TO "JDIMASSIMO"-
I want to ask you what your opinion is on the following. You seem to be in the nutrition industry, as I am, and wanted to see what you think. I personally have had a severe pain for six months. It gets worse at night, and sort of subsides during the day. It is on my left side/back along the lowest rib and just below. I have been in and out of the doctor's and hospitals, taking tests and xrays, ct scan, cbc, adrenal tests, kidneys, lungs, etc. Every test is "normal". I have tried natural supplements, and have 20 years in the industry, loaded with knowledge, but I cannot figure out what I have. Do you have any ideas? This came on in the end of december last year, and may have been brought on by chronic coughing associated with a bad cold I had for 5 weeks back then. I feel like a guinea pig, and have been to more than one doctor, and osteopath.

Hi Angel, It is so hard when you have a mysterious ailment that doctors cannot diagnose. I have been through it myself on more than one occassion! I don't know if I can help you or not, so I will ask a few questions.

1. You say the pain worsens at night - is it because you are lying down or simply the hour of the day? What else changes at night for you (do you eat more protein at dinner? Do you stand a certain way to do dishes? Do you sit in a chair to watch TV? Or do you just stand and move around more at night compared to sitting in a chair all day?)

2. Does the pain subside with massage or just with rest. I mean, if you rub it, does it relieve the pain?

3. In general, is it a dull ache that covers a large area, a sharp stabbing pain, a bruised feeling, or a very specific place you can point to that makes you scream with pain when touched?

4. What specific labs have you had done? A renal panel? 24 hour urine collection? What were the xrays of (ribs, spine)? Did you have tests for digestive disorders?

5. Asside from the pain, do you have any difficulty sleeping?

6. Do you have pain when you breath?

My gut tells me that because this seems to have occurred since your chronic coughing that this may be a rib problem - sometimes fractured ribs do not show up on xrays and sometimes a slipped rib won't show up at all. Either can interfere with muscles and nerves. You could just have a misalignment or compression in your spine - that could cause a tremendous amount of pain. I know you saw a DO, but have you seen a chiropractor?

Also, sometimes unexplained pain can be caused by "trigger points." This would typically be classified as a point of pain that is small and quite distinct - you will feel a tremendous amount of pain with even the lightest touch applied to that point. Trigger point pain is referred pain, typically from a problem elsewhere in your body. There are several possible trigger points on the lower left side which can be associated with kidney or digestive disorders, sleep disorders, fibromyalgia, or spinal misalignment/compression.

Looking at medical reasons for side pain - could be kidney, urinary, digestive, and a number of other things... but assuming you have had those tests done, I would steer you towards a chiropractor as a next step. A good one will be able to tell you if A) there is a definate muscular or skeletal cause for your pain or B) there isn't enough evidence of a problem to cause your pain and steer you back to seek further medical testing.

I wish I could be more helpful... I will think about it some more too.