Unexplained Body Pain: When to See a Neurologist?

Unexplained body aches?

I have been feeling very down for the past few weeks and often experience insomnia.
Recently, I have been feeling unexplained body aches, particularly pain near my left armpit close to my chest (not in the armpit itself) and pain in my elbow joint.
My left rib cage also hurts, but I believe it is not bone pain; it feels more like internal nerve pain (sudden sharp pains).
I also feel like there is a foreign object when swallowing.
I visited an ENT specialist who said that my muscles are too tense and that there is nothing serious.
After taking medication, it seems to have improved, but I still have shallow sleep.
Should I see a neurologist for this pain? The ENT doctor said I am just too tired and advised me not to overthink it, but I still feel somewhat uneasy.
Thank you.

Ning Ning, 20~29 year old female. Ask Date: 2013/03/01

Dr. Gao Chunde reply Neurology

The location of the pain you described closely corresponds to the sensory distribution of the second thoracic nerve on the skin.
Please pay attention over the next few days for any rashes or small blisters appearing along this painful area.
Feelings of depression combined with insomnia can lower your body's resistance, which raises the concern for early neuralgia associated with shingles, followed by skin changes.
It would be advisable to consult a neurologist for confirmation or to consider using some medications to alleviate the discomfort.

Reply Date: 2013/03/01

More Info

When experiencing unexplained body pain, especially when accompanied by emotional distress such as low mood and insomnia, it is essential to consider a comprehensive approach to diagnosis and treatment. Your symptoms, including the localized pain near your left armpit and rib area, as well as joint pain in your elbow, could be indicative of several underlying issues, including neurological, musculoskeletal, or even psychosomatic conditions.

Given that you have already consulted an ENT specialist who suggested muscle tightness as a potential cause, it may be beneficial to follow up with a neurologist. Neurologists specialize in diagnosing and treating conditions related to the nervous system, which includes the brain, spinal cord, and peripheral nerves. Your description of the pain as sudden and reminiscent of nerve-related discomfort could warrant further investigation to rule out conditions such as neuropathy, radiculopathy, or even more complex syndromes like fibromyalgia.

In addition to neurological concerns, your emotional state is also a significant factor. Chronic pain can lead to or exacerbate mental health issues, including anxiety and depression. The interplay between physical pain and emotional well-being is well-documented; for instance, chronic pain can alter brain chemistry and lead to changes in mood and cognitive function. Therefore, addressing both the physical and psychological aspects of your health is crucial.

Here are some steps you might consider:
1. Consult a Neurologist: Given your symptoms, a neurologist can perform a thorough examination, which may include imaging studies (like MRI or CT scans) and nerve conduction studies to assess the function of your nerves. They can help determine if there is a neurological basis for your pain.

2. Pain Management Specialist: If the neurologist rules out significant neurological issues, you might benefit from seeing a pain management specialist. They can provide a multidisciplinary approach to managing chronic pain, which may include medication, physical therapy, and psychological support.

3. Psychological Evaluation: Since you mentioned feelings of low mood and insomnia, consulting a mental health professional could be beneficial. Cognitive-behavioral therapy (CBT) and other therapeutic approaches can help address the psychological aspects of chronic pain and improve your overall quality of life.

4. Physical Therapy: Engaging in physical therapy may help alleviate muscle tightness and improve your overall physical function. A physical therapist can design a tailored exercise program that addresses your specific pain points and helps strengthen the affected areas.

5. Lifestyle Modifications: Incorporating stress-reducing activities such as yoga, meditation, or gentle exercise can also help manage both pain and emotional distress. These practices can promote relaxation and improve your overall mental health.

In summary, while your current symptoms may not immediately suggest a neurological disorder, consulting a neurologist is a prudent step to ensure that any underlying conditions are identified and treated appropriately. Additionally, addressing the psychological components of your experience is equally important, as they can significantly influence your perception of pain and overall well-being. Remember, you are not alone in this journey, and seeking help from various healthcare professionals can lead to a more comprehensive understanding and management of your symptoms.

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