[20F] Experiencing back and chest discomfort with nasal congestion

Patient Description

A 20-year-old female presents with a dull back ache that worsens when lying down, particularly at night, and does not radiate. The pain is most severe in the lower back and is rated 4 out of 10 in intensity. Hot showers and lying on the side provide some relief. Additionally, the patient reports a dull chest pressure with occasional sharp pain in the left breast, present for a couple of months and rated 2 out of 10 in intensity. The patient also describes a sensation of bubbling in the rib area when lying down, which has been present for a few days and is rated 1 out of 10 in severity. Neck and shoulder aches are described as a constant dull pain, present for months, with a severity of 1-2 out of 10. Nasal congestion is noted, particularly when lying on the side, and has been present for a few days, rated 1 out of 10 in severity. There is no reported fever, chills, joint swelling, redness, warmth, coughing, or shortness of breath. The patient's symptoms do not change with deep breaths.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Musculoskeletal Pain: This is a common cause of back, neck, and chest pain, especially if the pain is worse when lying down and relieved by heat. It can be caused by poor posture, muscle strain, or stress.

    • Treatment typically involves rest, heat, over-the-counter pain relievers, and sometimes physical therapy.
  • Costochondritis: This is inflammation of the cartilage in your rib cage. It can cause chest pain and discomfort, and might be worse when lying down.

    • Treatment typically involves rest, heat, and over-the-counter pain relievers.
  • Allergies or Common Cold: Your nasal congestion could be due to allergies or a common cold, especially if you've been experiencing it for a few days.

    • Treatment typically involves rest, hydration, and over-the-counter remedies.

What you can do

  1. Try to rest and avoid activities that make your pain worse.
  2. Apply a heat pack to the painful areas.
  3. Over-the-counter pain relievers, such as ibuprofen, can help with pain and inflammation.
  4. Maintain good posture, especially when sitting for long periods.
  5. For nasal congestion, try a saline nasal spray or a humidifier.
  6. If your symptoms persist or worsen, please seek medical attention.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe chest pain
  • Trouble breathing
  • Fever
  • Unexplained weight loss
  • Pain that wakes you up at night
  • Pain that doesn't improve with rest and over-the-counter remedies

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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11 mo ago

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People Also Ask


What could be causing my back pain that worsens at night?

Your back pain that worsens at night could be due to musculoskeletal issues such as poor posture, muscle strain, or stress. Applying heat and maintaining good posture can help alleviate the pain.


Why do I feel chest pressure and occasional sharp pain in my breast?

The chest pressure and occasional sharp pain in your breast could be related to costochondritis, which is inflammation of the cartilage in your rib cage. Rest, heat, and over-the-counter pain relievers can help manage the symptoms.


What might be causing the bubbling sensation in my rib area?

The bubbling sensation in your rib area might be related to musculoskeletal issues or could be a benign sensation. If it persists or worsens, it's advisable to consult a healthcare provider.


How can I relieve nasal congestion that worsens when lying down?

Nasal congestion that worsens when lying down could be due to allergies or a common cold. Using a saline nasal spray, a humidifier, or over-the-counter remedies can help relieve the congestion.


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