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Having pain in chest and shoulder, numbness on jaw. EKG and CT scan done. Taking xanax. Concerned

Dec 2014
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Practicing since : 2007
Answered : 4774 Questions
I have been having chest pains now for three weeks. They include left back shoulder blade pain, left neck pressure, , left Jew numbness and left arm numbness and tingling . These individual symptoms come and go or appear all at once.

These symptoms occurred to me three years ago. I went to the emergency and was given a series of tests. I had three different stress tests, a EKG, a test where they inject some substance in your veins and you lie in a machine like a ct scan. They could find nothing wrong. We all concluded ,myself and my doctor it was anxiety.

Well it is back. It was diagnosed as anxiety, however xanex is not taking it away. It diminishes the pain, however it seems to be more constant now. I just started the Xanax yesterday. Prior to that I received two massages that stopped the pain for 24 hours and then it slowly comes back.

I hat taking Xanax as it always seem sot help as a crisis intervention, then it stoops working and makes me more nervous( go figure?) . I am pretty discouraged, I do not wat to spend 4.000 even with insurance on tests because I have Pts or social anxiety. What to do? Naturally I am getting worried about this pain and discomfort.
Posted Sun, 21 Apr 2013 in Bones, Muscles and Joints
Answered by Dr. Seikhoo Bishnoi 2 hours later
Welcome to Health Care Magic

The symptoms you described as chest pains, numbness, shoulder pains, tingling in arm, neck stiffness etc. You were diagnosed with anxiety and were taking xanax for symptomatic relief. All your tests for heart like EKG, Angiography were normal. The symptoms occurred about 3 years back. The symptoms occurs episodically. Ultimately diagnosis of anxiety was made. You are a healthy 68 years female.

On the basis of symptoms I can say that these type of clinical symptoms may occur because of following possibilities-

- hemoglobin is common finding. Also Vitamin-B 12, Folate deficiency causes numbness. Due to low iron, vitamin B12, folate deficiency symptoms mimicing anxiety may occur. I would advise you to get Hemoglobin, Serum B12 and folate levels to rule out anaemia.

- Altered thyroid levels may also cause anxiety, numbness, fatigue like symptoms. Thyroid function tests are done to rule out any thyroid abnormality.

- If all these investigations come normal then we can proceed to management of anxiety. The symptoms may occur due to anxiety or they may be part of somatic symptoms seen in mild to moderate depression. For proper evaluation visit to a Psychiatrist is advised.

Treatment in form of Medicines and Psychotherapy is available.

Medicines like SSRIs as Fluoxetine,Paroxetine, Sertaline etc, and SNRI as Desvenlafexine, Duloxetine etc. are useful in correcting anxiety. These medicines will also provide improvement in low mood.
Non medicinal treatment is also equally effective in anxiety. Treatment options include Relaxation exercises like Progressive Muscle Relaxation, Deep Breathing Exercises, Yoga etc. These methods are free of any side effect and are also very effective in controlling anxiety.
Cognitive Behavior Therapy by a trained Psychologist will also improve anxiety symptoms as well as somatic symptoms.
So please get these investigations done and visit a Psychiatrist for evaluation. There is no need to take undue stress as even non medicinal treatment is very effective.

Hope I cleared your doube, If you have more questions you can ask again in follow up.

Dr. Seikhoo Bishnoi, MD
(Consultant Psychiatrist)
Above answer was peer-reviewed by
Follow-up: Having pain in chest and shoulder, numbness on jaw. EKG and CT scan done. Taking xanax. Concerned 3 hours later
I am scheduled for a full panel fasting blood test on the 8th of this month. I am surprised to your suggestion it could be low iron. I hardly ever experience fatigue. My sleep pattern always ends disrupted at exactly 4:00 am each night. It takes me an hour or so to return to sleep. I have very erratic dreams. But I do not ever really feel tired.

I would be relieved to find something, even thyroid or b-12 deficiency other than depression or anxiety as I hate the meds I have been given in the past.

I take a brisk walk with my dog every day, I do relaxation exercises and I soak in the tub with epsons salts, i have had a professional massage 4times in three weeks, as they really help. however, I am still suffering, my home remedies help for a while. The symptoms subside or even go away, only to return. In the evening is the worse.

I started taking Xanax .5 mg every 6hours since yesterday. I had a massage this morning. The anxiety is completely gone and the heart pain is gone . I have a little pressure on the left of my neck and I fee drunk from the drug. This is such a sale a dilemma . I just do not want to have a heart attack.

Do you feel it is not my heart.....

Answered by Dr. Seikhoo Bishnoi 5 hours later
Hello again

Low iron may present with symptoms of anxiety and also numbness, palpitations. Yes fatigue is presenting feature but still it may present with other symptoms also.
As you are scheduled for blood tests on 8 th just ensure that it includes Vitamin b12, folate and thyroid functions also.
You are having disturbed sleep pattern, for this I would advise you to take extended release Zolpidem as it will help in initiation and maintainence of sleep. Also it don't cause day time sedation.
For anxiety you can take Etizolam which is good anti anxiety drug and is also less sedating.
Relaxation exercises and message will definaty help and you can avoid medicines easily, but for some time I would advise you to take medicines.
To rule out any cardiac problem you can get your EKG done. It will rule out any cardiac cause of palpitations, and also any evidences of ischaemia. Pressure on left side of neck is a sign if fatigue and it is definaty not due to heart problem.

Thanks, if you have more questions you can ask again.
Above answer was peer-reviewed by
Follow-up: Having pain in chest and shoulder, numbness on jaw. EKG and CT scan done. Taking xanax. Concerned 2 hours later
Thank you so much for your time and information. It is a concerning feeling to have continual pain and discomfort in your heart in combination with the occasional neck back and arm discomfort.

In reading info on the web, I now am worried about angina. I do not have shortness of breath, or indigestion, or walking briskly does not aserbate the pain. It does come and go, it bothers me more in the evening and massages and sometime after taking a xanx the pain subsides for a while. It has been 3 week today and I can feel no improvement.

I want to be safe and I. Do not want to pay, even with my insurance 2000.00 for all the heart test my doctor recommends I take...but I hate this pain and it is wearing me out.

I guess I will go to the doctor Monday. I will rely on your good advice and when I take the tests I will ask for the things you suggested. Thanks again...
Answered by Dr. Seikhoo Bishnoi 21 minutes later
Hello again

Although you don't have symptoms of angina still I have advised you already for ECG to rule out angina. Don't take undue stress of angina as it will further increase the symptoms.
Get your all tests and and clarify all doubts from your doctor.
Hope I cleared your doubt, if you have more questions you again in follow up. If you are satisfied with my answer please review.

Dr. Seikhoo Bishnoi, MD
Above answer was peer-reviewed by
Follow-up: Having pain in chest and shoulder, numbness on jaw. EKG and CT scan done. Taking xanax. Concerned 2 minutes later
I am scheduled for a blood test and also, if i agree, four very expensive heart tests. If I am not better or dead by Monday, I guess I will go ahead with the administering of the heart tests I really can not afford.

You have been very helpful...I just noticed you are a psychiatrist . Maybe you could consult with a cardiac physician about the angina concern....thanks

It has certainly been monetarily worth while consulting with you... thanks again....

Answered by Dr. Seikhoo Bishnoi 6 minutes later
ECG is not a costly test. If it comes normal there is no need to go for costly heart tests.

Its my pleasure to answer you.

Dr. Seikhoo Bishnoi, MD
Above answer was peer-reviewed by
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