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What caues forearm pain after quitting smoking?

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Posted on Wed, 4 Jun 2014
Question: I have been smoking cigarettes for 9 years now. I generally smoke 5-6 cigarettes a day. When I drink alcohol the number of cigarettes increases. I am a 28 year old XXXXXXX male with height 5 feet 8 inches and weight 74 kgs. I am suffering for cough and fever these days and I get an ache in my left forearm every now and then during the day. The pain is inside the forearm almost midway between the left elbow and the left wrist. The pain comes on most of the times when I smoke(but sometimes even when I am not smoking the pain shows up). This has started happening ever since I caught cough and fever (about 6 days back). I was given some medicines by a GP for the cough and fever. The fever has gone but the cough is still there, but is getting better. The pain in the left forearm comes and goes during the day. There are no other problems or pain in the arm or chest. Even on pressing the area where the pain comes from I don't feel any pain. Seems like the pain is internal and not due to any injuries.
My cholesterol(LDL and Triglycerides) levels were quite high last year but have come done now. I was prescribed Fenolip 148mg. I also cut down on my alcohol consumption and have been physically active (on and off) over the last year. I used Fenolip and Liv. 52(as the LFT numbers showed non-alcoholic steatohepatitis) for 4 months and the triglycerides and LFT numbers were normal the last time I checked (Feb 2014). The following are the numbers from the lipid profile and LFT done in Feb 2014.
CHOLESTEROL - SERUM / PLASMA - 207 mg/dL
HDL CHOLESTEROL - SERUM / PLASMA 25 mg/dL
TRIGLYCERIDES - SERUM - 163 mg/dL
LDL CHOLESTEROL - SERUM / PLASMA:(Calculated) - 149.4 mg/dL
VLDL CHOLESTEROL - SERUM - CALCULATED - 32.6 mg/dL
TOTAL CHOLESTEROL/HDL CHOLESTEROL RATIO(Calculated) - 8.2

BILIRUBIN, TOTAL - SERUM - 0.5 mg/dL
BILIRUBIN CONJUGATED (DIRECT) - SERUM - 0.2 mg/dL
BILIRUBIN UNCONJUGATED - SERUM(Calculated) - 0.3 mg/dL
ALKALINE PHOSPHATASE - SERUM/PLASMA - 116 U/L
ALT(SGPT) - SERUM / PLASMA - 55 U/L
AST (SGOT) - SERUM - 28 U/L
GGTP: GAMMA GLUTAMYL TRANSPEPTIDASE - SERUM      - 44 U/L

PROTEIN, TOTAL - SERUM / PLASMA - 7.8 g/dL
ALBUMIN:GLOBULIN - SERUM(RATIO)(Calculated) - 1.4 g/dL
ALBUMIN - SERUM - 4.5 g/dL
GLOBULIN - SERUM:(Calculated) - 3.3 g/dL

After the normal LFT and triglycerides I was told by a doctor to stop Fenolip and Liv. 52, which I have done. I had my last TMT an year back(2013) and it was quite normal. The last 2D echo for the heart was done 6 months back and it was normal too. The cardiologist told me that my heart was healthy. I suffer from early repolarization syndrome, which I am told is benign. I have high blood pressure too which is under control with Stamlo 5mg. I also had a normal chest x-ray 1 year back. I exercise whenever I can and do pranayam yoga everyday as well. I also eat a high fiber diet(two bowls of salad a day) and avoid red meat. I am also trying to quit smoking by cutting down the dosage gradually. I drink once a week now.
The pain in the left forearm these days is bothering me and I want to know if I should see a cardiologist immediately. The pain is midway between the left elbow and wrist. I don't have any chest pains even during intense physical exercise (I played cricket yesterday and I am a fast bowler). I have been physically active most of my life and my resting heart rate is usually between 55 and 60. I have no family history of heart disease but I do have a family history of high blood pressure and diabetes. My grand father(maternal) passed away in his 70's after a stroke(he never took any medication for high blood pressure despite being diagnosed of it).
Should I quit smoking right away (cold turkey) due to the forearm pain? Is gradual smoking cessation a better plan? Is the forearm pain related to the heart? Do I need to get a TMT done again, since the last one was done an year back? Do I need to go to a doctor now?
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Answered by Dr. Rohit Gulati (1 hour later)
Brief Answer:
hi, I shall answer your queries one by one

Detailed Answer:
Hi
I will answer your queries one by one as below:

1. Quitting smoking gradually is a good idea. But wether it has something to do woth your forearm is difficult to say

2.the nature of pain that you mention does not seem to be related to heart. As the pain due to heart happens along with sweating and uneasiness. The pain also ocurrs from shoulder to forearm. But your pain is located between forearm and wrist.

3.though your physical status mentioned prevents you from heart ailments but at the same time smoking, alcohol and high BP prones you to heart ailments. In such scenario it is always advised to get a repeat TMT done.

4. Forearm pain may not be related to your heart problems and smoking but as it has brought your attention to all the things, it is always better to play safe and get the cardiac work up done

Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Rohit Gulati

Pain Medicine & Palliative Care Specialist

Practicing since :1999

Answered : 252 Questions

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What caues forearm pain after quitting smoking?

Brief Answer: hi, I shall answer your queries one by one Detailed Answer: Hi I will answer your queries one by one as below: 1. Quitting smoking gradually is a good idea. But wether it has something to do woth your forearm is difficult to say 2.the nature of pain that you mention does not seem to be related to heart. As the pain due to heart happens along with sweating and uneasiness. The pain also ocurrs from shoulder to forearm. But your pain is located between forearm and wrist. 3.though your physical status mentioned prevents you from heart ailments but at the same time smoking, alcohol and high BP prones you to heart ailments. In such scenario it is always advised to get a repeat TMT done. 4. Forearm pain may not be related to your heart problems and smoking but as it has brought your attention to all the things, it is always better to play safe and get the cardiac work up done Regards