Chest and Back Pain: When to Seek Medical Help

Chest pain and back pain?

Last week, I suddenly felt pain in my left chest while walking, and then the pain also extended to my upper left back.
When I inhale, I experience pain in my left chest and left back, but it is not very frequent.
The pain in my left chest occurs more frequently when I squat, and my breathing feels less smooth, requiring me to take deeper breaths.
This sudden onset of symptoms started just last week, and I have not experienced this before.
I am overweight and have slightly elevated cholesterol levels.
Is this pain due to being overweight, or could there be other factors involved? Which medical specialty should I consult?

Ru Ru, 20~29 year old female. Ask Date: 2020/07/09

Dr. Wu Zongying reply Family Medicine

There are many causes of chest pain, and it may require a physician to perform auscultation and take a chest X-ray for confirmation.
Some young individuals experience chest pain, but the X-ray may not reveal any underlying issues, which could be related to a lack of physical activity or prolonged sitting habits.
It is recommended to increase physical activity and change sedentary habits.
Wishing you good health.

Reply Date: 2020/07/09

More Info

Chest and back pain can be concerning symptoms, especially when they appear suddenly and are accompanied by difficulty breathing. Your description of left chest pain radiating to the upper back, particularly when breathing deeply or in certain positions, warrants careful evaluation. Given your history of being overweight and having slightly elevated cholesterol levels, there are several potential causes for your symptoms that need to be considered.

Firstly, it’s important to understand that chest pain can arise from a variety of sources, including musculoskeletal issues, gastrointestinal problems, and cardiac conditions. Musculoskeletal pain is often related to muscle strain or inflammation, which can occur due to poor posture, overexertion, or even stress. Given that you mentioned the pain is more pronounced when you squat or take deep breaths, it could be related to muscle strain or irritation of the intercostal muscles, which are located between the ribs.

However, it is crucial to rule out more serious conditions, particularly those related to the heart or lungs. Chest pain can sometimes indicate angina or even a heart attack, especially if it is accompanied by other symptoms such as shortness of breath, sweating, or radiating pain to the arm or jaw. Given your risk factors, including obesity and high cholesterol, it is advisable to take these symptoms seriously.

Additionally, gastrointestinal issues, such as acid reflux or gallbladder problems, can also present as chest pain. The pain may mimic cardiac pain and can be exacerbated by certain positions or activities.
Considering your symptoms and risk factors, I recommend that you seek medical attention promptly. The best course of action would be to start with a visit to your primary care physician, who can perform an initial evaluation. They may conduct a physical examination, review your medical history, and possibly order diagnostic tests such as an electrocardiogram (ECG), chest X-ray, or blood tests to assess your heart function and rule out any acute conditions.

If your primary care physician suspects a cardiac issue, they may refer you to a cardiologist for further evaluation. On the other hand, if they believe your symptoms are musculoskeletal or gastrointestinal in nature, they may refer you to an orthopedic specialist or a gastroenterologist, respectively.

In the meantime, it may be helpful to monitor your symptoms closely. Take note of when the pain occurs, its intensity, and any associated symptoms. Avoid activities that exacerbate the pain, and consider gentle stretching or over-the-counter pain relief if appropriate. However, do not delay seeking medical help, especially if the pain worsens or if you experience new symptoms such as dizziness, nausea, or severe shortness of breath.

In summary, while your symptoms could be related to musculoskeletal strain, given your risk factors and the nature of the pain, it is essential to seek medical evaluation to rule out any serious underlying conditions. Early intervention can lead to better outcomes and peace of mind.

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