Thread by @BadgleyLaurence

COSTOCHONDRITIS is common (mostly women) in Hypermobility syndrome. Costo- means rib (bone). Chondro- means cartilage (connective tissue). Each rib is joined to the sternum by cartilage, which is a place where biomechanical stress is focused. Set up for stress begins in the spine

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The spine of most women with Hypermobility I have examined (thousands) has a functional scoliosis: curved when upright & straight when reclined & sitting. This is easily examined in the exam room, but of course better discerned when person is unclothed.

Reason for the functional scoliosis is that spine is, in great part, cartilage; each disk is a specialized ligament. In women with Hypermobility, the pelvic girdle, platform for the upright spine, is commonly unstable & tilted. Gravity evokes the functional scoliosis.

Functional scoliosis is a way for the body to attempt to maintain symmetry when upright & to provide equality of load from side to side & equal load on the paired muscles that support the upright body.

Sitting posture seems to prevent the functional scoliosis curve in hyper-mobile women with scoliosis because while sitting the Ischial prominences, seat bones, contact the seat equally & maintain stability of the pelvic girdle platform. These are my own theories & observations.

FUNCTIONAL SCOLIOSIS (discussed above) is partly etiologic for Costochondritis, Gastroparesis, Panic Attacks, & POTS. All these conditions are highly correlated in hypermobile persons. Let me explain my theory. But first one more clinical exam finding about functional scoliosis.

In persons with scoliosis a useful exam is to have person bend over like a Halloween cat & flex their spine. Next, examiner repeatedly raises up & squats down to view horizon of patient’s back. What is often seen is a bump (Adams Sign) on one side of spine where ribs are higher.

Adam Sign often occurs on side of thoracic spine where spine curve is concave or at level where the curve goes from concave to convex, which is often at bottom of the barrel of ribs, at T-12. The concept of a “barrel of ribs” (my term) is key to understanding Chostochondritis.

Thoracic spine, ribs, costochondral junctions, & sternum all form a configuration not unlike a wooden barrel, except that thorax has slats that run horizontal, not vertical like in a wooden barrel. When spine is beset with a functional scoliosis, this skews barrel configuration.

A twisted thoracic spine & skewed Thorax barrel places biomechanical stress on all the costochondral junctions. Cartilage (chondral) is flexible. Ribs (bone) are not flexible. In those with Costochondritis strain in the junctions elicits stress & local inflammation = pain.

Chostochondritis pain is often mistaken, by patients & doctors, for “heart attack”. Countless times I have seen ER work ups fail to show an heart attack. Yet moderate pressure on exact rib-chondral junction exactly replicates pain. Once observed, diagnostic confirmation is easy.

Costochondritis is easily diagnosed by a SPECT Scan, a nuclear medicine scan that shows white cells gathered at the exact junction. Treatment is readily accomplished by easy & safe injection of a small deposit of cortisone into the costochondral junction, just under the skin.

Costochondritis is effectively aborted by the corticosteroid injection, but the underlying bio-mechanical disorder, a functional scoliosis is not. That is information that has been discussed in other of my threadreaders.

Earlier, I noted relationships of functional scoliosis to Gastroparesis, Panic Attacks, and POTS. These are all dysautonomias, and in my next threadreader I will discuss those relationships. These theories & findings are my own original inventions.

Finally, functional scoliosis is highly associated with asymmetric shoulder girdles. This biomechanical disorder begets crossed muscle syndromes in the shoulders & cervical spine: etiologies of other dysautonomias known as Thoracic Outlet Syndrome & Migraine, other threadreaders.

Autonomic nervous system tissues closely tract osseous system. Sympathetic/Parasympathetic tracts run in & beside vertebral spine. Impingements of autonomic nerves arouse pain & dysfunctions, but not nerve cell death. Are you beginning to understand Super-Syndrome Fibromyalgia?

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