Brief Answer:
Muscular pain or Gastrointestinal cause

Detailed Answer:
Hello XXXXXXX

Thanks for your query.
I have gone through your case history and the image attached to your post.

Regarding the symptoms as mentioned in your post, kindly let us know about the following:
1. Any history of recent illness or injury to the chest and back region?
2. Is the pain located only to a particular region or radiating to neck, shoulders or abdomen?
3. Is the pain associated with cough or difficulty in breathing?
4. Any history of systemic illness like Hypertension, Diabetes, Thyroid problems, etc. in past or in family?
5. Any history of vomiting or difficulty in swallowing food/ water?
6. Any history of stress or inadequate sleep?
7. History of smoking and alcohol consumption?
8. History of prolonged intake of any medication?
9. Any other associated symptoms?

If your answers to the above mentioned questions is "NO", then the symptoms can be attributed to:

1. Spasm of the chest muscles & para-spinal muscles - management will involve application of muscle relaxant gel & intake of analgesic (like Diclofenac) + Pantoprazole preparation.

2. Gastrointestinal cause - due to accumulation of gas and excess acid formation in stomach. Symptomatic relief can be obtained with intake of Proton pump inhibitors like Pantoprazole, which prevent acid formation in stomach (to be taken before meals)+ antacid gel (to be taken after meals).

However, an ECG needs to be done to rule out any Cardiovascular cause for the symptoms.

So, kindly consult your General Physician and start treatment as advised.
There is no need to worry, you will be fine.
Take care.

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Brief Answer:
Musculo-skeletal etiology to be ruled out by X ray & clinical examination

Detailed Answer:
Dear XXXXXXX

Thanks for your follow up query.

A. Since the ECG is within normal limits, any Cardiovascular cause for your symptoms can be ruled out.

B. As you had several bouts of diarrhea in the last several days, Gastrointestinal cause cannot be completely ruled out.

C. Though there is less chance of popping a rib without any direct trauma, the possibility cannot be ruled out. Moreover, formation of lump and tenderness on touching points towards Musculo-skeletal etiology. An X ray of the chest and clinical examination will be helpful in clinching the diagnosis.

Under such circumstances, symptomatic relief can be obtained with topical analgesic & muscle relaxant (ointment or spray) and intake of analgesic (like Diclofenac) + Pantoprazole preparation as mentioned in my previous answer.

In addition, certain diet and lifestyle measures need to be followed such as:
1. Take soft, plain, non-spicy foods.
2. Avoid gas producing food products like cabbage, etc.
3. Avoid smoking & alcohol.
4. Take adequate sleep of 8 hrs at night.
5. Avoid sleeping on left side.
6. Avoid lifting or pulling heavy weights.

Hope this answers your query.
If you have additional questions or follow up queries then please do not hesitate in writing to us.
I will be happy to answer your queries.

Take care.

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