Problem:
In the past month or so, I have been experiencing a strange pain in my back. It is only on one side of my spine and is located in what I believe to be the it the Thoracic region. More specifically the pain is located midway between my spinal column and the left edge of my back. It is right at the lower end of my rib cage.
The pain started off as a dull, chronic ache, very similar to muscle sorenes from exercise. Over the course of a month or so, the pain has progressed to become more and more intense. At times, the pain can be excrutiating…like that of a "stabbing" pain. The pain is made worse by bending at the waist, twisting at the waist, putting pressure on that side of my back, rapid movement, or deep, quick breathing.
History:
I am a 26 year old female. 5'8" 135lb, athletic normally but have gotten out of shape in the last 3-4 months. Previously an avid horseback rider since age 8 and trainer since age 15 years. Rider of english, jumping, and dressage. Diagnosed with mild scoliosis at age 13. Have suffered many serious falls from horseback. Multiple broken bones, a few concusions, ect. One injury resulted in fracture of L5 and S1 vertebrae and a herniation w rupture of the vertebral disc. Treated with 6 months of bed rest, then underwent extensive PT. Returned to horseback riding and resumed a very sucessful riding career. Back pain gradually decreased over time to almost what I'd consider normal levels. Now, XRAY reveals full fusion of L5-S1 joint, by natural causes. As a result of another tramatic fall from a horse, I broke one of my floating ribs. The injury was most likely either asymtomatic or the pain was generalized to be the result of bruising and normal pains associated with falling from a horse because the rib injury was not diagnosed until a later date. Diagnosis occured during an X-Ray that was unrelated, but radiologist pointed out abnormality and asked if I was aware of condition. I can not remember exact dates, but I assume the initial injury occured sometime between age 14 and 16. Diagnosis was approx age 18. I am 26 now. I remember the X-Ray of the rib was of a complete break of the most posterior floating rib. The main portion of the rib was shifted away from the base that attached to the vertebrae. The broken off portion was pointing downward at a much steeper angle than the corresponding rib on the other side of the body. There did not appear to be any bone spurs or fragments. I do not remember which side of the body the broken rib was located, but I do remember it was on the left side of the X-Ray file (but this may or may not correlate with body side, depending on how X-Ray was taken and then placed on viewing screen, correct?)
Recent changes in diet, lifestyle, and activites: (Just for background, ect)
In the last year, I moved to NYC and have not been able to ride horses at all. In the last 2 month, I took 2 riding lessons to resume my riding activities. One lesson was on Nov 15 and the second was on Nov 22. I have also recently resumed working out at the gym since mid December. In addition, I have been undergoing a colon cleanse smoothie program prescribed by an herbal health practitioner. I do not think this would have anything to do with pain, but feel its at least worth mentioning. Finally, I have been working at a desk job since Sept 2008, and find myself hunching over the deskwith poor posture. This has resulted in a general increase of overall back pain (mostly in the cervical region)…but not at all like the specific pain I have described above.
My question is this, could this pain be associated with broken rib injury in the past? Is it possible for an old injury like this to "flare up"? Can this rib move, migrate, or cause injury now? I have an appointment set up for next week, but my dr could not get my in immediatly and I am getting really worried as the pain increases! Also, is this best handled by going to a General Practitioner and having them refer me, or is there a more specific specialist I should directly go to? I have good insurance, but if I can save the co-pay and also time I have to take off work to go see each doctor, it would be very helpful. I am hoping that someone in the medical feild such as a doctor, surgeon, PT, PA, NP, nurse, ect, will take the time to read my long long query!
Thank you so much in advance!