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Pain in chest,shoulder and neck - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Environmental and Occupational Hazards
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1777 Questions
User :   Hi, I have symptoms that have stumped doctors. I've had extenive lab work and imaging. weakness limbs, stiffness, difficulty maintaining upright posture, difficult and painful to turn over in bed, flex foot, curl toes, throat pain, sore, raw, swollen (past 6 months, now 6 hrs a day, pain and numbness in calves and feet, pain shoulder and neck, chest pain and or pain in rib cage of back an dpian in sourrounding areas - shoulder, arm side back, now 2 hrs a day for 6 mo only on left side now also on right side, difficulty starting a movement, muscle contractions/twitching at night, pain in legs when walking causes limp and or pain on other areas of le, i.e., knee (front or back) or below knee or ankle area or foot (pain ceases when I stop moving), lack of coordination with hands, lean sideways, difficulty gettin out of bed then wlk stiffly like a mummy, ice cold feet etc.
Doctor :   Hi
User :   hi
Doctor :   let me read ur query
Doctor :   please give me a few minutes
User :   sure
Doctor :   may i know ur age, weight, height ?
User :   50 year old female, 135 lbs 5'9" previously in excellent health
Doctor :   do u have got any investigations done ?
User :   not sure what you mean, testing?
Doctor :   yesm tests like blood work, Xrays etc
User :   yes, vitually everything including: lab work for stiff person syndrom, huntington's etc. ct neck, brain mri, ultrasound thyroid (will have fllw up biopsy), chest x ray, parkinson's scan, ekg...
Doctor :   all are normal in that case ?
User :   yes. ultrasound thyrod requires fllw up biopsy but don't think my symptoms are related to thyroid cancer. also having a fllw up on HPV but again i don't think related. so many test are bound to find some things. also recent mri cervical spine showed evidence of cervical spondylosis and sic changes greatest at C5-C6 but no significant bulgin and arthritic bony hypertrophy with narrowing at c5 c6 yet they are not suggesting further.
Doctor :   have u on any medications for your pain ?
Doctor :   your pain appears to be of neuropathic origin
User :   yes, vicodin up to 8 day. i've had pain for about 1 yr started apin meds about 5 months ago. this pain med seems to cause severe constipation and pain at night esp throat, calves and chest is not alleviated.
Doctor :   you might be benefited by medications like gabapentin, cymbalta will be helpful
User :   thanks, are they more gentle on digestion issues
Doctor :   vicodin contains codiene and that can couse severe constipation
User :   got it.
Doctor :   yes, the medications mentioned by me, are better on the stomach
Doctor :   In addition, regular physiotherapy, body massage therapy, heat applications will help in improving mobility of the body joints and tissues
User :   any ideas what may be going on. i've been seeing a neurologist for over a year and prior to that was misdiagnosed several times. initially thought a movement disorder but they are now ruling out. one of my thoughts was multiple system atrophy - parkinsonism which few know about and very difficult to dx, my doc says no. desperate to find an answer
User :   the pain is not really in joints
User :   one other thing in addition to throat problems, for last 7 months ive had persistant cough
User :   and constant throat clearing
Doctor :   Your symptoms could be due to chronic fatigue syndrome , which has a similar presentation ,
User :   while i have some sleep problems i m not fatigued
Doctor :   do u have sleep apnea ?
User :   no
Doctor :   may i know if u have had lung function test, (breathing tests) to check your expansion of the chest wall
User :   they ruled out lyme with test but often wonder as i spend lots of time in CT and lung function test negative. my mother died of lung cancer but x ray of chest showed no abnormality
Doctor :   May i know the medications that you take on a daily basis ?
User :   right now just the vicodin
Doctor :   ok
Doctor :   In that case, your symptoms should be releieved by taking prescription medications like cymbalta, duloxetine, and pregabalin, on a daily basis
User :   thanks, i'll discuss with my doc
Doctor :   you are most welcome
User :   wish i knew what is going on vs just treating symptoms
Doctor :   this seems to be a chronic pain disorder associated with over active pain receptors
User :   yes, may be right. I'm also going to ask to visit the pain clinic to discuss options
Doctor :   since most of the tests are normal, there should not be any major organic condition affecting you
Doctor :   visiting a pain clinic and having physiotherapy will help u out
User :   i appreciate all yr help. many thanks!
Doctor :   you are most welcome
User :   goodbye
Doctor :   bye for now
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