The xiphoid process began to protrude. Diseases of the digestive tract. Differences between intercostal neuralgia and heart pain

The human body is a very complex and fragile system, all elements of which are in close interaction with each other. Therefore, having experienced pain in a certain part of the body, we often get lost, and cannot understand what they are caused by. Let's talk about what to do if the xiphoid process of the sternum hurts when pressed, what diseases it may indicate this symptom and when it is necessary to seek the help of a competent physician.

What is the xiphoid process?

The xiphoid process is the distal part of the sternum, which is initially cartilaginous, and gradually becomes ossified over time (as a rule, this happens before the age of 20). It is not connected to the ribs and fully grows to the sternum only when a person reaches the age of thirty. Moreover, the shape and dimensions of the considered process in different people are individual.

Why can he hurt

If a person notices that his xiphoid process of the sternum hurts when pressed, this can be a sign of a wide variety of diseases, damaging organs located in close proximity to the distal part of the sternum. These bodies are:

• heart;
• stomach;
• gallbladder.

And if the occurrence of uncomfortable sensations was due precisely to the disease of one of these organs, then they will appear not only with pressure, but also due to physical exertion on the body (even minor ones) and after eating. Consider this fact when you decide whether to go to the doctor with your problem.

In addition, the cause of pain in this part of the sternum is often the sliding costal cartilage syndrome. It usually occurs as a result of severe injuries- a person who has been injured first experiences severe pain in the sternum, but over time it disappears, and manifests itself exclusively with pressure (while the pain is dull). Moreover, often the patient, having got rid of severe pain, believes that the danger has already passed, and he no longer needs qualified treatment. But in fact, this is not the case - sliding costal cartilage syndrome can lead to inflammation of the xiphoid process. So, if you recently suffered a strong blow or other injury in which the sternum suffered, and now, when you press on the xiphoid process, you are experiencing pain, be sure to consult a surgeon.

It also happens that the occurrence of discomfort when pressing on the distal part of the sternum is a consequence of diseases of the gastrointestinal tract. intestinal tract. Thus, for example, a stomach ulcer or an ulcer of the lesser curvature of the stomach (in which inflammation spreads directly through fatty tissue and can reach the sternum region) can manifest itself. Therefore, pay attention not only directly to the pain, but also to the accompanying symptoms: vomiting or nausea, lack of appetite, heartburn, etc. If they are present, then the problem most likely lies precisely in the work of the digestive tract.

How to be treated

Prescribe treatment for a person who complains of such discomfort, not possible until installed exact reason their occurrence. Therefore, when you see a doctor, you must be prepared to undergo full examination: take tests, make an x-ray of the sternum, an electrocardiogram and fibrogastroscopy. And only after it is established what disease the patient suffers from, and why, when pressing on the xiphoid process, he feels pain in the sternum, the specialist will be able to prescribe treatment.

The top of the sternum is the upper part of the triangular shape, connecting with the clavicles and with the ribs. The body of the sternum in the middle part sternum, is a long, narrow, flat plate of spongy bone tissue that forms the center of the anterior chest. It has three parts: top, middle and bottom. The sides of the sternum are pointed where they meet the costal cartilages. These structures, together with the ribs, form chest protecting and supporting internal organs: heart, lungs and important vessels ... [Read below]

• Top part
• middle part
• Bottom part

[Beginning at the top] …

xiphoid process

This is the smallest and lowest region of the sternum. At birth, it is a thin, roughly triangular area of ​​cartilage that slowly ossifies and fuses with the body of the sternum. xiphoid process plays important role, acting as bony anatomical landmarks in the body and can be damaged by improperly performed artificial respiration.

The xiphoid process is located below the body of the sternum. It is attached by a mobile fibrous junction (syndemosis). From syndesmosis, it gradually narrows.
The xiphoid process exists as a construction consisting of hyaline cartilage at birth and during childhood, then slowly ossifies. In fact, xiphoid ossification is so slow that it often doesn't end until a person is in their 40s.

The xiphoid process acts as a vital important point mounts for multiple large muscles, as one of several beginnings for the diaphragm muscle, which forms the floor of the chest and performs vital important process breathing. The xiphoid process also acts as a ligament for the rectus abdominis and transverse abdominis muscles, which compress and flex the abdomen. During cardiopulmonary resuscitation(CPR), the xiphoid process can be used as a landmark to determine the location for exercise indirect massage hearts. It is extremely important that the pressure exerted on the xiphoid process of the sternum during chest compressions does not exceed the allowable limit, as this can separate the xiphoid process from the sternum, possibly puncturing the diaphragm or liver.

As an incidental finding, it may be found that the xiphoid process of the sternum hurts when pressed. Pain in this area of ​​the body requires careful study, because the processes that cause such a symptom can be a threat to health. To understand the essence possible pathologies it is necessary to get an idea about the structure of this part of the sternum.

What is the xiphoid process?

In the central part of the chest there is a small freely protruding downward process, characteristic shape which gave him the name - xiphoid. In children, the xiphoid process (MO) has a cartilaginous structure and is not connected to the sternum, with age its tissues harden, and after 30 years it gradually grows to the bones of the sternum. The shape of this bone formation may vary from person to person. Under MO is located solar plexus, which is a large knot of nerve clusters.

Possible causes of pain

Pain in the area of ​​the xiphoid process that occurs when pressed can have a number of reasons, these are:

• chest injury;
• chondropathy (Tietze's syndromes, "sliding ribs", etc.);
• pathological processes in the organs located in the projection of the MO;
• hernia MO;
• tumors;
• consequences of osteochondrosis;
• other rare pathologies.

A traumatic effect on the xiphoid process (for example, a strong blow) can cause or rupture the muscles, but even a simple bruise is often accompanied by intense pain, aggravated by breathing, coughing, or sudden movements. Most injuries go away without special treatment, but injury to this area has the property long time manifest itself as pain when pressing on the bone.

Injuries and injuries can contribute to the development of chondropathy, from which Tietze syndrome (TS) and sliding rib syndrome are distinguished.

TS often occurs without visible reasons, it manifests itself as local soreness at the junction of one or more upper ribs with the sternum. In this case, pain can be given to the xiphoid process, pressure on which is also painful. ST is aseptic inflammation cartilage tissue and requires conservative treatment.

Among the factors considered to be the causes of Tietze's syndrome are metabolic disorders, hypovitaminosis, lack of calcium in the body, diseases of the joints and muscles, excessive loads, infections, age-related changes.

Manifestation of sliding rib syndrome

Sliding rib syndrome (SRS) is a pathology in which pain is localized at the tips of the costal bones or in the area of ​​​​their connection with the sternum. In the second case, pain may increase with pressure on the MO. Pathology develops against the background of recurrent subluxation of the costal cartilage, which leads to increased mobility ribs (sliding), while the bone acts on the intercostal nerve, causing pain.

Problems in the abdomen

Organ pathologies abdominal cavity can cause pain in the MO area, often without a clear localization. Pressing on the xiphoid process increases the intensity of the pain. These diseases include:

• gastritis and stomach ulcer;
• pancreatitis;
• cholecystitis;
• esophageal pathology.

Recognize organ diseases gastrointestinal tract from musculoskeletal pathologies allows the presence additional features: heartburn, belching, nausea and vomiting, diarrhea (constipation). Ultrasound and blood tests help diagnose the disease.

Flatulence

Do not exclude such a problem as flatulence. Even healthy person consumption of foods that cause increased gas formation, creates excess pressure in the intestines, and since the upper part of the colon is adjacent to the region of the MO, pain and discomfort can occur in this part of the sternum.

Heart pathologies

The spread of pain in the region of the xiphoid process often accompanies heart pathologies. Angina is most often manifested by pain in the left and central parts chest, but pressure on the MO increases the pain (as well as jerky movements, physical or nervous tension). Taking a nitroglycerin tablet helps to differentiate angina pectoris, if the pain then disappears or decreases significantly, you should focus on accurately diagnosing a cardiac problem.

It must be remembered that in case of a heart attack, obstruction or rupture coronary artery Nitroglycerin does not relieve pain, in such cases urgent medical attention is required.

Inflammatory processes of the respiratory system

Soreness in the MO area can be caused by pathologies respiratory organs: pneumonia, bronchitis, tuberculosis, tumors. Distinguish pulmonary pathologies presence helps additional symptoms(cough, weakness, sweating, fever).

There is a violation in which the source of pain in the central part of the sternum is the xiphoid process itself - a hernia of the MO. Most often, developmental defects lead to this pathology, in which the MO splits, bends, and holes of various sizes form in it. Through the holes can protrude adipose tissue peritoneum causing pain. Sometimes these protrusions are visible or palpable through the skin. Similar pathological changes in clinical practice meet infrequently.

Thoracic osteochondrosis

Another violation painful in the MO area, - osteochondrosis thoracic of the spine and associated pathologies, primarily protrusions and hernias intervertebral discs. The gradual loss of elastic properties by the disc leads to the protrusion of its tissues into the area nerve fibers, compression of which is characterized by pain syndrome. The intensity and localization of pain depends on the location, size and direction of the hernial protrusion.

Other reasons

Other causes of pain in the central part of the chest include xifodynia (hypersensitivity of the xiphoid process), pathologies of regional vessels, benign tumors(lipomas, chondromas), oncological diseases, developmental anomalies (for example, aplasia of the xiphoid process).

Treatment

If you experience discomfort or pain in your chest, you should immediately consult a doctor. After the analysis of complaints and examination, diagnostic measures(ultrasound, MRI, X-ray, laboratory research blood), required list which are determined by the doctor.

Treatment of the diagnosed disease is prescribed and monitored by a specialist. In musculoskeletal pathologies, the standard course of therapy includes the use of non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, muscle relaxants, and chondroprotectors. Pain of high intensity can be relieved with anesthetic blockades. After the end of the first phase of treatment, physiotherapeutic procedures are recommended.

A group of diseases of the gastrointestinal tract is treated by a gastroenterologist. The course of therapy must be accompanied by a diet, which, with some chronic processes appointed for life.

The treatment of cardiovascular diseases involves the normalization blood pressure and receiving a series various medicines, the appointment of which depends on the condition of the person and the type of cardiac pathology, many drugs are taken for life.

Surgical intervention is indicated in the presence of a threat to life or with prolonged intense pain. For example, surgical treatment of sliding rib syndrome means removing the pathological portion of the costal bone. The critical size of a herniated disc also serves as a reason for surgery.

Prevention

Preventive measures are both general and specific. Regular physical exercise, healthy eating, compliance with the sleep regimen, the exclusion of mental overstrain and bad habits refer to general rules to avoid disease.

Specific prevention is to follow the instructions of the attending physician. This is a diet, taking supportive drugs, exclusion of intense exercise, physiotherapy. congenital anomalies require periodic monitoring with examinations.

Conclusion

Soreness in the region of the xiphoid process may indicate a variety of various diseases. The only true strategy in the event of such pain is to contact a medical institution.

Attempts self diagnosis and treatment are fraught with misdiagnosis with subsequent damage to health.

The xiphoid process is part of the skeleton of the sternum. This is the smallest and shortest part of it. It can be different in shape and size, with a hole in the center and a forked top. The apex may be blunt or sharp, facing anteriorly or posteriorly.

This element forms a dense bone tissue with the body of the sternum, which is connected with the help of cartilaginous tissue. However, with age, the xiphoid process ossifies and fuses with the body of the sternum.

Where is the xiphoid process located? The sternum consists of three parts:

• lever;
• body;
• xiphoid process.

These three parts are interconnected. If you run your hand from where the neck ends (in the front central part of it) and follow straight down to the stomach, then this is the body of the sternum. Its lowest part is the xiphoid process. It is tightly connected to the body, and hyaline cartilage is located at the point of contact with the bone.

Functions of the sternum

The sternum performs the following important functions:

• protects internal organs from mechanical damage;
• participates in the process of hematopoiesis, since it contains bone marrow;
• this function is used in the treatment of blood cancer when a puncture is required, since it is in the most convenient location for this procedure.

The xiphoid process of the sternum hurts when pressed

Pain in this area of ​​the chest, especially when pressed, may indicate different pathologies organs of both the thoracic part of the body and adjacent to the sternum.

These bodies are:

• heart;
• lungs;
• stomach;
• pancreas;
• gallbladder.

Of course, when serious illnesses pains are observed not only with pressure, but also with movements, as well as at rest and after eating.

In addition, the cause of pain is often an injury to this anatomical region. For example, due to serious injury characteristic slippery costal cartilage is formed. Its appearance causes very strong pain in the chest, but through certain period it will disappear and will only appear dull pain when pressing on the xiphoid process. When severe pain disappears, it may seem that the disease has passed. However, this is a dangerous delusion. If you do not promptly seek qualified medical care, then inflammation of the xiphoid process may appear.

Some injuries can tear the muscles in the front of the abdominal region, and also provoke the development of tumors.

Also, the cause of pain can be damage to the organs of the gastrointestinal tract. For example, with a stomach ulcer inflammatory processes may radiate to the chest. In this case, the patient himself does not understand where the source of pain is. And only by the symptoms you can determine the cause of pain:

• lack of appetite;
• vomiting and nausea;
• heartburn.

Pathologies and injuries

The main damage to this anatomical region can be:

• hernia;
• trauma;
• xiphoidalgia;
• tumors.

Hernia

Hernia symptoms:

• severe chest pain;
• atypical bulging in the region of the process of the sternum;
• the hernial sac is easily palpable;
• sometimes a hernia needs to be reduced;
• when repositioning, you can feel the edges of the hernia gate.

For accurate diagnosis must pass instrumental research: x-ray, computed tomography (CT) and magnetic - resonance imaging(MRI). As a rule, in the treatment of a hernia, only surgical treatment is used. But before the operation, it is necessary to carry out differential diagnosis since these symptoms are characteristic of a number of other diseases. Surgery to remove a hernia is not too complicated. The gate of the opening of the appendix is ​​sutured, and the hernial sac is processed. Then an incision of about 10 cm is made in order to detach the process from the sternum.

Injuries

Sternum injuries are quite common. They appear as a result of road traffic accidents, falls from high altitude, strong blows. Traumatic lesion sternum is called "motorist injury". Fractures and bruises of the sternum are rarely independent, more often they are accompanied by fractures of the ribs, spine or limbs. In some cases, fractures can form bone fragments that can damage internal organs. At the site of injury, there is a slight swelling of the soft tissues and pain. When the debris is displaced, the treatment is surgical. In this case, it is necessary to compare bone fragments for their better fusion.

Xyphoidalgia

This is inflammation of the xiphoid process, or, as it is also called, xiphoid process syndrome. At this disease organs that communicate and have a common innervation with the process are affected:

• diaphragm;
• stomach (with an ulcer);
• inflammation lymph nodes(lymphadenitis).

In such cases, it is not the process that hurts in patients, but the zone located behind it. There may also be an attack of nausea and a feeling of constriction in the throat. These symptoms and discomfort can be exacerbated rich food or intense movement. The pain is aching in nature, variable intensifying and weakening.

With xifoidalgia, there is a violation of posture. It can be pronounced or slightly noticeable. Pain in xiphoidalgia must be differentiated from other pathologies:

• heart pains;
• pain in the digestive system;
• pathologies of the pulmonary system.

This ailment may have the most common symptoms. Treatment is started only when the diagnosis is established accurately.

For accurate diagnosis, the following studies are carried out:

• radiography;
• ECG (electrocardiogram);
• FGS (fibrogastroscopy) of the stomach;
• magnetic resonance imaging (MRI).

Treatment of the disease consists in the correct position of the spine (straighten the shoulder blades). When pain occurs, ice wrapped in a soft cloth is applied to the process.

When xifoidalgia is strictly prohibited:

• traction of the spine;
• physiotherapy;
• straightening the spine on your own with the help of gymnastic exercises.

Why can't you do the above? Because they can provoke strong pain syndrome. In addition, pain in this disease is difficult to remove with the help of analgesics (analgin, novocaine, ketorol). Such diseases can only be cured by a qualified chiropractor.

Tumors

Diagnosis of tumor processes at the first stage is difficult, since symptoms are not always clearly expressed. characteristic feature are pain that is transient. And only with time the pain intensifies and manifests itself more intensely at night. An elastic compaction appears below the sternum, which is well palpated. Gradually it increases and grows. The tumor quickly grows into neighboring tissues and metastasizes.

The human spinal column has two lordosis and kyphosis each. This is the normal position of the spine. But it happens that physiological curves have too much or, conversely, insufficient curvature - in this case they speak of pathology. This shape of the spine affects the posture of a person. AT advanced stage this leads not only to pain, but also to impaired functioning internal organs and body systems. What is a disease, how to treat it, should be considered in more detail.

What is lordosis?

In all people, the spine has such a bend as lordosis. What it is, not everyone knows. This bend has a bulge facing forward. Physiological lordosis can be in the cervical and lumbar spine. Here under the influence adverse effects sometimes develops pathological type lordosis. The deviation differs from the physiological variety by the index of its bending.

Very rarely, such a curvature can develop in the thoracic spine. Incorrect bending in this case is caused by damage to the vertebrae or muscles of the back, as well as hip joints. To understand the difference between physiological and pathological lordosis, it is necessary to familiarize yourself with the structural features of the human spine.

Anatomy of the spine

Normally, the human spine has 4 curvatures. All of them are located in the sagginal (posterior or anterior) direction. Side bends are considered deviations.

Physiologically correct bends are laid from the moment of birth, however, in early age they are not yet sufficiently pronounced.

When the baby learns to walk, the spine takes on a more familiar, pronounced curvature. His position is finally established at the age of 16-18. Each bend is necessary to reduce the load on the spine.

Spinal pathology can develop both in adults and infancy. The changes affect the vertebrae that move forward. Structure bone tissue rarefied, intervertebral discs are expanding. In the vertebrae, which are located next to the affected sections, compaction and convergence of the spinous processes are observed.

Classification of lordosis

There are several signs by which lordosis is grouped. This allows you to choose proper treatment doctor. According to the type of localization, there are:

• Cervical type of lordosis.
• Lumbar type of lordosis.

This classification is determined on inspection. The doctor, according to certain signs, refers the disease to one of these groups. According to the causes of occurrence, there are:

• primary type.
• secondary type.

The first variety is called pathological changes spine. The second type of curvature is compensatory, it is caused by conditions that provoke a non-physiological position of the body. According to the strength of the bend, they distinguish:

• Physiological lordosis.
• Hyperlordosis (the angle is curved more than normal).
• Hypolordosis (the angle is curved less than normal).

There is another type of lordosis - preserved lordosis. This means that the bend practically corresponds to the norm, but at the same time it is somewhat different from the classical norm.

Causes

Straightening of physiological lordosis or, conversely, its strengthening can occur at any age. Adults and children have their own reasons for development similar diseases. The first symptoms that give out hyperlordosis of the lumbar spine, neck, as well as hypolordosis, appear in the smallest patients due to such reasons:

• Rachitic softening of the bone tissue.
• Injuries received during the passage of the birth canal.
• Dysplasia of the hip joint.
• Teenagers have too fast growth also sometimes leads to such changes.

Moreover, both excessive bending and smoothness of the cervical or lumbar lordosis can appear. In adults, a number of pathologies most often provoke changes in the spine. The main ones are the following:

• Osteochondrosis.
• Achondroplasia.
• Neoplasms in the spine.
• Bechterew's disease.
• Spondylolisthesis.
• Infections affecting the spine.
• Ankylosis.
• Hernia between vertebrae.
• Rheumatism.
• Obesity.
• Spinal injury.
• degenerative processes in muscle frame spine.

Also quite often lordosis cervical spine and lower back is manifested in women after pregnancy. Under the weight of the abdomen, the spine adjusts to new conditions. Therefore, hyperlordosis of the neck and lower back occurs. After the birth of the baby, this process is completely reversible.

Only a doctor will advise the correct treatment of pathological lordosis.

Symptoms

Exist certain symptoms indicating the development of the disease. Hyperlordosis of the cervical region, as well as in the lumbar region, is manifested by some sensations, and straightening of the spine by others. Conducts diagnostics experienced doctor. Self-diagnosis at home will not work. It is necessary to undergo an appropriate examination. When the lumbar, cervical lordosis is straightened or increased, the following symptoms are noted:

• Pain in the spine.
• The stomach sticks out.
• Sleep is disturbed.
• Feeling constantly tired.
• Sore feet.
• The work of internal organs is disrupted.

If there were similar symptoms means you need to see a doctor immediately. Only a specialist can determine whether the patient has smoothness or hyperlordosis of the neck, lower back. After diagnosis, appropriate treatment and physical exercises are prescribed.

Strengthening lordosis

There are certain symptoms that allow the specialist to understand that the patient has an enhanced type of lordosis of the cervical spine or lower back. This is determined by a doctor's examination. He may notice such symptoms inherent in such a condition:

• The abdomen strongly protrudes forward.
• The pelvis and buttocks are set back.
• The legs are slightly apart.
• The lumbar muscles are strongly tensed.
• Lying and sleeping on your stomach is extremely difficult (causes pain).
• To lean forward, a person can only flex the hip joints.
• If you lie on your back, a fairly large space is noted between the lower back and the floor.

If the disease is not treated when the first signs appear, accompanying deviations develop. It is no less dangerous if straightening of the cervical lordosis is determined, as well as excessive bending in lumbar spine. The above symptoms make it necessary to consult an experienced specialist as soon as possible.

Smoothness of lordosis

The opposite violation, when the lumbar or cervical lordosis is smoothed out, is an equally unpleasant condition. He also has certain symptoms. They can be distinguished by the doctor during the examination. If cervical lumbar lordosis smoothed, the following signs are noted:

• The back takes on a flat shape.
• The patient feels constant pain in the lower back, neck.
• Fatigue while standing or sitting is increased.
• The gait has been changed.
• In the field of pathology, numbness is noted.

If such symptoms appear, it is necessary to treat the smoothed type of curvature.

The patient is assigned a set of procedures, exercises, depending on the severity, characteristics of the course of the disease.

Treatment

The doctor in the process of making a diagnosis examines the patient. Next, he appoints an x-ray in the lateral and direct projection. This allows you to understand what factors can complicate the disease and the type of curvature. X-rays allow you to assess the degree of mobility of the spine, deviations in the shape and structure of the vertebrae.

Treatment of lordosis is within the competence of an orthopedist and vertebrologist. Depending on the severity of the course of the disease, the doctor prescribes one or another complex medical measures. These include:

• Physical exercises.
• Drug treatment of lordosis.
• Surgical intervention.
• Massage.

Usually, treatment consists of a course of anti-inflammatory drugs, vitamins, chondroprotectors, and painkillers. Mandatory are exercises that allow you to correct wrong position spine.

Physical education, aimed at eliminating pathology, involves forward bending:

• In the supine position, the patient tries to press his back against a flat surface. Then he raises his straight legs and throws them over his head.
• Exercises are also performed in the supine position (a special roller is placed under it). Hands are clasped behind the head. The patient raises the chest above the floor. Each movement is repeated 5-10 times.

Mandatory are massage sessions that allow you to relax your muscles. In some cases, it is indicated to wear a bandage. If the pathology is too advanced, the doctor may decide to surgical treatment ailment.

To eliminate the possibility of the occurrence of the disease in the future, it is necessary to observe correct posture, prevent the appearance excess weight, do sport. At the first signs of pathology spinal column You need to consult an orthopedist. This will cure the wrong bend on early stage. Wherein negative consequences guaranteed to be avoided.