[20F] Experiencing chest and lower back pain

Patient Description

A 20-year-old female has been experiencing sharp chest pain in the middle of the chest when breathing or stretching, rated as 5/10 in severity, for the past 24 hours. The pain is alleviated somewhat by sitting up straight. Additionally, the patient reports dull lower back pain, rated as 3/10 in severity, which is not influenced by the time of day but is exacerbated by bending down or turning. The patient has a medical history of fatty liver and is currently using Nexplanon as a contraceptive. She is also taking Wellbutrin XL 150mg daily for mental health. There is no reported family history of clotting disorders or pulmonary embolism, and the patient has no known drug allergies. No recent injuries, fever, cough, or radiating pain have been noted.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be causing your symptoms:

  • Costochondritis: This is an inflammation of the cartilage in your rib cage. The condition usually affects the cartilage where the upper ribs attach to the breastbone, or sternum, an area known as the costosternal joint. Costochondritis causes chest pain that can be reproduced by pressing on the area, and can worsen with deep breathing or physical activity.

    • Treatment typically involves rest, avoiding strenuous activities, and over-the-counter pain relievers such as ibuprofen or naproxen.

  • Musculoskeletal strain: This can occur due to poor posture, lifting heavy objects, or other physical activities. This condition can cause chest and back pain, which can worsen with movement or deep breathing.

    • Treatment usually involves rest, heat or cold therapy, over-the-counter pain relievers, and physical therapy exercises.

  • Pleurisy: This is an inflammation of the lining of the lungs and chest (the pleura) that leads to chest pain when you take a breath or cough.

    • Treatment of pleurisy involves addressing the underlying cause, such as a viral or bacterial infection, and may involve antibiotics, anti-inflammatory drugs, and rest.

Remember, it's important to get a proper diagnosis from a healthcare professional. These are just possible causes based on the symptoms you've described.

What you can do

  1. Rest and avoid any strenuous activities that may worsen your pain.
  2. Over-the-counter pain relievers such as ibuprofen or naproxen may help alleviate your pain.
  3. Applying a warm compress to the painful areas may also provide some relief.
  4. Maintain good posture to avoid putting strain on your chest and back muscles.

What you should look out for

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

  • Severe chest pain
  • Chest pain that radiates to your jaw, left arm, or back
  • Shortness of breath
  • Sweating
  • Nausea
  • Dizziness or fainting

These could be signs of a more serious condition, such as a heart attack. Remember, it's always better to be safe and get checked out if you're experiencing chest pain.

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9 mo ago

People Also Ask

What is costochondritis and how is it treated?

Costochondritis is an inflammation of the cartilage in the rib cage, often where the ribs attach to the breastbone. It causes chest pain that can worsen with deep breathing or physical activity. Treatment typically involves rest, avoiding strenuous activities, and using over-the-counter pain relievers like ibuprofen or naproxen.

Can musculoskeletal strain cause both chest and back pain?

Yes, musculoskeletal strain can cause both chest and back pain. This can occur due to poor posture, lifting heavy objects, or other physical activities. The pain can worsen with movement or deep breathing. Treatment usually involves rest, heat or cold therapy, over-the-counter pain relievers, and physical therapy exercises.

What are the symptoms of pleurisy and how is it treated?

Pleurisy is an inflammation of the lining of the lungs and chest, leading to chest pain when breathing or coughing. Treatment involves addressing the underlying cause, such as a viral or bacterial infection, and may include antibiotics, anti-inflammatory drugs, and rest.

When should I seek immediate medical attention for chest pain?

You should seek immediate medical attention if you experience severe chest pain, chest pain that radiates to your jaw, left arm, or back, shortness of breath, sweating, nausea, dizziness, or fainting, as these could be signs of a more serious condition like a heart attack.

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