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What Causes Pain In Shoulder And Elbow Despite Having Normal Cardiac Test Reports?
Question: Hi,
I'm a 27 yr old male, 154lbs, 5' 11". I have a high stress relationship with my spouse and have had recent job and health changes. I've had ekgs, echo, and a stress test done on my heart and my cardiologist had no concerns.
Today as every now and then I have notice pain in my shoulder after getting out of the car and heading up the stairs to my apartment. my drive home is about 10 minutes sometimes 20. I am a bit of a spirited driver and as my car is standard I tend to drive with my left arm often as I did today.
I have been having paranoia that I am experiencing angina from getting out of my car and going up the stairs. I don't have chest pain and my shoulder pain is where my pectoral meets my shoulder or just before the crease. My elbow may ache for a minute or forearm. my should may ache for a few minutes or a little while, sometimes I am stuck focusing on it. My anxiety will sometimes lead that into pain in my shoulder blades and the right side of my neck will hurt inhaling. These symptoms seem to reside when I calm down but I am just scared these may be heart related.
Again I don't have any chest pain or trouble breathing with the shoulder and or arm pain.
Would you be able to provide some input aside from my young age? my parents have a family history of heart disease but they are in good health and have not had any heart related events at the ages of 61 and 65.
Thanks
I'm a 27 yr old male, 154lbs, 5' 11". I have a high stress relationship with my spouse and have had recent job and health changes. I've had ekgs, echo, and a stress test done on my heart and my cardiologist had no concerns.
Today as every now and then I have notice pain in my shoulder after getting out of the car and heading up the stairs to my apartment. my drive home is about 10 minutes sometimes 20. I am a bit of a spirited driver and as my car is standard I tend to drive with my left arm often as I did today.
I have been having paranoia that I am experiencing angina from getting out of my car and going up the stairs. I don't have chest pain and my shoulder pain is where my pectoral meets my shoulder or just before the crease. My elbow may ache for a minute or forearm. my should may ache for a few minutes or a little while, sometimes I am stuck focusing on it. My anxiety will sometimes lead that into pain in my shoulder blades and the right side of my neck will hurt inhaling. These symptoms seem to reside when I calm down but I am just scared these may be heart related.
Again I don't have any chest pain or trouble breathing with the shoulder and or arm pain.
Would you be able to provide some input aside from my young age? my parents have a family history of heart disease but they are in good health and have not had any heart related events at the ages of 61 and 65.
Thanks
Brief Answer:
no heart problem,from history is seems anxiety only,take orthopedic opinion
Detailed Answer:
Hello ,
Thanks for writing to us.
You are 28 year young.
Your cardiac check up was absolutely normal and cardiologist says nothing.It is confirmed that no possibility of heart disease.
Your shoulder pain may be due to some muscular stretching or only due to anxiety in which you perceive minor strain as pain. Characteristics you described about your shoulder pain does not fit in category of heart pain.
In our practice we used to get such patients very frequently and most of them relieved with counseling and few needs medicines.
I suggest to go to orthopedic for evaluation once.If some problem is there it can be treated. If everything come fine and still pain persists it is likely anxiety disorder.
Best treatment of anxiety disorder includes both medicines and cognitive behavior therapy (CBT).
In mild cases only CBT is sufficient. In moderate to severe cases initially medicines and then CBT is added. And later on medicines stopped gradually.
If medicines alone are used chances of relapse are more after stopping the medicines.
In medicines SSRI group of drugs (fluoxetine, paroxetine, sertraline, escitalopram) are main stay of the treatment. I prefer paroxetine. Benzodiazepines group of drugs (clonazeapm, lorazepam or etizolam) are used initially for short duration for fast symptomatic relief.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
no heart problem,from history is seems anxiety only,take orthopedic opinion
Detailed Answer:
Hello ,
Thanks for writing to us.
You are 28 year young.
Your cardiac check up was absolutely normal and cardiologist says nothing.It is confirmed that no possibility of heart disease.
Your shoulder pain may be due to some muscular stretching or only due to anxiety in which you perceive minor strain as pain. Characteristics you described about your shoulder pain does not fit in category of heart pain.
In our practice we used to get such patients very frequently and most of them relieved with counseling and few needs medicines.
I suggest to go to orthopedic for evaluation once.If some problem is there it can be treated. If everything come fine and still pain persists it is likely anxiety disorder.
Best treatment of anxiety disorder includes both medicines and cognitive behavior therapy (CBT).
In mild cases only CBT is sufficient. In moderate to severe cases initially medicines and then CBT is added. And later on medicines stopped gradually.
If medicines alone are used chances of relapse are more after stopping the medicines.
In medicines SSRI group of drugs (fluoxetine, paroxetine, sertraline, escitalopram) are main stay of the treatment. I prefer paroxetine. Benzodiazepines group of drugs (clonazeapm, lorazepam or etizolam) are used initially for short duration for fast symptomatic relief.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for responding.
Is there still no concern if the pain or aches come and go and appear in different spots typically between my shoulder bicep and elbow?
I am also having tightness occasionally from the tendons that hold up or turn my head near the suprasternal notch. Also tightness on the left back of my neck.
It seems like the pain is just randomly appearing and is not tender to the touch but deeper in the tissue. This has been going out for the past few hours.
Is there still no concern if the pain or aches come and go and appear in different spots typically between my shoulder bicep and elbow?
I am also having tightness occasionally from the tendons that hold up or turn my head near the suprasternal notch. Also tightness on the left back of my neck.
It seems like the pain is just randomly appearing and is not tender to the touch but deeper in the tissue. This has been going out for the past few hours.
Brief Answer:
need to rule out neuromascular or bone related problem
Detailed Answer:
Hello,
Thanks for follow up.
Concern for pain is there of course. But from narration it does not fit in to angina pain. Pain is associated with movement, at specific site and tightness suggest some neuromascular or bone involvement. Possibility of some cervical spine involvement is there. I have already mentioned to go for orthopedic check up. Specific treatment can be done after diagnosis.
If no orthopedic component found then only we can consider anxiety.
Other option is you can take over the counter pain killer like ibuprofen or diclofenac with some food. If pain is relieved it is likely to be neuromascular in origin.
Feel free to discuss further.
Regards,
Dr. Chintan Solanki.
need to rule out neuromascular or bone related problem
Detailed Answer:
Hello,
Thanks for follow up.
Concern for pain is there of course. But from narration it does not fit in to angina pain. Pain is associated with movement, at specific site and tightness suggest some neuromascular or bone involvement. Possibility of some cervical spine involvement is there. I have already mentioned to go for orthopedic check up. Specific treatment can be done after diagnosis.
If no orthopedic component found then only we can consider anxiety.
Other option is you can take over the counter pain killer like ibuprofen or diclofenac with some food. If pain is relieved it is likely to be neuromascular in origin.
Feel free to discuss further.
Regards,
Dr. Chintan Solanki.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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