Intermittent Chest and Side Pain: When to Seek Medical Help

Dull pain

I experience sharp pain in my left armpit and rib area, as well as in my right armpit and chest.
The pain occurs only on one side at a time.
I have had this sharp pain before, but it was infrequent; recently, it has become more common, mostly on the left side, while the right side is less frequent.
I would like to know what might be causing this.
If I need to seek medical attention, which specialty should I see first? Thank you.

Xiong, 20~29 year old female. Ask Date: 2008/04/10

Dr. Lin Huanquan reply Traditional Chinese Medicine

1.
Since the pain occurs only on one side at a time and the frequency of episodes is low, it is likely related to neuropathic pain.

2.
I believe traditional Chinese medicine should be sufficient.

3.
The concept of liver qi stagnation in traditional Chinese medicine aligns well with your current symptoms.

4.
Treatment: Modified Xiao Yao San, Shao Fu Zhu Yu Tang, and Shao Yao Gan Cao Tang.
You should see improvement after a few days of taking these.

5.
Dietary restrictions include avoiding bamboo shoots, spicy foods, alcohol, and smoking.

6.
Ensure adequate sleep and avoid staying up late.

7.
Avoid direct exposure to electric fans.

Reply Date: 2008/04/10

More Info

Intermittent chest and side pain can be concerning, especially when it occurs frequently or intensifies over time. Given your description of experiencing sharp pains in the left side under the armpit and ribs, as well as in the chest, it is important to understand the potential causes and when to seek medical help.

First, it is essential to recognize that chest pain can arise from various sources, including musculoskeletal issues, gastrointestinal problems, and more serious conditions such as cardiac issues. The fact that you mention the pain is intermittent and primarily on one side may suggest a few possibilities:
1. Musculoskeletal Pain: This is one of the most common causes of chest pain, especially if the pain is sharp and localized. It can result from muscle strain, rib injury, or inflammation of the cartilage connecting the ribs to the sternum (costochondritis). If you have recently engaged in activities that involve heavy lifting or unusual physical exertion, this could be a contributing factor.

2. Nerve Irritation: Conditions such as a pinched nerve in the neck or upper back can cause referred pain to the chest and sides. This type of pain may be sharp and can be exacerbated by certain movements or positions.

3. Gastrointestinal Issues: Problems such as acid reflux or esophageal spasms can also manifest as chest pain. If you notice that the pain correlates with eating or lying down, this could be a possibility.

4. Cardiac Concerns: While less likely given your description, it is crucial to rule out any heart-related issues, especially if you have risk factors such as a family history of heart disease, high blood pressure, or high cholesterol. Symptoms such as shortness of breath, dizziness, or pain radiating to the arm or jaw should prompt immediate medical attention.

Given the intermittent nature of your pain and its location, it would be prudent to start by consulting a primary care physician. They can perform a thorough evaluation, including a physical examination and possibly some initial tests (like an EKG or chest X-ray) to rule out serious conditions. If necessary, they may refer you to a specialist, such as a cardiologist for heart-related concerns or an orthopedist for musculoskeletal issues.

In summary, while your symptoms may not immediately suggest a life-threatening condition, it is essential to take them seriously, especially since they have increased in frequency. Seeking medical advice from a primary care physician is the best first step. They can help determine the underlying cause of your pain and guide you on the appropriate treatment or further evaluation needed. Remember, it is always better to err on the side of caution when it comes to chest pain.

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