[48F] Experiencing chest tightness and constant back pain

Patient Description

A 48-year-old female reports waking up with chest tightness described as a band around the chest and a dull, constant pain in the center of the back, rated 5 out of 10 in severity. The pain started suddenly this morning, and the patient also experienced shortness of breath for about a minute upon waking, which has since resolved. The patient has no known pre-existing conditions, allergies, or adverse reactions to medications, and is not currently on any medications.

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Arora's Assessment

What might be happening

Based on the information you provided, the following conditions might be causing your symptoms:

  • Musculoskeletal pain: This is a common cause of back pain and can occur due to poor posture, strain, or injury. However, it usually doesn't cause chest tightness or shortness of breath.

    • Treatment typically involves rest, pain relief medication, and physical therapy.
  • Gastroesophageal reflux disease (GERD): This condition occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus, causing symptoms like chest pain and discomfort.

    • Treatment typically involves lifestyle changes and over-the-counter medications.
  • Panic disorder or anxiety: These conditions can cause symptoms like chest tightness, shortness of breath, and a feeling of impending doom. However, they usually don't cause back pain.

    • Treatment typically involves psychotherapy and medications.
  • Heart conditions: Certain heart conditions like angina or a heart attack can cause symptoms like chest tightness and shortness of breath. However, these conditions usually cause severe symptoms and are considered medical emergencies.

    • Treatment typically involves medications, lifestyle changes, and in some cases, surgery.

Please note that this is not an exhaustive list of all possible conditions that could be causing your symptoms. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

Here are some general suggestions based on your symptoms:

  1. Rest and avoid any strenuous activities until you've consulted with a healthcare provider.
  2. Over-the-counter pain relief medication may help to alleviate your back pain.
  3. If your symptoms are caused by GERD, lifestyle changes like avoiding spicy foods, not eating before bed, and maintaining a healthy weight may help.
  4. If your symptoms are caused by anxiety, relaxation techniques like deep breathing, meditation, and yoga may help.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe chest pain
  • Shortness of breath
  • Pain radiating to your arm, shoulder, jaw, or back
  • Nausea, vomiting, or sweating
  • Dizziness or fainting

These could be signs of a serious heart condition and require immediate medical attention.

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1 yr ago

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People Also Ask


What are the common causes of chest tightness and back pain?

Common causes of chest tightness and back pain include musculoskeletal issues, gastroesophageal reflux disease (GERD), anxiety or panic disorders, and heart conditions. Each has distinct characteristics, and a healthcare provider can help determine the exact cause.


How can I differentiate between heart-related chest pain and other causes?

Heart-related chest pain often presents as severe, with symptoms like pain radiating to the arm, shoulder, jaw, or back, along with nausea, sweating, or dizziness. Non-heart-related causes might not have these additional symptoms. It's important to seek medical evaluation to differentiate them.


What lifestyle changes can help manage symptoms of GERD?

To manage GERD symptoms, consider lifestyle changes such as avoiding spicy and fatty foods, not eating close to bedtime, maintaining a healthy weight, and elevating the head of your bed. These changes can help reduce acid reflux and its associated symptoms.


When should I seek immediate medical attention for chest pain?

Seek immediate medical attention if you experience severe chest pain, shortness of breath, pain radiating to your arm, shoulder, jaw, or back, nausea, vomiting, sweating, dizziness, or fainting. These could be signs of a serious heart condition.


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2 Comments


Leo#3962

1 yr ago

Med student here. The back pain radiating to your chest in a band sounds most consistent with a musculoskeletal injury. Not sure if you have had any recently? Lifting weights at the gym or twisting your body could count. Try pressing on your ribs and back areas and see if any hurt a lot (this helps localize the origin of the pain to something relatively superficial as opposed to an internal organ). I think you'll likely get better with rest, but be sure to get a checkup if your symptoms worsen or keep happening for no reason.

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William (MDandMe Team)#4027

1 yr ago

Thanks! I did go to pilates a few days ago, so that might have done it. I feel this tender spot near my spine so I think what you're saying could make sense

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