[23F] With painful armpit lumps, chronic low back pain, and headaches

Patient Description

A 23-year-old female presents with a cluster of painful lumps under the skin in her armpit, which are red but not warm or discharging. The pain is exacerbated by lifting her arm or reaching for something. She also reports feeling ill and experiencing a sensation of fever without an actual fever. Additionally, she has a swollen lymph node in her throat that makes swallowing painful. The patient has a history of throbbing low back pain on the left side that radiates into her left leg, which worsens with bending over and standing for prolonged periods. This pain has been present for over a year and is only alleviated by ibuprofen. She also experiences throbbing headaches that affect the top front of her head and extend into her eyes, with a severity ranging from 4 to 9 out of 10. These headaches have been occurring off and on throughout her life but have become more frequent in the past few months. The patient also reports sharp chest pains occurring at rest. She vapes and smokes weed daily for the past five years. She has not had a menstrual period in seven months but is not sexually active. There is no significant family history of heart disease, stroke, autoimmune diseases, diabetes, cancer, or psychiatric illnesses. No recent travel or significant changes in diet reported. No known pre-existing conditions or chronic illnesses.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

Painful Armpit Lumps

  • Infections: The redness and pain in your armpit lumps could be due to an infection, such as an abscess or infected lymph nodes.
  • Hidradenitis Suppurativa: This is a chronic skin condition that causes painful lumps under the skin, often in the armpits.
  • Lymphadenopathy: Swollen lymph nodes can be painful and are often a response to infection or inflammation.

Throbbing Low Back Pain Radiating to the Leg

  • Sciatica: This condition occurs when the sciatic nerve is compressed, often due to a herniated disc, causing pain that radiates from the lower back down the leg.
  • Lumbar Radiculopathy: Similar to sciatica, this involves nerve root compression in the lower spine, leading to radiating pain.

Nausea and Headaches

  • Migraines: Throbbing headaches that affect the front of your head and eyes, accompanied by nausea, could be migraines.
  • Tension Headaches: These can also cause throbbing pain and are often related to stress or muscle tension.

Swollen Lymph Node in Throat and Painful Swallowing

  • Pharyngitis: Inflammation of the throat, often due to viral or bacterial infections, can cause swollen lymph nodes and pain when swallowing.
  • Tonsillitis: Inflammation of the tonsils can also cause similar symptoms.

Sharp Chest Pain at Rest

  • Costochondritis: Inflammation of the cartilage that connects a rib to the breastbone can cause sharp chest pain.
  • Pleuritis: Inflammation of the tissues that line the lungs and chest cavity can cause sharp pain, especially when breathing deeply.

What you can do

Painful Armpit Lumps

  • See a Doctor: It's important to get these lumps evaluated to rule out infections or other serious conditions.
  • Warm Compress: Applying a warm compress can help reduce pain and swelling.
  • Avoid Irritants: Avoid using deodorants or shaving the area until you see a doctor.

Throbbing Low Back Pain Radiating to the Leg

  • Consult a Doctor: You may need imaging tests like an MRI to diagnose the cause of your pain.
  • Pain Management: Continue using ibuprofen as needed, but consult your doctor for long-term pain management strategies.
  • Physical Therapy: Exercises and stretches can help alleviate pain and improve mobility.

Nausea and Headaches

  • Hydration: Drink plenty of water to stay hydrated, which can help reduce headaches.
  • Rest: Ensure you get adequate rest and avoid stressors that may trigger headaches.
  • Over-the-Counter Medications: Medications like acetaminophen or ibuprofen can help manage headache pain.

Swollen Lymph Node in Throat and Painful Swallowing

  • See a Doctor: You may need a throat swab or other tests to diagnose the cause of your symptoms.
  • Hydration and Rest: Drink plenty of fluids and get adequate rest to help your body fight off any infection.

Sharp Chest Pain at Rest

  • Seek Medical Attention: Sharp chest pain should be evaluated by a healthcare provider to rule out serious conditions.
  • Avoid Strain: Avoid activities that may exacerbate the pain until you see a doctor.

What you should look out for

Given the severity and variety of your symptoms, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Fever, chills, or night sweats
  • Unexplained weight loss
  • Shortness of breath or fainting
  • Severe or worsening pain

Remember, while I can provide information and suggestions, it's crucial to consult a healthcare professional for a formal diagnosis and treatment plan. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

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4 mo ago

People Also Ask


What could be causing the painful lumps under my armpit?

The painful lumps under your armpit could be due to infections like abscesses or infected lymph nodes, a chronic skin condition called hidradenitis suppurativa, or lymphadenopathy, which is often a response to infection or inflammation.


Why do I have throbbing low back pain that radiates into my leg?

Throbbing low back pain that radiates into the leg could be caused by sciatica, which occurs when the sciatic nerve is compressed, often due to a herniated disc, or lumbar radiculopathy, which involves nerve root compression in the lower spine.


What might be the reason for my frequent headaches and nausea?

Frequent headaches and nausea could be due to migraines, which are characterized by throbbing pain affecting the front of the head and eyes, or tension headaches, which are often related to stress or muscle tension.


What should I do about the sharp chest pain I experience at rest?

Sharp chest pain at rest should be evaluated by a healthcare provider to rule out serious conditions. It could be due to costochondritis, which is inflammation of the cartilage connecting a rib to the breastbone, or pleuritis, which is inflammation of the tissues lining the lungs and chest cavity.


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