Unexplained Muscle Pain: When to Seek Medical Advice

Unexplained pain or discomfort?

Hello, Doctor.
Recently, I've been experiencing a sensation of soreness in my body, somewhat similar to the muscle aches associated with a cold or fever, but not quite the same (I feel fine and do not have a fever).
The discomfort most frequently occurs in the chest area, back, and sides, followed by my arms, neck, while my legs and toe joints are less affected.
Each episode lasts about a few seconds to just over ten seconds, and I feel a patchy sensation that makes me want to press on it, but it’s not intensely uncomfortable and goes away quickly.
This pain does not worsen or become more frequent with exercise.
My current health status includes: cough variant asthma, unstable blood sugar levels (I have a BMI of 32, and my parents have type 2 diabetes), and slightly enlarged spleen (but all blood cell counts are normal).
I would like to ask you: 1.
Which specialty should I consult for this symptom? What kind of examination would be appropriate? 2.
Could this be angina? What does angina-related chest pain and shoulder/neck pain typically feel like? 3.
Is it possible that a lung tumor could be pressing on nerves? Thank you!

KKK, 20~29 year old female. Ask Date: 2016/06/25

Dr. Gao Chunde reply Neurology

From a neurology perspective, issues related to the spinal cord from the cervical to thoracic region should be considered.
It is advisable to refer the patient to a neurologist for a detailed history and physical examination.
If there is evidence, further imaging studies or laboratory tests will be arranged.
While angina or lung tumors cannot be completely ruled out, they are relatively less likely.

Reply Date: 2016/06/25

More Info

When experiencing unexplained muscle pain, especially in the context of your symptoms, it's essential to approach the situation methodically. Your description of the pain—localized primarily in the chest, back, arms, neck, and occasionally in the legs and toes—suggests a few potential underlying issues that warrant further investigation.

1. Which Specialist to See and Appropriate Tests: Given the nature of your symptoms, it would be prudent to consult a primary care physician first. They can perform an initial evaluation and determine if a referral to a specialist is necessary. Depending on the findings, you may be referred to a rheumatologist (for potential inflammatory conditions), a neurologist (to assess for nerve-related issues), or a pulmonologist (given your history of asthma and respiratory symptoms).
For diagnostic tests, a complete blood count (CBC) and metabolic panel can help rule out systemic issues. An electrocardiogram (ECG) may be warranted to assess heart function, especially if there are concerns about cardiac-related symptoms. Imaging studies, such as a chest X-ray or CT scan, could be useful if there is suspicion of lung involvement or structural abnormalities.

2. Is It Angina?: Angina, or chest pain due to reduced blood flow to the heart, typically presents as a feeling of pressure, squeezing, or fullness in the chest. It may radiate to the arms, neck, jaw, or back and is often triggered by physical exertion or emotional stress. The pain usually lasts for a few minutes and is relieved by rest or nitroglycerin. Your symptoms, which are brief and not exacerbated by activity, seem less characteristic of angina. However, given your risk factors (such as a family history of type 2 diabetes and your BMI), it’s crucial to rule out any cardiac issues.

3. Could It Be Lung Tumors Pressing on Nerves?: While it is theoretically possible for lung tumors to cause pain by pressing on surrounding structures, this scenario is less common, especially in the absence of other symptoms such as significant weight loss, persistent cough, or hemoptysis (coughing up blood). Your history of asthma and the nature of your pain suggest that it may be more related to muscular or neurological factors rather than a malignancy. However, if there are concerns about lung involvement, imaging studies would be essential to evaluate this possibility.

In summary, while your symptoms may not immediately suggest a serious condition, they warrant a thorough evaluation to rule out any underlying issues. It’s essential to communicate all your symptoms clearly to your healthcare provider, including the duration, intensity, and any associated factors. Early intervention can lead to better management and outcomes, so don’t hesitate to seek medical advice.

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