Sudden Chest and Back Pain: When to Seek Medical Help

Pain in the chest, back, and sides while breathing?

I do not have symptoms of a cold, fever, or runny nose, but I smoke.
Two nights ago, I suddenly experienced sharp pain on the sides of my chest and back while lying down.
The next day, I felt mild pain in my right chest and back when breathing, and it hurt to turn.
Deep breathing caused more pain, and by the evening, deep breaths made me want to cough.
What could be wrong with me? Which department should I see?

Ying, 30~39 year old female. Ask Date: 2020/03/08

Dr. Chen Junwei reply Pulmonology

It is recommended to further arrange a chest X-ray examination at the thoracic medicine outpatient clinic.
Thank you.

Reply Date: 2020/03/08

More Info

Sudden chest and back pain can be alarming and may indicate a variety of underlying conditions, some of which can be serious. Given your description of the pain being sudden, localized to the right side of your chest and back, and exacerbated by deep breathing and movement, it is essential to approach this situation with caution.

Firstly, the symptoms you are experiencing could be related to musculoskeletal issues, such as a muscle strain or rib dysfunction. These types of pain often occur after physical activity or can be related to poor posture, especially if you have been sitting or lying in an awkward position. However, the fact that the pain is severe enough to cause discomfort during deep breaths and movement raises the possibility of other conditions that need to be ruled out.

One potential concern is pleuritic pain, which occurs when the pleura (the lining around the lungs) becomes inflamed, often due to conditions such as pneumonia or pleurisy. Given your history of smoking, it is also important to consider the risk of lung-related issues, including pulmonary embolism or even a pneumothorax (collapsed lung), especially if you have any risk factors such as a history of blood clots or recent long periods of immobility.

Another possibility is that the pain could be related to gastrointestinal issues, such as acid reflux or esophageal spasms, which can sometimes present as chest pain and may radiate to the back. However, the acute nature of your symptoms makes this less likely.

Given the range of potential causes, it is crucial to seek medical attention promptly. You should consider visiting an emergency department or an urgent care facility, especially since your symptoms are severe and have not improved. When you arrive, inform the healthcare providers about your symptoms, including the onset, nature, and any associated factors such as smoking history. They may perform a physical examination and order diagnostic tests, such as a chest X-ray, EKG, or blood tests, to rule out serious conditions.

In terms of which specialty to consult, starting with a primary care physician or an emergency medicine doctor would be appropriate. They can evaluate your symptoms and determine if a referral to a specialist, such as a pulmonologist or cardiologist, is necessary based on their findings.

In summary, sudden chest and back pain warrants immediate medical evaluation, especially given the potential for serious underlying conditions. Do not hesitate to seek help, as timely intervention can be crucial in addressing any serious health issues. Remember, your health is paramount, and it is always better to err on the side of caution when it comes to symptoms like these.

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