Left Chest and Upper Back Pain: When to Seek Medical Help

Pain in the lower left chest and upper back?

Hello Doctor: Around February 20th of this year, I started experiencing cold symptoms, including a runny nose and a persistent cough that has become quite severe and continues to this day.
I recently visited a traditional Chinese medicine practitioner, and while there has been some improvement in my cough, I am still not fully recovered.
About two to three weeks ago, I began to feel pain and discomfort in the area below my left rib cage, which later extended to the left side of my back.
A few days ago, I noticed that when I touched the lower edge of my left rib cage and the corresponding area on the right side, the left side was swollen and more painful when I coughed.
Approximately two days ago, I started experiencing pain and discomfort in my upper back, which feels like a stiff neck or poor blood circulation, especially noticeable when I lie flat at night, making it difficult to sleep.

1.
I would like to ask which specialty I should consult for this condition.
I have an appointment with a pulmonologist, but I'm unsure if that is the correct specialty or if I should see a thoracic surgeon instead.

2.
Additionally, what could be the possible issues related to these symptoms, and how should I manage them?
3.
I have already seen a pulmonologist once, but the doctor was unable to answer my questions.
I had an X-ray and blood tests, but the results will take two weeks to come back.
Is there any immediate danger associated with my condition? Thank you, Doctor.

Ting, 30~39 year old female. Ask Date: 2023/03/27

Dr. Liao Yaopan reply Family Medicine

Hello, based on your description, if the symptoms persist or change, it is advisable to return to the original treating physician for further evaluation.
It is also appropriate to have a specialist in pulmonary medicine assess for any specific underlying causes.
If necessary, referrals to other specialties can be made based on the situation.
Please note that online consultations are not equivalent to in-person medical visits and cannot provide diagnoses or treatment recommendations.
Changhua Hospital cares about your well-being.

Reply Date: 2023/03/27

More Info

When experiencing persistent pain in the left chest and upper back, especially following a prolonged cough, it is essential to approach the situation with caution. Your symptoms, which include pain in the left chest area that radiates to the back and worsens with coughing, could be indicative of several underlying conditions.
1. Which Specialist to See: Given your symptoms, it would be appropriate to consult a pulmonologist (lung specialist) or a primary care physician initially. They can evaluate your respiratory health and determine if your symptoms are related to a respiratory infection, such as pneumonia or bronchitis, which can cause chest pain and discomfort. If your symptoms suggest a more serious condition, they may refer you to a cardiologist or a thoracic surgeon if necessary.

2. Possible Causes of Your Symptoms: The pain you are experiencing could be due to several factors:
- Musculoskeletal Issues: Prolonged coughing can lead to muscle strain in the chest and back, resulting in pain. This is often exacerbated by certain movements or positions, such as lying flat.

- Respiratory Infections: Conditions like pneumonia or pleuritis (inflammation of the lining of the lungs) can cause localized pain, especially when coughing or taking deep breaths.

- Costochondritis: This is an inflammation of the cartilage connecting the ribs to the sternum, which can cause sharp pain in the chest, particularly with movement or pressure.

- Referred Pain: Sometimes, pain from other areas, such as the heart or digestive system, can manifest as chest or back pain. Given your symptoms, it is crucial to rule out cardiac issues, especially if you have risk factors for heart disease.

3. Immediate Risks: While it is difficult to assess the immediate danger without a thorough examination, any new or worsening chest pain should be taken seriously. If you experience symptoms such as shortness of breath, dizziness, or pain radiating to the arm or jaw, you should seek emergency medical attention immediately. These could be signs of a more serious condition, such as a heart attack or pulmonary embolism.

In the meantime, here are some steps you can take to manage your symptoms:
- Rest: Allow your body to recover from the cough and any associated strain.

- Pain Relief: Over-the-counter pain relievers like ibuprofen or acetaminophen may help alleviate discomfort.

- Hydration: Staying well-hydrated can help thin mucus and ease coughing.

- Heat Therapy: Applying a warm compress to the affected area may help relieve muscle tension and pain.

It's important to follow up with your healthcare provider regarding your X-ray and blood test results. If your symptoms persist or worsen, do not hesitate to seek further evaluation. Your health and well-being are paramount, and addressing these symptoms promptly can lead to better outcomes.

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