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Suggest Treatment For Severe Back And Neck Pain In An Obese Person
Question: Hello, I have chronic upper back and neck pain due to my profession - dental professional. I consult with chiro and massage therapist every 2 weeks. This week, I've had heart burns, my upper back between shoulder blades has been worst ( it can be, it flares up) and pain goes to the center of my chest at times, the pain to the chest is short lived and sharp. I've been able to reproduce the chest pain moving around. I've also had fleeting pain in my left arm, twinges and my pinky and ring fingers on left hand are a bit numb. My blood pressure is normal and my pulse is normal 60 to 75. There is no pain when I exercise, bring my hr to 140 bpm and no discomfort. I am a bit overweight but exercise regularly.
I have no feeling of dizziness or breathlessness. I also had some tingling on left side of my face last week, like dental freezing coming off, beside my mouth, then my brow then the tip of my left ear. This hasn't come back,
My question is, should I rush myself to the hospital for cardiac workup or could it be nerve entrapment in my back or other upper back/neck related pain, or could it be stomach related?
I have no feeling of dizziness or breathlessness. I also had some tingling on left side of my face last week, like dental freezing coming off, beside my mouth, then my brow then the tip of my left ear. This hasn't come back,
My question is, should I rush myself to the hospital for cardiac workup or could it be nerve entrapment in my back or other upper back/neck related pain, or could it be stomach related?
Brief Answer:
Looks like muscular pain.
Detailed Answer:
Hello,
Thank you for using HCM to post your question.
I read it carefully and I understand your concern.
What you are describing seems like a muscular pain because of the posture. Keeping shoulders upfront and down streches the muscles of the chest and compresses the nerves of the arms which explains the numbness radiated in the fingers.
Also, the fact that the pain is sharp, not when you exercise, and its reproduced by movement...all these are symptoms of being something muscular and not related with the heart.
If I was your caring doctor I would recommend to take Ibuprofen 400 or another painkiller as needed, and also a proton pump inhititor to reduce the acid in the stomach like Omeprazole 20mg once/day.
Hope this is helpful.
Let me know if you need more clarifications.
Otherwise please kindly close and rate the answer.
Regards,
Dr.Papaqako
Looks like muscular pain.
Detailed Answer:
Hello,
Thank you for using HCM to post your question.
I read it carefully and I understand your concern.
What you are describing seems like a muscular pain because of the posture. Keeping shoulders upfront and down streches the muscles of the chest and compresses the nerves of the arms which explains the numbness radiated in the fingers.
Also, the fact that the pain is sharp, not when you exercise, and its reproduced by movement...all these are symptoms of being something muscular and not related with the heart.
If I was your caring doctor I would recommend to take Ibuprofen 400 or another painkiller as needed, and also a proton pump inhititor to reduce the acid in the stomach like Omeprazole 20mg once/day.
Hope this is helpful.
Let me know if you need more clarifications.
Otherwise please kindly close and rate the answer.
Regards,
Dr.Papaqako
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Do you think the episodes of tingling by the mouth, forehead and ear on left side may have been signs of nerve compression? Is this abd the finger numbness could be related and signs of entrapment?
Brief Answer:
Symptoms in the face nothing to worry about if do not persist or repeated.
Detailed Answer:
Hello dear,
Thank you for the follow-up question.
The episode of the tingling in the mouth and head, I think its nothing to worry about because it has happened only once as I understand it. It may have been an anxiety symptoms. Sometimes our body reacts with symptoms we don not understand. But if that happens again and if it persists, then you should go to see a neurologist who can examine you and find the cause of it.
While about the numbness of the fingers, it is typical of a nerve entrapment. And as I said above, the nerve entrapment may happen from the bad posture sometimes, sometimes from the thickening of the muscles which surround the nerves, ect. Talk about this with your physical therapist and they will be able to adjust their exercises so it avoids to cause that.
Hope this helps and I have answered your question.
Regards,
Symptoms in the face nothing to worry about if do not persist or repeated.
Detailed Answer:
Hello dear,
Thank you for the follow-up question.
The episode of the tingling in the mouth and head, I think its nothing to worry about because it has happened only once as I understand it. It may have been an anxiety symptoms. Sometimes our body reacts with symptoms we don not understand. But if that happens again and if it persists, then you should go to see a neurologist who can examine you and find the cause of it.
While about the numbness of the fingers, it is typical of a nerve entrapment. And as I said above, the nerve entrapment may happen from the bad posture sometimes, sometimes from the thickening of the muscles which surround the nerves, ect. Talk about this with your physical therapist and they will be able to adjust their exercises so it avoids to cause that.
Hope this helps and I have answered your question.
Regards,
Above answer was peer-reviewed by :
Dr. Prasad
Thank you for the answers. I will make an appointment with my doctor. The upper back pain has been present for at least 15 years and is getting worst. No xrays or tests have been done. Treated pnly by strecthes massages and chiro. Can nerve entrapment been detected on mri or other tests? When ot computer, arm gets cold and numb as well
Brief Answer:
Yes,MRI can detect but we don't do it in general because diagnoses is clear
Detailed Answer:
Hello, welcome back,
Yes, MRI can surely detect the nerve entrapment.
But on the other side we don't recommend the MRI in general because the diagnoses is suggested by the symptoms which are very typical.
After we decide the diagnoses by the symptoms, the treatment is the same, with or without MRI- .e. physical therapy, good posture, avoiding what is causing the problem and as a last resort surgery.
Regards,
Yes,MRI can detect but we don't do it in general because diagnoses is clear
Detailed Answer:
Hello, welcome back,
Yes, MRI can surely detect the nerve entrapment.
But on the other side we don't recommend the MRI in general because the diagnoses is suggested by the symptoms which are very typical.
After we decide the diagnoses by the symptoms, the treatment is the same, with or without MRI- .e. physical therapy, good posture, avoiding what is causing the problem and as a last resort surgery.
Regards,
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thanks for the replies, my back pain has settled down for now, not as bad and the pain to the chest has also stopped. I've had that in the past when my back gets this bad but each time, I worry it may be heart disease so it gets me worked up. It must not be, or I would not be here writing this today haha!
Just to put my mind at rest when this happens again, I have a few burning questions I am too embarrassed to ask my own doctor.
If I can exercise at moderate to high level, brining my heart rate into the 140's and not feel chest pain or weakness, would it still be possible to have symptoms of heart disease like chest pain at rest?
Another thing is, I've been diagnosed with preventricular contractions over 15 years ago when I got checked out for palpitations and was told it was benign. If I work out really hard, like high intensity interval training HIIT, I then get palpitations and get tired for about 2 days, very tired. No pain associated with it. My heart rate also gets really low between 45 to 55 bpm during these couple of days. I have never pursued this because it only happens when I do this type of excercise so I have quit doing this and pushing this hard and symptoms do not return. Typically, when I exercise regularly, my regular heart rate overs between 58 and 70.
Just to put my mind at rest when this happens again, I have a few burning questions I am too embarrassed to ask my own doctor.
If I can exercise at moderate to high level, brining my heart rate into the 140's and not feel chest pain or weakness, would it still be possible to have symptoms of heart disease like chest pain at rest?
Another thing is, I've been diagnosed with preventricular contractions over 15 years ago when I got checked out for palpitations and was told it was benign. If I work out really hard, like high intensity interval training HIIT, I then get palpitations and get tired for about 2 days, very tired. No pain associated with it. My heart rate also gets really low between 45 to 55 bpm during these couple of days. I have never pursued this because it only happens when I do this type of excercise so I have quit doing this and pushing this hard and symptoms do not return. Typically, when I exercise regularly, my regular heart rate overs between 58 and 70.
Brief Answer:
Pain that comes from the heart is exacerbated by effort.
Detailed Answer:
Hello,
Glad to hear that your back pain is better by now.
No, it is not possible to have chest pain at rest and not having any such while exercising.
Those pains at rest are mostly muscular or nerve pain or spasms of the heart which are not problematic.
But, the pain from the myocardial infarction though may happen while at rest, it is like a tightness in all your chest, it can be mild but also very strong, and it doesn't get better. An ECG would rule that out for sure, because sometimes even doctors are not sure and they just observe the patient.
I agree that the peri-ventricular contractions are benign and nothing to worry about.
The low heart rate is typical for people who exercise a lot. And it is said to not be problematic.
But the fact that you feel tired, I would say to consider an ECG just to check if you have any block in the conduction system of the heart. Do the exercises 1 day before doing it. If it is normal, then great. As I said, it is normal finding for people who exercise a lot, but those values should better be evaluated in details.
These are my thoughts.
Hope this helps. Let me know if you have other questions.
Regards,
Pain that comes from the heart is exacerbated by effort.
Detailed Answer:
Hello,
Glad to hear that your back pain is better by now.
No, it is not possible to have chest pain at rest and not having any such while exercising.
Those pains at rest are mostly muscular or nerve pain or spasms of the heart which are not problematic.
But, the pain from the myocardial infarction though may happen while at rest, it is like a tightness in all your chest, it can be mild but also very strong, and it doesn't get better. An ECG would rule that out for sure, because sometimes even doctors are not sure and they just observe the patient.
I agree that the peri-ventricular contractions are benign and nothing to worry about.
The low heart rate is typical for people who exercise a lot. And it is said to not be problematic.
But the fact that you feel tired, I would say to consider an ECG just to check if you have any block in the conduction system of the heart. Do the exercises 1 day before doing it. If it is normal, then great. As I said, it is normal finding for people who exercise a lot, but those values should better be evaluated in details.
These are my thoughts.
Hope this helps. Let me know if you have other questions.
Regards,
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Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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