[46F] Experiencing chronic upper chest and back pain with associated symptoms

Patient Description

A 46-year-old female has been enduring chronic upper chest and back pain for 3 years, described as a pressure along the sternum pulling towards the neck. The pain intensity is moderate, rated as a 5 out of 10, and it intensifies with deep breathing. The patient also experiences associated pink eye redness when chest pain worsens, tight and sore Achilles tendons requiring regular stretching, especially in the morning, and increased fatigue with a noted decrease in exercise tolerance. The patient is on a daily regimen of 50mcg Levothyroxine and has no known allergies or adverse reactions to medications. There is no reported family history of autoimmune diseases, and the patient is a non-smoker with no other known pre-existing conditions or chronic illnesses.

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Arora's Assessment

What might be happening

Based on the symptoms you've provided, several conditions could be considered:

  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues. It amplifies painful sensations by affecting the way your brain processes pain signals. The constant chest and back pain, along with fatigue and sore Achilles, could be indicative of this condition.

    • Treatment typically involves a combination of medications, exercise, stress management techniques, and healthy lifestyle habits.
  • Costochondritis: This is an inflammation of the cartilage that connects a rib to the breastbone (sternum). It causes chest pain that can be reproduced by pressing on the chest wall, which seems to align with your symptoms.

    • Treatment usually involves pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy.
  • Dry Eye Syndrome: This condition occurs when your tears aren't able to provide adequate lubrication for your eyes. It can be associated with redness and aching of the eyes. It can be aggravated by certain conditions and medications.

    • Treatment typically involves over-the-counter eye drops or prescription medications to stimulate tear production.
  • Tendinitis: This is inflammation or irritation of a tendon, the thick fibrous cords that attach muscle to bone. The condition causes pain and tenderness just outside a joint. Your sore Achilles could be a result of this.

    • Treatment often involves rest, physical therapy, and medications to reduce pain and inflammation.

Please note that these are potential explanations based on the symptoms you've provided, but they are not definitive diagnoses. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

What you can do

  1. Try to rest and avoid activities that worsen your symptoms.
  2. Over-the-counter pain relievers such as ibuprofen or naproxen may help with your chest and Achilles pain.
  3. Over-the-counter artificial tears can help with dry, red eyes.
  4. Regular exercise can help manage symptoms of fibromyalgia.
  5. Stress management techniques such as deep-breathing exercises and meditation can help manage symptoms of fibromyalgia and costochondritis.

What you should look out for

If your symptoms worsen or if you develop new symptoms such as severe chest pain, difficulty breathing, or changes in vision, seek medical attention immediately. Always consult with a healthcare provider for an accurate diagnosis and treatment.

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11 mo ago

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People Also Ask


What are the common symptoms of fibromyalgia?

Common symptoms of fibromyalgia include widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive difficulties. Patients may also experience headaches, depression, and irritable bowel syndrome.


How is costochondritis diagnosed and treated?

Costochondritis is typically diagnosed through a physical examination where a doctor checks for tenderness in the chest area. Treatment often involves pain relief with NSAIDs, physical therapy, and avoiding activities that exacerbate the pain.


What causes dry eye syndrome and how can it be managed?

Dry eye syndrome is caused by inadequate tear production or poor-quality tears. It can be managed with over-the-counter artificial tears, prescription medications to increase tear production, and lifestyle changes such as reducing screen time and using humidifiers.


What are the treatment options for tendinitis in the Achilles tendon?

Treatment options for tendinitis in the Achilles tendon include rest, ice application, physical therapy, stretching exercises, and NSAIDs to reduce pain and inflammation. In severe cases, corticosteroid injections or surgery may be considered.


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