Question
For the last 2 months I have been getting a severe/uncomfortable pain just below my chest and on top of the rib cage right in the center. This only happens after i have lifted something of around 7kg or over. It lasts for about 6 hours and then subsides.Its affects my breathing slightly and even makes me feel a little sick but not that often. I have tried not lifting/ resting for three weeks and I don't get the pain. However as soon as I lift again after the pain returns and doesnt seem to want to heal.Please could you help.Could it be muscular ? It doesn`t feel like it.

Answer
Dear James,

Very interesting symptoms. This is not something typical that a chiropractor would address, but let me give you my thoughts, for what they are worth...

I am assuming that the pain is located about 7-8 inches above the belly button, at or about where the ribs end and the abdomen begins... dead center.

Since this is worse with lifting, I have come up with a couple of thoughts.

This could be a strain of the Diaphragm, which is the muscle just under the rib cage that, when it contracts, it inflates the lungs. I understand that it affects your breathing, and that it makes you feel a little bit sick...  The esophagus passes through the Diaphragm on its way to the stomach. At times the top of the stomach can herniate up through this opening. The additional stress of lifting could theoretically make this worse by applying more abdominal pressure.

If I were you, I would probably start at an MD, Gastroenterologist office and have the stomach and esophagus evaluated... and ask him if they symptoms could be related to a hiatal hernia, or rupture of the diaphragm.

Here is a link about hiatal hernias...   http://www.mayoclinic.com/health/hiatal-hernia/DS00099


Good luck James. I really hope that you are able to get to the bottom of this issue. Please understand that at best my information is an educated guess. There is no way that any advise that I can give would be of an value compared to the advise you could get after a good examination by a competent physician  :)

Keith Biggs, DC
http://www.eastmesachiropractor.com