[35F] Experiencing chest discomfort, migraine, and shoulder pain

Patient Description

A 35-year-old female presents with a few days of chest discomfort described as tightness and sharp pain, not significantly relieved by rest and exacerbated by walking and lying down. The patient also reports a migraine on the left side, rated 5/10 in severity, associated with nausea and exacerbated by light, lasting two days. Shoulder pain is characterized as sharp, dull, and burning, rated 5/10, and has been present for three days. A mild, dry cough coinciding with the onset of chest discomfort has also been noted. The patient has a medical history of sphincter of Oddi dysfunction diagnosed at age 28, fibromyalgia, and endometriosis diagnosed in youth. Current medications include Tylenol, ibuprofen, vitamins, and tramadol. The patient has allergies to Cipro and cephalexin. No fever above 99°F, shortness of breath, or recent injuries reported.

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Arora's Assessment

What might be happening

Based on the information provided, possible explanations for your symptoms include:

  • Musculoskeletal Pain: This is a common cause of chest, shoulder, and back pain, especially if the pain is made worse with movement or certain positions. It can be caused by strain or injury to the muscles and ligaments of the chest wall, ribs, or shoulder joint.

    • Treatment typically involves rest, heat or cold therapy, over-the-counter pain relievers, and physical therapy exercises.
  • Migraine: Migraines are a type of headache characterized by severe pain, often on one side of the head, and can be accompanied by nausea and sensitivity to light and sound.

    • Treatment options include over-the-counter pain relievers, prescription medications, and lifestyle modifications to avoid known triggers.
  • Fibromyalgia: This is a chronic condition characterized by widespread pain, fatigue, and tenderness. It can cause a variety of symptoms, including headaches, muscle pain, and abdominal discomfort.

    • Treatment typically involves a combination of medications, exercise, stress management techniques, and healthy lifestyle habits.
  • Sphincter of Oddi Dysfunction: This condition involves the muscle between the pancreas and the small intestine not opening and closing properly, which can cause abdominal pain and discomfort.

    • Treatment may involve medications, lifestyle changes, or in some cases, surgery.

Please note that these are potential explanations based on the information provided, and it's important to consult with a healthcare provider for a formal diagnosis.

What you can do

  1. Continue taking your prescribed medications as directed by your healthcare provider.
  2. Try over-the-counter pain relievers for your headache and musculoskeletal pain, but be sure not to exceed the recommended dosage.
  3. Apply a warm compress to your shoulder and back to help alleviate the pain.
  4. Rest and avoid any activities that worsen your pain.
  5. Maintain a healthy lifestyle, including regular exercise and a balanced diet, to help manage your fibromyalgia symptoms.
  6. Keep a symptom diary to track your symptoms and potential triggers, which can be helpful information for your healthcare provider.

What you should look out for

Please seek immediate medical attention if you experience:

  • Severe chest pain or pressure, especially if it's associated with shortness of breath, sweating, or nausea
  • A headache that is sudden and severe, or accompanied by fever, stiff neck, confusion, seizures, double vision, weakness, numbness, or difficulty speaking
  • Severe abdominal pain or discomfort
  • Any other symptoms that are severe or concerning to you.

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.

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11 mo ago

People Also Ask


What are common causes of chest discomfort that is not relieved by rest?

Common causes of chest discomfort not relieved by rest include musculoskeletal pain, gastroesophageal reflux disease (GERD), and less commonly, cardiac issues. It's important to consult a healthcare provider to determine the exact cause.


How can migraines be managed effectively, especially when associated with nausea and light sensitivity?

Migraines can be managed with over-the-counter pain relievers, prescription medications like triptans, and lifestyle modifications such as avoiding known triggers, maintaining a regular sleep schedule, and managing stress.


What are some effective treatments for fibromyalgia-related pain and fatigue?

Effective treatments for fibromyalgia include medications like antidepressants and anticonvulsants, regular physical exercise, stress management techniques, and maintaining a healthy lifestyle with a balanced diet.


What should I do if I have a mild, dry cough along with chest discomfort?

For a mild, dry cough with chest discomfort, staying hydrated, using a humidifier, and avoiding irritants like smoke can help. If symptoms persist or worsen, it's important to consult a healthcare provider.


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