[45F] Experiencing musculoskeletal pain and psychological changes

Patient Description

A 45-year-old female presents with pain in the shoulders and arms, a knot on the upper back on the right side, and muscles that appear enlarged or are protruding. She also reports having circular bruising in the affected areas. Additionally, the patient describes a recent change in mood, characterized by a short temper and a lack of patience.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible conditions include:

  • Musculoskeletal Strain: Overuse, heavy lifting, or awkward movements can strain the muscles in your back and arms, causing pain and muscle protrusion. The knot you're feeling could be a muscle spasm or a trigger point.

    • Treatment usually involves rest, ice, and over-the-counter pain relievers. Physical therapy and massage can also be helpful.
  • Fibromyalgia: This is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. It can also cause mood changes such as irritability.

    • Treatment often involves a combination of medications, exercise, stress-management measures, and healthy lifestyle habits.
  • Hematoma: A collection of blood outside of a blood vessel that can cause a lump and discoloration (bruising). This can occur due to injury or trauma to that area.

    • Small hematomas can be treated with rest, ice, compression, and elevation. Larger ones may require medical intervention.
  • Mood Disorders: Conditions like depression or anxiety can cause irritability and impatience. These conditions can also cause physical symptoms like muscle tension and pain.

    • Treatment often involves a combination of medication and psychotherapy.

Please note, this is not an exhaustive list and other conditions may also cause your symptoms. It's important to consult with a healthcare provider for a formal diagnosis.

What you can do

  1. Try to rest and avoid activities that worsen your pain.
  2. Apply ice to the painful areas for 15 minutes at a time to help reduce inflammation.
  3. Over-the-counter pain relievers, such as ibuprofen, can help with pain and inflammation.
  4. Gentle stretching and relaxation exercises can help relieve tension in your muscles.
  5. If you're feeling stressed or overwhelmed, techniques like deep breathing, meditation, or yoga may be helpful.

What you should look out for

Please seek immediate medical attention if you experience:

  • Severe pain or swelling
  • Difficulty moving your arms or shoulders
  • Numbness or tingling in your arms or hands
  • Symptoms of a mood disorder, such as persistent feelings of sadness, loss of interest in activities you once enjoyed, or thoughts of suicide.

Remember, I'm an AI and this advice is not a substitute for professional medical advice. Always consult with a healthcare provider for a formal diagnosis.

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11 mo ago

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People Also Ask


What could be causing the knot and pain in my upper back and shoulders?

The knot and pain in your upper back and shoulders could be due to musculoskeletal strain, which might result from overuse, heavy lifting, or awkward movements. It could also be a muscle spasm or a trigger point.


Why do I have circular bruising in the areas where I feel pain?

Circular bruising in the affected areas could be due to a hematoma, which is a collection of blood outside of a blood vessel, often caused by injury or trauma to that area.


Can mood changes like irritability be related to physical symptoms?

Yes, mood changes such as irritability can be related to physical symptoms. Conditions like fibromyalgia or mood disorders can cause both mood changes and physical symptoms like muscle tension and pain.


What are some effective treatments for musculoskeletal strain?

Effective treatments for musculoskeletal strain include rest, applying ice to reduce inflammation, over-the-counter pain relievers, physical therapy, and massage. Gentle stretching and relaxation exercises can also help relieve tension.


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