Intermittent Pain in the Center of the Clavicle: Which Specialist to Consult?

Q: Intermittent Pain in the Center of the Clavicle: Which Specialist to Consult?

Dear Miss Ping：<br>1. <br>When a clinician addresses the issue of chest pain, the first four critical conditions to rule out are myocardial infarction, pulmonary embolism, pneumothorax, and aortic dissection. <br>If none of these conditions are present, differential diagnoses sho

Intermittent sharp pain in the central area of the clavicle (depression)?

Based on the symptoms described, you should consider seeing a specialist in orthopedics or a physician specializing in musculoskeletal disorders.
They can evaluate your condition and determine the underlying cause of the intermittent sharp pain in the central area of your clavicle.

Ping, 30~39 year old female. Ask Date: 2020/11/09

Dr. Xiao Yongxun reply Family Medicine

Dear Miss Ping:
1.
When a clinician addresses the issue of chest pain, the first four critical conditions to rule out are myocardial infarction, pulmonary embolism, pneumothorax, and aortic dissection.
If none of these conditions are present, differential diagnoses should be made based on the chief complaint and symptoms, considering possibilities such as lung tumors, lung abscesses, pneumonia, tuberculosis, arrhythmias, congenital heart disease, myocardial ischemia, pericardial issues, gastroesophageal reflux disease, esophageal tumors, esophageal structural abnormalities, musculoskeletal problems, and neuropathies.
Additionally, anxiety disorders, hypochondriasis, and psychoneurosis should also be considered.
2.
The issue of occasional sharp pain in the central depression of the clavicle is less frequently mentioned in relation to chest pain.
Typically, a chest X-ray is performed for initial differential diagnosis; it is also important to determine whether it is the left or right clavicle.
3.
I recommend that you discuss and examine these issues in detail with your family physician or attending physician.
If necessary, you may directly visit the outpatient department of a regional hospital's pulmonology unit for further evaluation.

Reply Date: 2020/11/09

More Info

If you are experiencing intermittent pain in the center of your clavicle that has been worsening over the past three months, it is important to seek medical attention to determine the underlying cause of your symptoms. Given the nature of your pain and its location, there are a few specialists you might consider consulting.

1. Orthopedic Surgeon: This specialist focuses on the musculoskeletal system, which includes bones, joints, ligaments, tendons, and muscles. Since your pain is located around the clavicle, an orthopedic surgeon can assess for any potential issues related to the bones or joints in that area, such as fractures, arthritis, or other orthopedic conditions.

2. Rheumatologist: If there is a suspicion that your pain may be related to an autoimmune condition or inflammatory disease, a rheumatologist would be the appropriate specialist. They can evaluate for conditions such as rheumatoid arthritis or other systemic issues that could be causing pain in the clavicle region.

3. Neurologist: If your pain is sharp and intermittent, it could be related to nerve issues. A neurologist can evaluate for conditions such as thoracic outlet syndrome, which can cause pain due to nerve compression in the neck and shoulder area.

4. Physical Medicine and Rehabilitation (PM&R) Specialist: Also known as physiatrists, these specialists focus on rehabilitation and pain management. They can help assess your pain and develop a treatment plan that may include physical therapy, medication, or other non-surgical interventions.

5. Pain Management Specialist: If your pain is significant and affecting your quality of life, a pain management specialist can provide strategies to manage your pain effectively, including medications, injections, or other therapies.

Before making an appointment, it may be helpful to keep a detailed record of your symptoms, including when the pain occurs, its intensity, any activities that seem to trigger it, and any other associated symptoms. This information can assist the specialist in making a more accurate diagnosis.

In addition to consulting a specialist, there are some general recommendations you can follow to manage your symptoms in the meantime:
- Rest: Avoid activities that exacerbate the pain, especially heavy lifting or repetitive motions that involve the shoulders and arms.

- Ice Therapy: Applying ice to the affected area can help reduce inflammation and numb the pain.

- Over-the-Counter Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help alleviate pain and reduce inflammation.

- Posture Awareness: Maintaining good posture, especially if you spend long hours sitting or working at a desk, can help reduce strain on the clavicle and surrounding areas.

Ultimately, it is crucial to consult with a healthcare professional to obtain a proper diagnosis and treatment plan tailored to your specific condition. Ignoring persistent pain can lead to further complications, so seeking medical advice sooner rather than later is advisable.

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