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What causes dull pain in the right chest?

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Posted on Sat, 16 May 2015
Question: Hi Doctor,

I'm 27/male/Indian and here's my story: In September 2013, I started getting these dull chest pains in my right chest whenever I would exert even moderately. I thought it was because I had travelled abroad and handled very heavy luggage on multiple occassions so the pain must be some temporary muscular pain. Infact, I even visited the emergency rooms twice and they took chest x-rays and said everything was fine and I just needed to take some painkiller 3-4 times a day until it gets fine. The pain definitely subsided and it would stay that way until I started exerting even little again. This continued but wasn't too worrying since I was fine most of the time.

Another incident that occurred with me was in December 2014 when the finger next to the pinky in my left hand got numb for a couple of days and on consulting a doctor was told that this was due to a pinched ulnar nerve which was a result of me sitting with my hand lying on the elbow in the same position for hours at a stretch playing live poker regularly (sometimes sitting 20 hours at a stretch at the table). Again, this got better and didn't stay for too long.

Afterwards, I consulted my university's GP again for the right chest pain since it would be frequent and he examined my back and said I have "scoliosis". Initially, I was terrified since I didn't know what that meant but he said he wasn't sure if that could be the reason for the chest pain and wanted me to get in touch with a neurologist. I was stressed since I didn't know what lied ahead since I had started reading some really scary articles on the web about scoliosis and how, if progressive, requires intrusive surgery and stuff, which was very scary.

Later, the same night in April 2014, I felt a sharp electric shock-like sensation somewhere in my lower spine for a second or two while walking back home and it felt really scary. I immediately left back for XXXXXXX since it was hard to get a quick appointment with a neurologist abroad. During my travel, I again noticed my left hand's same finger felt numb after picking up the heavy bags. However, that settled soon on its own in 3-4 days I think.

Once in XXXXXXX I first got in touch with a neurologist who got my blood levels tested. My D3 was disastrously low at 4 whereas my B12 was low as well at 140. I was told to take some shots and tablets. To this day, I have been taking Shelcal-M and Nuroday daily and Uprise 60k once a month for life (as advised by the ortho I visited later). I even got some electromagnetic nerve test done which came out all normal.

However, I next visited an ortho (specializing in hip surgery though) to find out about my scoliosis, the one thing I was hugely worried about. The ortho initially examined and said it looks like a small 15-20 degree curve and nothing to worry about but since I wasn't convinced, I got a backside chest xray done on which he marked the curve angle as 35 degrees with a pen, asking me to check it every year. He even told me that it was a moderate curve and chances of progression are close to zero. I asked him if I should get a spine MRI and he said it's absolutely unnecessary and my problems were related to vitamin deficiency most likely. He said my right side chest pain can't be related to scoliosis since the curve is to the left. I decided to listen to him and felt relieved. He also advised me to do some back exercises for the scoliosis (but I never do them).

Now, it's been exactly a year since I've been following this advice and I know that vitamin deficiency symptoms take a while to disappear, but a year is quite a long period. I still get the pinprick sensations almost all the time, although much lesser now, and they're spread all over the body. Also, my right side chest pain comes everytime I exert myself and goes away after I rest. Also, everytime I go to lie down in my bed at night, my backside gives a "I've been tired" kind of a mild pain for a second or two as I lie flat on the bed. I'm also getting an extremely mild pain in the same finger as I type this.

I'm really confused if this is because of scoliosis and it's starting to scare me tremendously. I even think of MS sometimes. I'm not sure what to do. Any advice is highly appreciated.
doctor
Answered by Dr. Sudhir Kumar (27 minutes later)
Brief Answer:
You are on the right treatment.

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted your details and agree with your doctor's approach to the treatment.

Your symptoms are most likely due to vitamin D and B12 deficiency, which, as you said, take a while to go away.

35 degrees of scoliosis is not something to worry about, especially if it is not increasing in severity over the years.

However, I would like to get an MRI of spine done to exclude any compression of the spinal cord, or nerve roots, even though the chances are low.

I agree with the exercises advised to you.

MS is unlikely, however, MRI would help us exclude it altogether.

I hope my reply has helped you.

I would be pleased to answer, if you have any follow up queries or if you require any further information.
     
Best wishes,     
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (14 hours later)
Hi Dr. XXXXXXX

It it comforting to hear your response and that it may be due to D3 and B12 deficiencies only. I have a couple of questions if you'd be kind enough to answer them so that I can relieve my mind off this:

a) Vitamin deficiency: How long do you think it could take for the symptoms to go away? It's been already a year so far.

b) MRI: Should I get an MRI of the ENTIRE spine (cervical, thoracic and lumbar) and with or without contrast? Should I get one of the brain too just to make sure it's not MS because although unlikely as you said so, it really scares me.

c) Back Exercises: I would ofcourse remember to try and do the exercises, but as you know, we get lazy sometimes to exercise so would it harm if I don't do the exercises given by the doctor? What about gym training? Is that safe for my scoliosis?

d) What do you think causes the right chest pain? Could it be my uneven ribs due to scoliosis hitting the lungs or something when I exert? I never had this type of pain before. But then again, my curve is to the left and the pain comes on the right side.

Thank you for your help, Doctor. It means a lot.

Regards,
Neville.

doctor
Answered by Dr. Sudhir Kumar (1 hour later)
Brief Answer:
Improvement may take 2-3 years.

Detailed Answer:
Thank you for getting back.

My replies to your queries are below:

a. The complete improvement in cases of vitamin deficiencies may take upto 2-3 years.

b. You should get MRI of entire spine. Contrast is not needed.

c. Not doing back exercises would not harm, however, it would be better to do them, even if you do 4-5 days per week. Gym training would also be useful to make your back muscle stronger.

d. It could be muscular pain, or due to nerve compression at the back.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Sudhir Kumar (7 hours later)
Thank you so much doctor. I shall be getting my MRI in 2 months time when I go back to XXXXXXX since it is far cheaper there.

Regards,
Neville
doctor
Answered by Dr. Sudhir Kumar (17 minutes later)
Brief Answer:
That is fine.

Detailed Answer:
Thank you for getting back.

You can get the MRI done in XXXXXXX

Let me know the report after that.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
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Follow up: Dr. Sudhir Kumar (26 hours later)
Hi Doctor,

A very dull pain has also been occuring occassionally in my right leg's calves. Sometimes, I feel similar pain in my bisceps. Could this be more due to nerve pinching?
doctor
Answered by Dr. Sudhir Kumar (4 hours later)
Brief Answer:
Could be due to nerve pinching.

Detailed Answer:
Thank you for getting back.

Yes, these symptoms could also be due to nerve pinching or vitamin deficiency.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Sudhir Kumar

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What causes dull pain in the right chest?

Brief Answer: You are on the right treatment. Detailed Answer: Hi, Thank you for posting your query. I have noted your details and agree with your doctor's approach to the treatment. Your symptoms are most likely due to vitamin D and B12 deficiency, which, as you said, take a while to go away. 35 degrees of scoliosis is not something to worry about, especially if it is not increasing in severity over the years. However, I would like to get an MRI of spine done to exclude any compression of the spinal cord, or nerve roots, even though the chances are low. I agree with the exercises advised to you. MS is unlikely, however, MRI would help us exclude it altogether. I hope my reply has helped you. I would be pleased to answer, if you have any follow up queries or if you require any further information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, XXXXXXX For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar My blog: http://bestneurodoctor.blogspot.com/