[31M] With sharp shin pain and chest tightness

Patient Description

A 31-year-old male has been experiencing sharp, stabbing pain in his left shin for the past week. The pain occurs whether walking or lying down, comes on suddenly, and can last from a few seconds to a minute, sometimes occurring back-to-back. Pain intensity is rated as 8 out of 10. Additionally, the patient reports tightness and occasional pain in the chest, which worsens with pressure. The patient also experiences numbness and tingling in the left shin and foot, which comes and goes, but no significant weakness affecting daily activities. There is no noticeable swelling, redness, or warmth in the left shin. The patient has recently increased physical activity due to construction work. The patient notes that the hair on the shin area has gone away, making the skin appear shiny, but this is present on both legs. The patient has gained a few pounds recently and has been using tobacco for a few years, about half a pack a day. There is no history of diabetes, high blood pressure, or high cholesterol, but the patient's mother has rheumatoid arthritis. The patient has experienced shortness of breath, dizziness, and sweating along with the chest tightness and pain. No recent diagnostic tests like an EKG or chest X-ray have been performed. The patient has seasonal allergies but is not currently taking any medications.

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Arora's Assessment

What might be happening

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

Sharp Stabbing Pain in Left Shin

  • Shin Splints: This is a common condition among people who have recently increased their physical activity, especially in high-impact activities like construction work. Shin splints cause pain along the shin bone (tibia) and can be sharp and stabbing.
  • Nerve Compression or Irritation: The numbness and tingling you experience could be due to nerve compression or irritation, possibly from increased physical activity or an underlying condition.

Chest Tightness and Pain

  • Musculoskeletal Pain: Given your recent increase in physical activity, the chest pain could be related to muscle strain or inflammation in the chest wall.
  • Cardiac Issues: Although less likely given your age and lack of significant risk factors, chest pain, especially when associated with shortness of breath, dizziness, and sweating, should be evaluated to rule out heart-related issues.

Unifying Diagnoses

  • Increased Physical Activity: The recent increase in physical activity due to construction work could be contributing to both your shin pain and chest discomfort.
  • Nerve-Related Issues: The numbness and tingling in your shin, along with the pain, could suggest a nerve-related issue that might also be contributing to your symptoms.

What you can do

Sharp Stabbing Pain in Left Shin

  • Rest and Ice: Rest your leg and apply ice to the affected area for 15-20 minutes several times a day to reduce inflammation.
  • Proper Footwear: Ensure you are wearing supportive footwear, especially during physical activities.
  • Stretching and Strengthening: Gentle stretching and strengthening exercises for your lower legs can help alleviate symptoms.
  • Over-the-Counter Pain Relief: Consider taking over-the-counter pain relievers like ibuprofen (Advil) or acetaminophen (Tylenol) to manage pain.

Chest Tightness and Pain

  • Consult a Doctor: Given the combination of chest pain, tightness, shortness of breath, dizziness, and sweating, it's important to consult a healthcare provider to rule out any serious conditions.
  • Avoid Strenuous Activities: Until you have been evaluated by a healthcare provider, avoid strenuous activities that could exacerbate your symptoms.
  • Monitor Symptoms: Keep track of when the chest pain occurs, its intensity, and any associated symptoms. This information can be helpful for your healthcare provider.

General Recommendations

  • Symptom Journal: Use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.
  • Healthy Lifestyle: Maintain a healthy lifestyle with a balanced diet, regular exercise, and adequate sleep. Reducing tobacco use can also improve overall health and reduce the risk of various conditions.

What you should look out for

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

  • Severe or Worsening Chest Pain: If the chest pain becomes severe, or if you experience new or worsening shortness of breath, dizziness, or sweating, seek immediate medical attention.
  • Persistent or Worsening Shin Pain: If the pain in your shin persists or worsens despite rest and home care, consult a healthcare provider.
  • New Symptoms: If you develop new symptoms such as swelling, redness, or warmth in your shin, or if you experience significant weakness in your leg, seek medical evaluation.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment. If you have any more questions or need further assistance, feel free to continue the conversation.

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4 mo ago

People Also Ask


What could be causing the sharp, stabbing pain in my shin?

The sharp, stabbing pain in your shin could be due to shin splints, which are common when increasing physical activity, or it might be related to nerve compression or irritation.


Should I be concerned about the chest tightness and pain I'm experiencing?

While musculoskeletal pain from increased activity is a possibility, chest pain accompanied by shortness of breath, dizziness, and sweating should be evaluated by a healthcare provider to rule out cardiac issues.


What are some ways to manage shin pain at home?

To manage shin pain at home, rest your leg, apply ice, wear supportive footwear, and consider gentle stretching and strengthening exercises. Over-the-counter pain relievers like ibuprofen or acetaminophen can also help.


How can increased physical activity affect my body, and what precautions should I take?

Increased physical activity can lead to muscle strain or overuse injuries. It's important to gradually increase activity levels, use proper equipment, and listen to your body to prevent injuries. If you experience pain or discomfort, it's advisable to rest and consult a healthcare provider if symptoms persist.


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