Treatment of a female collegiate rower with costochondritis: a case report

External application of two unrestricted herbal medicines to treat costochondritis in a young collegiate athlete: A case report

Costochondritis (ChC), especially chronic ChC, typically manifests as spontaneous vague pain in anterior chest area and often occurs in adolescents for unknown reasons; it has prevented many collegiate athletes from participating in physical training and competitions. A 21-year-old female collegiate taekwondo athlete suffering from chronic chest pain was sent by her coaches for diagnosis and treatment. Seated motion palpation was used to identify spontaneous and motion-involved pain areas. Palpation in the supine position was used to initially rule out breast diseases. X-ray, electrocardiogram, and cardiac Doppler ultrasound were used in conjunction with myocardial enzyme testing to rule out lung and cardiovascular diseases. The patient was treated using herbal medicines applied via an external patch. The medicine was comprised of Rhizoma Corydalis and borneol, and the treatment lasted for seven weeks. For five weeks patches were applied at a frequency of two or three times per day, followed by a two-week period of once per day. The patient reported that the pain was relieved after two weeks of external herb use, and the autonomic chest pain had resolved. Re-examination after one month showed that her upper limb range of motion was close to normal, and her psychological burden had almost disappeared. It is possible to seek more active medicinal treatment and more practical external products for young athletes who is suffering chronic ChC that affects the sport training and competitive performances.

IMPAIRMENT BASED EXAMINATION AND TREATMENT OF COSTOCHONDRITIS: A CASE SERIES

BACKGROUND

Costochondritis is commonly encountered in primary care, but is not routinely referred to PT. Costochondritis can last from several weeks to several months, limiting the patient's ability to perform tasks at work and home.

PURPOSE

Identify common impairments and examine the effects of treatment in subjects with costochondritis.

STUDY DESIGN

Retrospective case series.

CASE DESCRIPTION

Eight subjects were referred to physical therapy for costochondritis (mean duration of condition 6.3 ± 1.3 months) and reported that their condition restricted their ability to participate in occupational and fitness activities. The numerical pain rating scale (NPRS) and patient-specific functional scale (PSFS) were administered at the initial evaluation and at discharge. The Global Rating of Change (GROC) scale was only administered at discharge. All subjects received treatment directed at the cervicothoracic spine and ribcage and consisting of manual therapy and exercise.

OUTCOMES

Subjects were seen 4.8 ± 0.9 (mean±standard deviation) times. All subjects showed clinically meaningful changes at discharge. The mean NPRS decreased by 5.1 ± 1.7 points; the mean PSFS increased by 5.3 ± 1.4 points; and the mean GROC was 5.9 ± 1.1 points. All subjects were able to return to participation in previous activities without restrictions at discharge.

DISCUSSION - CONCLUSION

The results of this case series suggests that PT utilizing an impairment based examination and treatment approach including manual therapy and therapeutic exercise may facilitate the resolution of costochondritis.

LEVEL OF EVIDENCE

Level IV.

Thoracic region self-mobilization: a clinical suggestion

Limitations in thoracic spine motion may be due to restrictions in contractile or non-contractile tissues. Joint mobilizations are indicated when hypomobility of a joint (non-contractile tissue) is identified. The ability for a patient to perform self-mobilizations of the thoracic spine and ribs may help maximize intervention outcomes. The purpose of this article is to describe a low cost, portable device which can be used for thoracic spine self-mobilization techniques.