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Musculoskeletal pain over chest - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
User :   I have really bad pain in the left side of my rib cage. When I cough it is twice as bad and radiates to my back. My wife mention to me that I fell out of bed last Saturday night however I was fine Sunday. The pain started Monday AM and it has gotten worse each day since. It hard for me to get up when lying down and to cough is unbearable.
                                                  
                                                  
                                                  
User :   Hi
User :  
let me read
Doctor :   OK
Doctor :  
May I ask you few questions to know about you?
User :   sure
Doctor :   Please give your Age, Gender, Location, Occupation, Marital status, Height, Weight and Waist circumference.


User :   49, male, Illinois , Management, married, 5'9" 202 lbs, 36 waist
Doctor :   Do you suffer from any other medical problems?
User :   no
Doctor :  
Previous significant problems?
User :   For the last year I have ringing in my ears
Doctor :  
Do you still have it?
User :   Yes however had ears cleaned and have some loss, last blood test was ok except high digicerates? not sure how to spell that.
Doctor :  
Do you have any other symptoms other than the ones you have mentioned?
User :   I have some neck pain that comes and goes it depends on my sleep position. Other then that Im ok, I work out regualary sine Jan-2010
Doctor :   Do you have cough?
User :   Yes
Doctor :  
Is it productive? Has it begun after the pain started or is it there since before
User :   It is productive and yes it has been there before and not worse with this recent problem
Doctor :  
Do you smoke?
User :   Yes
Doctor :   How much/how often and how long you have?
User :   20+ years around a pack and and half
Doctor :  
So can I assume that you have been having smokers cough from much before the pain started?
User :   yes, it goes away when I work out more frequently and when the weather is clear
Doctor :  
How much sputum are you producing?
Doctor :  
Has it been increasing since the pain started?
Doctor :  
In quantity?
User :   No about the same as before, just since this pain Its hard to get rid of it
Doctor :  
Were you producing it before the pain startedx?
User :   yes
Doctor :  
You said that pain is in the left side of rib cage, is it above near the armpit
Doctor :  
or much below?
User :   Yes, slightly towards the center and It hurts to touch in certain ares
Doctor :  
You don't get pains in he front side of the chest do you?
User :   The pain is in the area above the nipple about two inches from the center of my chest
Doctor :  
That is on the
Doctor :  
front side right?
Doctor :  
OK
User :   Yes the front side however when I cough I can feel it in my back
Doctor :  
OK, could you do a proxy physical examination? Will you press along the ribs & let me know whether it pains on pressing?
User :   Yes pains on pressing
Doctor :  
How many ribs?
Doctor :  
What is the extent?
User :   dull ache, maby two ribs, however its real bad when I get up from bed or cough
Doctor :  
Now take a deep breath, does it pain on doing this? Same thing with a complete exhalation
User :   Yes pain on both inhale and exhale
Doctor :   OK, so your wife must be right
Doctor :  
you have injured yourself
Doctor :  
Is there any swelling in that area?
Doctor :  
any change in colour- red, or
User :   No swelling no color. How or why did the pain take so long to appear.
Doctor :  
change in temperature- warmer than the surroundings?
Doctor :  
You can use the back of your fingers for this
User :   No change in Temp
Doctor :  
Ok
Doctor :  
Then its unlikely to be a fracture
User :   Can I or should still workout?
Doctor :  
You need rest till the
Doctor :  
pain disappears
Doctor :  
There is a controversy
User :   Anything to look out for?
Doctor :  
The productive cough
Doctor :  
I hope it is not due to a lung disease
Doctor :  
Your symptoms, other than the productive cough
Doctor :  
is suggestive of a musculoskeletal pain
Doctor :  
So please stop smoking
User :   Could be. My grandmother had bronchidist her whole life without somking. I know I should quit, tried a few times. so hard
Doctor :  
Get yourself examined by a physician to rule out any
Doctor :  
such possibilities
Doctor :  
For now you can use a painkiller cream on that area
Doctor :  
Take some over the counter painkillers
Doctor :  
Rest
User :   Thanks and I have some Ibuprofin, however i rarely take any meds. However I will take you advise and try to quit again.
Doctor :  
Is there any thing else I can help you with?
User :   No thanks again
Doctor :   Please fill the feedback form say done when done.
User :   Ok
Doctor :   Thanks for consulting me. Bye for now. Please refer your friends to our service.
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