[55F] Experiencing dull back pain radiating to chest with associated symptoms

Patient Description

A 55-year-old female presents with a dull back pain between the shoulder blades radiating to the chest, specifically the breastbone area. The pain has been described as a constant dull ache/pressure, rated as 2 on the pain scale, and is most severe upon waking in the morning. The patient also reports associated symptoms including fatigue, a sensation of 'heavy' legs with muscle and joint aches that improve with movement, loss of appetite beginning yesterday, and an inability to get warm. These symptoms have been present for approximately 3 days. The patient denies any recent injuries, shortness of breath, severe chest pain, heartburn, or difficulty swallowing. There is no significant change in weight.

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Arora's Assessment

What might be happening

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

  • Musculoskeletal Pain: This is pain that affects the muscles, ligaments and tendons, and bones. The pain can be localized in your back and radiate to your chest. It is often associated with overuse or strain, but can also occur without a clear cause.

    • Treatment typically involves rest, physical therapy, and over-the-counter pain relievers.
  • 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. GERD can cause a burning sensation in the chest (heartburn), as well as other symptoms like loss of appetite.

    • Treatment typically involves lifestyle changes and over-the-counter medications. Prescription medications and surgery are also options for more severe cases.
  • Anxiety: This is a mental health disorder characterized by feelings of worry, anxiety, or fear that are strong enough to interfere with one's daily activities. Symptoms can include fatigue, loss of appetite, and muscle tension, which could explain your back pain.

    • Treatment typically involves psychotherapy (counseling), medications, or both.
  • Heart Disease: While less likely given your description of the pain, in some cases, heart disease can present as back pain that radiates to the chest. Other symptoms can include fatigue and loss of appetite.

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

Please note that this is not a comprehensive list and other conditions could also be causing your symptoms.

What you can do

It's important to consult a healthcare provider for an accurate diagnosis. They may order tests or refer you to a specialist based on your symptoms. In the meantime, here are some things you can do:

  1. Rest and avoid strenuous activities that may exacerbate your back pain.
  2. Over-the-counter pain relievers may help alleviate your back pain. Always follow the instructions on the label and consult a healthcare provider if you have any questions.
  3. Pay attention to your diet and try to eat small, balanced meals even if you're not feeling hungry. This can help maintain your energy levels.
  4. Practice relaxation techniques, such as deep breathing, meditation, or yoga, to help manage potential anxiety.

What you should look out for

If you experience any of the following symptoms, seek immediate medical attention:

  • Severe chest pain or pressure, especially if it radiates to your arm, jaw, or back
  • Shortness of breath or difficulty breathing
  • Sudden, severe headache
  • Fainting or loss of consciousness
  • Sudden, severe abdominal pain

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

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11 mo ago

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People Also Ask


What are common causes of dull back pain that radiates to the chest?

Common causes of dull back pain that radiates to the chest include musculoskeletal issues, such as muscle strain or tension, and less commonly, conditions like heart disease or GERD. It's important to consult a healthcare provider for an accurate diagnosis.


How can musculoskeletal pain be managed at home?

Musculoskeletal pain can often be managed at home with rest, avoiding activities that worsen the pain, using over-the-counter pain relievers, and applying heat or cold packs to the affected area. Gentle stretching and physical therapy exercises may also help.


What lifestyle changes can help manage GERD symptoms?

Lifestyle changes to manage GERD symptoms include eating smaller meals, avoiding foods and drinks that trigger symptoms (such as spicy foods, caffeine, and alcohol), not lying down immediately after eating, and maintaining a healthy weight. Elevating the head of the bed can also help reduce nighttime symptoms.


When should I be concerned about back pain and seek immediate medical attention?

You should seek immediate medical attention if you experience severe chest pain or pressure, especially if it radiates to your arm, jaw, or back, shortness of breath, sudden severe headache, fainting, or sudden severe abdominal pain, as these could be signs of a more serious condition.


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