteen years ago. As far as I am aware, there are 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 to swell. Or could it?

Tietze’s Syndrome: Searching for Answers

I looked for answers starting with a Google search for stress & Tietze’s syndrome. Of course, the top article was Wikipedia, followed by a lot of opinion sites like “Jim’s health site” and “Sue’s pain blog.” There was nothing to substantiate that Wikipedia statement from a verifiable source (i.e. something that referenced a medical journal or other good source). I went to PubMed next and performed a search there.

I found one article stating that chest pain can cause anxiety, but not the other way around. Another article said that chest pain can be caused by stress fractures, but not “stress”. Another article talked about chest-related musculoskeletal pain after heart surgery, referring to it as “mechanical stress” i.e. trauma to the chest wall. But not one article mentioned stress itself as a cause.

Tietze’s Syndrome: Wikipedia Corrected

My conclusion is that I have no idea where that statement in Wikipedia came from. It wasn’t referenced, and I could not find anything in PubMed to substantiate it (PubMed is perhaps the most comprehensive medical database there is) to indicate that stress is a cause of Tietze’s syndrome. So for those of you who are wondering if you somehow caused your Tietze’s syndrome by being too high strung or if you brought it on yourself by “stressing out” then relax: you didn’t.

I changed the Wikipedia article to read “Psychological stress can exacerbate Tietze’s Syndrome, but it is not a direct cause.” Of course, someone will probably jump in and change it back. We’ll see if that happens.

References

Gregory PL, Biswas AC, Batt ME. Musculoskeletal problems of the chest wall in athletes. Sports Med. 2002;32(4):235-50.

Jensen, S. Musculoskeletal causes of chest pain. Aust Fam Physician. 2001 Sep;30(9):834-9

Szántó D, Szücs G, Bíró BP, Priska M. [Degenerative chondroarthropathy of the sternocostal joint following heart surgery]

[Article in Hungarian] Orv Hetil. 1994 Nov 27;135(48):2639-42.

---

Featured on :

Find out more about my book »

---

Post a comment in the Tietze's Syndrome Forum »