Brief Answer: Pneumonia and asthma, needs management Detailed Answer: Thank you for asking! The reason for pain persistence despite the use of NSAIDs and Muscadol is because it needs to nip the evil from the bud and that is severe pneumonia most likely recurring and a complete control of asthma and compliance with medications. Chest pains with postures like bending and twisting indicates the pleural involvement and infected pleural membranes can be very painful as their pain radiates to outer chest. Superadded by the bronchospasm of asthma and its exacerbations by an infection makes the chest more tight and result in troubles like this. First step here is to seek a pulmonologist and sort out the recurrence of pneumonia and see if there is the need for an antibiotics and allied management for pneumonia.irrespective of the causes of chest pain like gastroesophageal reflux disease (GERD), followed by musculoskeletal conditions, other gastrointestinal conditions, psychiatric conditions (e.g., panic disorder), pulmonary disease, or stable coronary artery disease, All needs a referral to physician and you would have to seek one to get help and managed further. Bronchodilators and nebulization with steroids and ventolin and ipratropium bromide would help.Some good skeletal muscle relaxants will help too like tizanidine and orphenadrine. Now the asthma, you know it. first and most important of all is to avoid allergens and triggers infection like pneumonia is one of them. Early management might spare the troubles so seek help sooner than possible whenever you get some respiratory tract infection or symptom. Try some new advancements like allergen immunotherapy (SCIT- Subcutaneous immunotherapy), Bronchial thermoplasty and Monoclonal antibody therapy. In nut shell, Chest pain has thousand of etiologies and it is always the protocol to rule them out from serious to trivial. Seek a visit to nearby doctor and let them help you with it. Hope it helps. Dont forget to close the discussion please. May the odds be ever in your favour. S Khan

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