[21F] Experiencing chronic right shoulder and rib pain with sharp chest sensations

Patient Description

A 21-year-old female has been enduring chronic pain under her right shoulder blade and right rib area, with sharp chest sensations when raising her arm. The pain, rated 7/10 in severity, has persisted for 3 years and is described as mostly dull but can become sharp with sudden movements or deep breathing. The pain exacerbates during work, especially when standing for extended periods. The patient has a history of asthma diagnosed at age 5 and is currently using an albuterol inhaler. She has allergies to penicillins and animals. No recent injuries, swelling, redness, fever, cough, or difficulty breathing have been reported. No other medications are being taken.

Arora's Assessment

What might be happening

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

Musculoskeletal Strain: This is a common cause of pain in the back and ribs, especially with movements like raising your arm. It can result from overuse, poor posture, or an injury. In your case, your history of playing softball and having scapular tendencies could have contributed to this.
- Treatment usually involves rest, pain relief with over-the-counter medications like ibuprofen or acetaminophen, and physical therapy exercises to strengthen the affected muscles and prevent future strains.
Costochondritis: This is inflammation of the cartilage in your rib cage. It usually occurs after heavy lifting or strenuous exercise, and can cause pain in your chest that may spread to your back or abdomen.
- Treatment typically involves rest, avoiding activities that make your pain worse, and over-the-counter pain relievers.
Gallbladder Disease: The gallbladder is located under the right rib cage, and conditions affecting it can cause pain in this area. This pain can also spread to the right shoulder or back.
- Treatment depends on the specific gallbladder condition and may include dietary changes, medications, or surgery.

Please note that these are possible explanations for your symptoms based on the information you've provided, and not a definitive diagnosis. You should consult with a healthcare professional who can evaluate you in person and provide a formal diagnosis.

What you can do

In the meantime, here are some general suggestions that may help:

Rest and avoid activities that make your pain worse.
Over-the-counter pain relievers like ibuprofen or acetaminophen may help relieve your pain. Be sure to follow the package instructions.
Apply a warm compress to the painful area for 15-20 minutes at a time, several times a day.
If your pain is related to muscle strain, gentle stretching and strengthening exercises may help. A physical therapist can provide you with specific exercises based on your condition.