[21F] Experiencing sharp chest and back pain

Patient Description

A 21-year-old female is experiencing sharp, pressure-like chest pain in the center of her chest, which began approximately 5 minutes prior to the encounter. The pain intensity is rated as a 6 out of 10 and is sometimes alleviated by stretching. Additionally, the patient reports a sensation akin to a pinched nerve in the center of the shoulder blades in the back, rated as a 1 out of 10 for pain severity. The patient has been recently ill with a cold and has been vaping, which may be contributing factors. There is no history of pre-existing conditions, allergies, or adverse reactions to medications, and the patient is not currently on any medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible causes for your symptoms could include:

  • Musculoskeletal Pain: This is pain that affects the muscles, ligaments and tendons, and bones. The fact that your pain seems to be affected by movement or stretching suggests this could be a possibility. This could be due to overuse, strain, or injury to the muscles, ligaments, and discs that support your spine.

    • Treatment typically involves rest, physical therapy, pain relievers, and sometimes surgery.
  • Costochondritis: This is an inflammation of the junctions where the upper ribs join with the cartilage that holds them to the breastbone, or sternum. The condition causes localized chest pain that you can reproduce by pushing on the cartilage in the front of your ribcage.

    • Treatment typically involves rest, physical therapy, and nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Pleurisy: This is an inflammation of the lining of the lungs and chest (the pleura) that leads to chest pain (usually sharp) when you take a breath or cough.

    • Treatment typically involves addressing the underlying cause of the inflammation.
  • Heart-related issues: While less likely in someone of your age and gender, certain heart conditions like pericarditis or myocarditis can also cause chest pain. These conditions involve inflammation of the heart or surrounding tissue.

    • Treatment typically involves medications and sometimes surgery.

Your recent cold and vaping could potentially contribute to your symptoms, particularly if they resulted in coughing that strained your chest muscles or caused inflammation in your lungs or airways.

What you can do

  1. Rest and avoid any activities that make your pain worse.
  2. Apply a heat pad to the painful area to help relieve pain.
  3. Over-the-counter pain relievers such as ibuprofen can help reduce pain and inflammation.
  4. Stop vaping, as it can cause lung inflammation and other health problems.

However, it's important to get your symptoms checked out by a healthcare professional, especially because chest pain can sometimes indicate serious conditions. They can provide a proper diagnosis and appropriate treatment.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe chest pain
  • Chest pain that spreads to your jaw, left arm, or back
  • Chest pain accompanied by nausea, sweating, difficulty breathing, fast heartbeat, dizziness, or fainting
  • New or worsening shortness of breath
  • A high fever or coughing up blood

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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People Also Ask


What is costochondritis and how is it treated?

Costochondritis is an inflammation of the cartilage that connects the ribs to the breastbone, causing localized chest pain. Treatment typically involves rest, physical therapy, and nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation.


Can vaping contribute to chest pain or other respiratory issues?

Yes, vaping can contribute to chest pain and other respiratory issues. It can cause lung inflammation and irritation, which may exacerbate symptoms like coughing and chest discomfort.


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

Pleurisy is characterized by sharp chest pain that worsens with breathing or coughing, due to inflammation of the lining of the lungs and chest. Treatment involves addressing the underlying cause of the inflammation, which may include medications to reduce pain and inflammation.


When should I seek immediate medical attention for chest pain?

You should seek immediate medical attention for chest pain if it is severe, spreads to your jaw, left arm, or back, or is accompanied by symptoms like nausea, sweating, difficulty breathing, fast heartbeat, dizziness, or fainting. Additionally, new or worsening shortness of breath, high fever, or coughing up blood warrant urgent medical evaluation.


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