[38F] Experiencing back pain and headaches with additional symptoms

Patient Description

A 38-year-old female presents with intermittent dull back pain between the shoulders, rated 4 out of 10, which is worse in the morning and exacerbated by breathing and twisting. The pain has been present for 3 weeks. The patient also reports a migraine on the right side of the head, described as aching with occasional sharp pains, rated 6 out of 10, lasting for 2 days. Additionally, the patient experiences a taste of blood in the mouth, predominantly in the morning and correlated with back pain episodes, and fatigue. The taste of blood has been occurring on and off for the same duration as the back pain. The patient's medical history includes breast cancer diagnosed 4 years ago, and IBS and reflux diagnosed 9 years ago. The patient has allergies to sulfites and sulfa and is currently taking Imodium and Gaviscon for symptom management. No recent injuries or other medications were reported.

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Arora's Assessment

What might be happening

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

  • Musculoskeletal Strain: This is a common cause of back pain, especially in the upper back between the shoulders. This can be caused by poor posture, overuse, or physical strain. The pain is often described as dull and can be exacerbated by movement and deep breathing.

    • Treatment typically involves rest, physical therapy, and over-the-counter pain relievers.
  • Tension Headache: This is a common type of headache that can cause a dull, aching sensation all over your head. It's often described as feeling like a tight band around your forehead or at the back of your head. It's often related to stress, anxiety, or muscle strain.

    • Treatment typically involves over-the-counter pain relievers, stress management, and relaxation techniques.
  • Gastroesophageal Reflux Disease (GERD): This is a digestive disorder that occurs when acidic stomach juices, or food and fluids back up from the stomach into the esophagus. This can cause a bitter or acidic taste in the mouth, especially upon waking. It can also cause discomfort or pain in the chest area, which could potentially be felt in the back.

    • Treatment typically involves lifestyle changes, such as avoiding trigger foods, and over-the-counter or prescription medications to reduce stomach acid.
  • Fatigue: This can be related to a number of factors, including physical exertion, lack of sleep, stress, or an underlying medical condition.

    • Treatment depends on the underlying cause and can include lifestyle changes and addressing any potential medical issues.

Please note that these are potential explanations and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Rest and avoid activities that exacerbate your back pain.
  2. Over-the-counter pain relievers, such as ibuprofen, can help with both your back pain and headache.
  3. Try to maintain good posture, especially if you're working at a desk or frequently lifting heavy objects.
  4. For your GERD symptoms, avoid eating within 2-3 hours of bedtime, raise the head of your bed, and avoid foods that trigger your symptoms.
  5. Regular exercise can help with both musculoskeletal back pain and tension headaches.
  6. If you're feeling stressed or anxious, relaxation techniques such as deep breathing, yoga, or meditation may be beneficial.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe pain or pain that doesn't improve with rest and over-the-counter pain relievers.
  • Difficulty breathing or shortness of breath.
  • Chest pain or pressure.
  • Blood in your stool or vomit.
  • Unexplained weight loss or loss of appetite.
  • Symptoms of a severe headache such as sudden onset, very severe pain, changes in vision, difficulty speaking, or weakness on one side of your body.

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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11 mo ago

People Also Ask


What could be causing the dull back pain between the shoulders?

The dull back pain between the shoulders could be caused by musculoskeletal strain, which is often due to poor posture, overuse, or physical strain. It can be exacerbated by movement and deep breathing.


How can I manage a tension headache at home?

To manage a tension headache at home, you can use over-the-counter pain relievers, practice stress management techniques, and engage in relaxation exercises such as deep breathing or yoga.


What lifestyle changes can help alleviate GERD symptoms?

To alleviate GERD symptoms, avoid eating within 2-3 hours of bedtime, raise the head of your bed, and avoid foods that trigger your symptoms. Lifestyle changes such as maintaining a healthy weight and avoiding smoking can also help.


When should I seek medical attention for my symptoms?

Seek medical attention if you experience severe pain, difficulty breathing, chest pain, blood in your stool or vomit, unexplained weight loss, or symptoms of a severe headache such as sudden onset, very severe pain, or changes in vision.


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