What causes uncomfortable muscle spasms while breathing?

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Posted on Sat, 25 Apr 2015 in Brain and Spine
Question: Im under treatment for severe uncontrollable muscle "spasms" which often leave me with sharp pains areas of ribs on right, back then front, even just with inhale and exhale. (Chest xray is neg)This is my second wk on Baclofen 10mg tid. which i hope might stop the spasms. I do have early Parkinsons. The ribs (or muscles therein) are the main pain currently. Two Vicodin help a little to take the edge off. Ideas/suggestions? Thank you
doctor
Answered by Dr. Ajay Panwar 36 minutes later
Brief Answer:
Anxiety/Intercostal muscle spasm/Revert back with TMT.

Detailed Answer:
Hi XXXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

If you would have presented to me as an outpatient,I would have listed the following possible differentials in your case-
1)Anxiety
2)Intercostal muscle spasm
3)Cardiac angina

Cardiac etiology definitely,is of the severe nature and must be excluded.Its good that you are getting a Thallium Tread mill test(TMT) done.Please revert back with the TMT results.
However, 2 points which goes against cardiac etiology are-
1)Pain is not referred to arms, shoulders, abdomen or any other upper thoracic region (as I could make out from your description).
2)Pain increases with breathing-This typically is not a feature of cardiac angina. Rather, it is more common in intercostal muscle spasm and anxiety.

For now, I advise you to start doing mental relaxation exercises/meditation/Yoga regularly to reduce your anxiety levels.
During the event of pain or spasm, just lie supine on bed with your arms raised overhead, the symptoms should improve.

Parkinson's should not be a cause for these spasms and rationale of taking baclofen is not clear.

Hope I have answered your query. If you have some follow-up questions, I shall be glad to answer else, please close the thread-rate it and write a review as your rating will be of help to me.

Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ajay Panwar 13 hours later
Your assessment makes good sense to me. My TMT was normal. Currently only some degree of intercostal pain is with 2 Hydrocodone/APAP. I tried lying supine today as you suggested with good relief. I will continue that of course. Thank you!!
doctor
Answered by Dr. Ajay Panwar 21 minutes later
Brief Answer:
Thanks for appreciation.

Detailed Answer:
Hi XXXX,
Thanks for being in follow-up and appreciating.

Your TMT coming normal,rules out cardiac angina.Your pain improved with the maneuver I suggested indicates that it is primarily the 'intercostal muscle spasm' with possible component of anxiety.

Please try to reduce the anxiety levels with mental relaxation exercises and medicines,if needed.That should help you further.Try to stop hydrocodone to prevent opioid addiction due to chronic use.

Hope I have answered your query. If you have some follow-up questions, I shall be glad to answer else, please close the thread-rate it and write a review as your rating will be of help to me.

Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Ajay Panwar

Neurologist

Practicing since :2007

Answered : 1794 Questions

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