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Dr- 1. About A Week Ago I Experienced Severe Back

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Posted on Sat, 4 May 2019
Question: Dr-

1. About a week ago I experienced severe back pain and my doctor determined that it was a muscle cramp & he gave me a steroid shot & it seemed to help

2. A few days later I also started to experience pain in my left arm and left side of the chest

3. Pain in the chest usually occurs at night especially when I'm laying down on the left side - but also when I'm lying down on the right side

3. I want to be sure that the pain is that I am experiencing in my left arm and left side of the chest are not related to the heart - do you have any suggestions whereby I can ensure that these are not heart related symptoms?

Thanks.
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Follow up: Dr. Ilir Sharka (0 minute later)
Dr-

1. About a week ago I experienced severe back pain and my doctor determined that it was a muscle cramp & he gave me a steroid shot & it seemed to help

2. A few days later I also started to experience pain in my left arm and left side of the chest

3. Pain in the chest usually occurs at night especially when I'm laying down on the left side - but also when I'm lying down on the right side

3. I want to be sure that the pain is that I am experiencing in my left arm and left side of the chest are not related to the heart - do you have any suggestions whereby I can ensure that these are not heart related symptoms?

Thanks.
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome to Ask a Doctor service!

I passed carefully through your question and would explain that your symptoms are not typical of a cardiac disorder.

Gastroesophageal reflux can trigger chest pain while laying down. A musculoskeletal pain can not be excluded either , considering the fact that the pain is modulated by body position.

Anyway,a resting ECG and an exercise cardiac stress test would help exclude coronary artery disease.

Other tests to consider would be: a cardiac ultrasound, a chest X ray study, complete blood count, PCR, ESR for inflammation.

In the meantime, I would recommend taking an antiacid or PPI (omeprazole, pantoprazole) for acid reflux. If it helps improve your situation, a fibrogastroscopy may be needed.

Hope you will find this answer helpful!

I remain at your disposal for any further questions whenever you need!

Kind regards,

Dr. Ilir Sharka, Cardiologist
Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome to Ask a Doctor service!

I passed carefully through your question and would explain that your symptoms are not typical of a cardiac disorder.

Gastroesophageal reflux can trigger chest pain while laying down. A musculoskeletal pain can not be excluded either , considering the fact that the pain is modulated by body position.

Anyway,a resting ECG and an exercise cardiac stress test would help exclude coronary artery disease.

Other tests to consider would be: a cardiac ultrasound, a chest X ray study, complete blood count, PCR, ESR for inflammation.

In the meantime, I would recommend taking an antiacid or PPI (omeprazole, pantoprazole) for acid reflux. If it helps improve your situation, a fibrogastroscopy may be needed.

Hope you will find this answer helpful!

I remain at your disposal for any further questions whenever you need!

Kind regards,

Dr. Ilir Sharka, Cardiologist
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Ilir Sharka (2 days later)
Dr-

1. I went to the emergency room & they checked my lungs with x-Ray & my heart with EKG, blood work, cardiac monitor

2. They found no problems

3. Now I just woke up & I was still experiencing the pain it's best described as - off and on dull ache & inside left pectoral muscle most noticible when I lie down to rest or sleep

4. Any thoughts ?
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Follow up: Dr. Ilir Sharka (0 minute later)
Dr-

1. I went to the emergency room & they checked my lungs with x-Ray & my heart with EKG, blood work, cardiac monitor

2. They found no problems

3. Now I just woke up & I was still experiencing the pain it's best described as - off and on dull ache & inside left pectoral muscle most noticible when I lie down to rest or sleep

4. Any thoughts ?
doctor
Answered by Dr. Ilir Sharka (4 hours later)
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again!

I am glad that all your performed tests have resulted normal!

This means that we can exclude any possible cardiac or lung disorder.

In my opinion, this could be just local musculoskeletal pain, due to local inflammation.

Is the pain triggered by manual pressure on the chest or deep breathing?

Coming to this point, I would recommend taking ibuprofen three times daily and using local warm packs.

I am sure that your situation will improve in the next days.

Hope you will find this answer helpful!

Kind regards,

Dr.Iliri
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again!

I am glad that all your performed tests have resulted normal!

This means that we can exclude any possible cardiac or lung disorder.

In my opinion, this could be just local musculoskeletal pain, due to local inflammation.

Is the pain triggered by manual pressure on the chest or deep breathing?

Coming to this point, I would recommend taking ibuprofen three times daily and using local warm packs.

I am sure that your situation will improve in the next days.

Hope you will find this answer helpful!

Kind regards,

Dr.Iliri
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Ilir Sharka (23 hours later)
Dr-

1. I want to give you an update on my situation

2. The pain does seem to be more intense at night when I lie down to sleep specially in certain positions

3. In fact last night I woke up with a pretty extreme pain in the show in the shoulder chest and arm area on the left side

4. The only exclamation could be that I did lift the chair earlier in the day but I’m not sure what else could’ve caused this increase in symptoms

5. I did not take any pain medication last night instead when I woke up with this extreme pain I put on a hot heating pad on my shoulders and chest and that seem to calm it down and then I went back to sleep

6. I haven’t felt any pain all morning or all day so far

7. Do you have any suggestions doctor? Do you know what could be causing the symptoms? Thank you
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Follow up: Dr. Ilir Sharka (0 minute later)
Dr-

1. I want to give you an update on my situation

2. The pain does seem to be more intense at night when I lie down to sleep specially in certain positions

3. In fact last night I woke up with a pretty extreme pain in the show in the shoulder chest and arm area on the left side

4. The only exclamation could be that I did lift the chair earlier in the day but I’m not sure what else could’ve caused this increase in symptoms

5. I did not take any pain medication last night instead when I woke up with this extreme pain I put on a hot heating pad on my shoulders and chest and that seem to calm it down and then I went back to sleep

6. I haven’t felt any pain all morning or all day so far

7. Do you have any suggestions doctor? Do you know what could be causing the symptoms? Thank you
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Follow up: Dr. Ilir Sharka (3 minutes later)
Dr-

1. I want to give you an update on my situation

2. The pain does seem to be more intense at night when I lie down to sleep specially in certain positions

3. In fact last night I woke up with pretty extreme pain in the shoulder chest and arm area on the left side

4. The only explanation could be that I did lift a chair earlier in the day but I’m not sure what else could’ve caused this increase in symptoms

5. I did not take any pain medication last night instead when I woke up with this extreme pain - I put on a hot heating pad on my shoulders and chest and that seem to calm it down and then I went back to sleep

6. I haven’t felt any pain all morning or all day so far

7. Do you have any suggestions doctor? Do you know what could be causing the symptoms? Thank you
default
Follow up: Dr. Ilir Sharka (0 minute later)
Dr-

1. I want to give you an update on my situation

2. The pain does seem to be more intense at night when I lie down to sleep specially in certain positions

3. In fact last night I woke up with pretty extreme pain in the shoulder chest and arm area on the left side

4. The only explanation could be that I did lift a chair earlier in the day but I’m not sure what else could’ve caused this increase in symptoms

5. I did not take any pain medication last night instead when I woke up with this extreme pain - I put on a hot heating pad on my shoulders and chest and that seem to calm it down and then I went back to sleep

6. I haven’t felt any pain all morning or all day so far

7. Do you have any suggestions doctor? Do you know what could be causing the symptoms? Thank you
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Follow up: Dr. Ilir Sharka (2 hours later)
DR --

1. I have done some research & I think I may be suffering from Prinzmetal angina

2. for the last 2 weeks I have had a radiating pain in the left pectoral/chest & left arm area

3. last night the pain was much more severe & I awoke with an extreme pain in the left pectoral/chest & left arm area

4. do you have any suggestions? Thanks,
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Follow up: Dr. Ilir Sharka (0 minute later)
DR --

1. I have done some research & I think I may be suffering from Prinzmetal angina

2. for the last 2 weeks I have had a radiating pain in the left pectoral/chest & left arm area

3. last night the pain was much more severe & I awoke with an extreme pain in the left pectoral/chest & left arm area

4. do you have any suggestions? Thanks,
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
I would explain:

Detailed Answer:
Hello again!

After reviewing again your clinical symptomatology I would exclude with a high certainty a cardiac related origin of you chest pain.

Furthermore, such a prolonged chest pain would have increased cardiac enzymes level when checking blood tests.

Cardiac ischemia is not related by body position or local maneuvers (relieved by a hot heating pad); this holds true also for Prinzmetal angina.

I remain of the opinion that it seems to be a musculoskeletal disorder and would encourage you to check the above mentioned inflammation tests (PCR, ESR).

In addition, in order to investigate for a possible backbone disorder a lateral X ray film of the cervical - thoracic spine would be recommended and if necessary a CT scan.

In the meantime, you may use pain medications (anti-inflammatory drugs like ibuprofen, naproxen ,etc.).

Wishing you a good health!

Regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
I would explain:

Detailed Answer:
Hello again!

After reviewing again your clinical symptomatology I would exclude with a high certainty a cardiac related origin of you chest pain.

Furthermore, such a prolonged chest pain would have increased cardiac enzymes level when checking blood tests.

Cardiac ischemia is not related by body position or local maneuvers (relieved by a hot heating pad); this holds true also for Prinzmetal angina.

I remain of the opinion that it seems to be a musculoskeletal disorder and would encourage you to check the above mentioned inflammation tests (PCR, ESR).

In addition, in order to investigate for a possible backbone disorder a lateral X ray film of the cervical - thoracic spine would be recommended and if necessary a CT scan.

In the meantime, you may use pain medications (anti-inflammatory drugs like ibuprofen, naproxen ,etc.).

Wishing you a good health!

Regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (40 hours later)
Dr -- thank you for your advice

1. I was reviewing your previous comments & you asked if "the pain is triggered by manual pressure on the chest or deep breathing" ?

2. the answer to this question is yes -- I do feel a sharp pain in my chest when I cough or strain & of course in certain positions

3. other than that - my back pain & radiating pain in the chest seem better than before

Thanks again
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Follow up: Dr. Ilir Sharka (0 minute later)
Dr -- thank you for your advice

1. I was reviewing your previous comments & you asked if "the pain is triggered by manual pressure on the chest or deep breathing" ?

2. the answer to this question is yes -- I do feel a sharp pain in my chest when I cough or strain & of course in certain positions

3. other than that - my back pain & radiating pain in the chest seem better than before

Thanks again
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again!

Thank you for the additional information!

Based on the description of the pain I would conclude about a musculo-skeletal pain!

So, nothing serious is going on!

I am glad that you are feeling better!

I would recommend continuing painkillers form some days and avoid straining physical activity.

Some warm local packs may be helpful too!

Hope you will find this answer helpful!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again!

Thank you for the additional information!

Based on the description of the pain I would conclude about a musculo-skeletal pain!

So, nothing serious is going on!

I am glad that you are feeling better!

I would recommend continuing painkillers form some days and avoid straining physical activity.

Some warm local packs may be helpful too!

Hope you will find this answer helpful!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka (9 minutes later)
Brief Answer:
You are welcome!

Detailed Answer:
I am glad to have been helpful to you!

If you have any other questions in the future, please don't hesitate to ask me at any time directly!

I would be happy to answer to all of your questions!

Wishing good health,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
You are welcome!

Detailed Answer:
I am glad to have been helpful to you!

If you have any other questions in the future, please don't hesitate to ask me at any time directly!

I would be happy to answer to all of your questions!

Wishing good health,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (1 minute later)
Dr --

Thank you very much. You have been of great assistance as always. God bless & take care.
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Follow up: Dr. Ilir Sharka (0 minute later)
Dr --

Thank you very much. You have been of great assistance as always. God bless & take care.
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Follow up: Dr. Ilir Sharka (32 hours later)
Dr -

1. I will use Tylenol instead of ibuprofen since it is easier on stomach & will not affect my blood pressure. Would that be ok?

2. And of course warm local packs

3. Does this sound ok to you? Thanks.
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Follow up: Dr. Ilir Sharka (0 minute later)
Dr -

1. I will use Tylenol instead of ibuprofen since it is easier on stomach & will not affect my blood pressure. Would that be ok?

2. And of course warm local packs

3. Does this sound ok to you? Thanks.
doctor
Answered by Dr. Ilir Sharka (7 hours later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

Yes, Tylenol is more safe for your stomach compared to ibuprofen and it is OK to reduce the pain.

Anyway, it has no anti-inflammatory effects,and does not calm local inflammation, which could be the origin of the pain. While ibuprofen acts also as an anti-inflammtory drug.

Anyway, I would recommend trying first Tylenol and see if it helps improve your situation. Local warm packs will help improve your situation too.

Hope to have been helpful!

Wishing all the best,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

Yes, Tylenol is more safe for your stomach compared to ibuprofen and it is OK to reduce the pain.

Anyway, it has no anti-inflammatory effects,and does not calm local inflammation, which could be the origin of the pain. While ibuprofen acts also as an anti-inflammtory drug.

Anyway, I would recommend trying first Tylenol and see if it helps improve your situation. Local warm packs will help improve your situation too.

Hope to have been helpful!

Wishing all the best,

Dr. Iliri

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9541 Questions

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Dr- 1. About A Week Ago I Experienced Severe Back

Dr- 1. About a week ago I experienced severe back pain and my doctor determined that it was a muscle cramp & he gave me a steroid shot & it seemed to help 2. A few days later I also started to experience pain in my left arm and left side of the chest 3. Pain in the chest usually occurs at night especially when I'm laying down on the left side - but also when I'm lying down on the right side 3. I want to be sure that the pain is that I am experiencing in my left arm and left side of the chest are not related to the heart - do you have any suggestions whereby I can ensure that these are not heart related symptoms? Thanks.