[43F] Experiencing migraines, chest and shoulder pain, and constipation

Patient Description

A 43-year-old female presents with a history of severe migraines since childhood, which occur within minutes and can last for weeks. The migraines are described as an 8 out of 10 in severity, with pain located in the middle of the forehead and temples, and are not relieved by any measures. The patient also reports a dull, sharp, and sometimes shooting chest pain rated 6-7 out of 10 in severity, which has been occurring on and off since receiving a Covid shot in 2021. The pain radiates to the back and right shoulder. Additionally, the patient has been experiencing constipation for over a month, requiring laxatives every three days to manage, with the last bowel movement being hard and dark brown. The patient also experiences shooting pain in the right shoulder blade area without any known injury. No recent weight changes have been noted. The patient had a hysterectomy in 2018 and experiences hot flashes. There is a history of anaphylactic shock with contrast dye. The only medication currently being taken is Motrin. No other pre-existing conditions, chronic illnesses, or medication allergies are reported.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Migraine: A neurological condition that can cause multiple symptoms. It's frequently characterized by intense, debilitating headaches. Symptoms may include nausea, vomiting, difficulty speaking, numbness or tingling, and sensitivity to light and sound. Migraines often run in families and affect all ages.

    • Treatment of migraines often involves medications to help reduce the frequency and severity of migraines. Lifestyle alterations might help reduce the frequency of migraines.
  • Musculoskeletal Chest Pain: This is a common cause of chest pain, and it's often described as a sharp, shooting pain. It can be due to a strained muscle in your chest wall, which can happen suddenly, such as from an injury or heavy lifting.

    • Treatment usually involves rest and avoiding activities that make your pain worse. Over-the-counter pain relievers can also help.
  • Constipation: This is a common condition that affects people of all ages. It can mean that you're not passing stools regularly or you're unable to completely empty your bowel. Constipation can also cause your stools to be hard and lumpy, as well as unusually large or small.

    • Treatment for constipation typically involves changes to your diet and lifestyle, such as eating more high-fiber foods, drinking plenty of water, and regular physical activity. Over-the-counter or prescription medications may also be recommended.
  • Shoulder Pain: This can have many causes, including sprains, strains, and other injuries. It can also be caused by conditions like arthritis and rotator cuff disease.

    • Treatment of shoulder pain depends on the cause but can include rest, physical therapy, pain relievers, and sometimes surgery.

Please note that these are just possible diagnoses based on the information you've provided. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. For your migraines, try to identify any triggers and avoid them. Regular exercise and relaxation techniques may also help to reduce the frequency of migraines. Over-the-counter pain relievers may help, but it's important to use these under the guidance of a healthcare provider.

  2. For your chest pain, rest and avoid activities that make your pain worse. Over-the-counter pain relievers can also help, but it's important to use these under the guidance of a healthcare provider.

  3. For your constipation, try to eat more high-fiber foods, drink plenty of water, and get regular physical activity. Over-the-counter or prescription medications may also be recommended.

  4. For your shoulder pain, rest and avoid activities that make your pain worse. Physical therapy may also be helpful. Over-the-counter pain relievers can also help, but it's important to use these under the guidance of a healthcare provider.

What you should look out for

Reasons to see a doctor more urgently:

  • If your migraines become more frequent or severe
  • If your chest pain worsens or is accompanied by other symptoms such as shortness of breath, sweating, nausea, or pain radiating to your jaw, neck, or arm
  • If your constipation persists or is accompanied by other symptoms such as abdominal pain or blood in your stools
  • If your shoulder pain persists or is accompanied by other symptoms such as weakness or numbness in your arm

Please remember that while I strive to provide accurate and helpful information, I am an AI and not a substitute for professional medical advice. Always consult with a healthcare provider for an accurate diagnosis and treatment.

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1 yr ago

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People Also Ask


What are some common triggers for migraines and how can they be managed?

Common triggers for migraines include stress, certain foods and drinks, hormonal changes, and lack of sleep. Managing migraines often involves identifying and avoiding these triggers, maintaining a regular sleep schedule, staying hydrated, and using prescribed medications as needed.


What could be causing chest pain after receiving a Covid shot, and when should I be concerned?

Chest pain after a Covid shot could be due to musculoskeletal issues or inflammation. However, if the pain is severe, persistent, or accompanied by symptoms like shortness of breath or radiating pain, it is important to seek medical attention to rule out more serious conditions.


What lifestyle changes can help alleviate constipation?

To alleviate constipation, increase your intake of high-fiber foods such as fruits, vegetables, and whole grains. Drink plenty of water, engage in regular physical activity, and consider using over-the-counter laxatives if necessary, but consult a healthcare provider if symptoms persist.


What are some common causes of shoulder pain and how can it be treated?

Common causes of shoulder pain include strains, sprains, arthritis, and rotator cuff injuries. Treatment may involve rest, physical therapy, pain relievers, and in some cases, surgery. It's important to consult a healthcare provider for a proper diagnosis and treatment plan.


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