[25F] Experiencing chest and back pain after starting buspirone

Patient Description

A 25-year-old female has been experiencing chest pain that is located in the middle of the chest but leans more towards the right side. The pain feels like an ache and occurs on and off every day for the past week or two. It sometimes starts in the back as a burning pain between the shoulder blades and then radiates into the chest. The chest pain is rated as a 5-6 on a scale of 1-10. Laying down exacerbates the back pain, and no positions or activities have been found to relieve it. The patient recently started taking buspirone and began a new job, but no specific patterns or triggers related to the job have been identified. The patient did not have these symptoms before starting buspirone and has not discussed them with the prescribing healthcare provider. This is the first time the patient is noticing something unusual. There have been no recent injuries or physical strain, and the patient has no pre-existing conditions, chronic illnesses, or allergies. Current medications include buspirone 5mg 2-3 times daily, bupropion 200mg once daily, and ibuprofen as needed.

Arora's Assessment

What might be happening

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

Musculoskeletal Pain: The chest and back pain you describe could be related to muscle strain or tension, especially since it worsens when lying down. This type of pain can sometimes be mistaken for more serious conditions but is often due to posture or physical activity.
- Treatment typically involves rest, over-the-counter pain relievers like ibuprofen, and applying heat or cold to the affected area.
Gastroesophageal Reflux Disease (GERD): Sometimes, chest pain can be related to acid reflux, where stomach acid irritates the esophagus. This can cause a burning sensation that might radiate to the back.
- Treatment includes dietary changes, avoiding triggers like spicy foods, and possibly using antacids or other medications.
Side Effects of Medication: Since you started experiencing these symptoms after beginning buspirone, it's possible that the medication could be contributing to your discomfort. Chest pain is a less common side effect but should be discussed with your healthcare provider.
- Your doctor may adjust your dosage or suggest an alternative medication.

What you can do

While it's important to consult with a healthcare professional for a formal diagnosis, here are some steps you can take in the meantime:

Monitor Your Symptoms: Keep a journal of when your pain occurs, its intensity, and any potential triggers. This information can be valuable for your healthcare provider.
Try Relaxation Techniques: Since you mentioned anxiety, consider practicing deep breathing exercises, meditation, or yoga to help manage stress and potentially reduce muscle tension.
Adjust Your Position: Experiment with different sleeping positions or use supportive pillows to see if this alleviates your pain.
Use MDandMe: Utilize the MDandMe app to track your symptoms, medication, and any changes you notice. This can help you and your healthcare provider make informed decisions about your care.

What you should look out for

Seek medical attention if you experience any of the following:

Severe or worsening chest pain
Shortness of breath or difficulty breathing
Pain that radiates to your jaw, neck, or arm
Dizziness, lightheadedness, or fainting

These could be signs of a more serious condition that requires immediate medical evaluation. Remember, it's always best to consult with a healthcare professional for a thorough assessment and appropriate treatment.

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2 mo ago

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