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What Causes Dizziness And Tightness In The Arms Along With Panic Attacks?

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Posted on Sat, 30 Apr 2016
Question: Hi,

You can see that I have had quite the medical history over the past few years. I am having an issue that I had back this July and I am concerned about why it keeps coming back. I had been feeling pretty normal for the past few months, but a few weeks ago I had a stomach bug that seemed to kick up all my symptoms again. For the past few weeks (since February 11, 2016) I have been having tightness in my left back, along with pain (at times) down my arm into my hand (sometimes ulnar/sometimes radial). I had what seemed like a panic attack on the 11th and went to an urgent care clinic where they did bloodwork and an ekg and everything was normal. I had another issue this weekend where my heart was racing and my arm, shoulder, and neck all felt tight. The symptoms started in the morning and I ended up back at the ER at around 6pm. They ran similar tests and my cardiac markers, bp, and everything else were normal. Finally, today I was feeling kind of lightheaded in the morning and my left arm, shoulder, and neck were still tight, but I decided to run during my lunch hour. My run was fine, but when I finished up, I felt very light headed. I ended up getting my blood pressure taken by a coworker and it was normal (but lower than usual). I have since ate and am feeling better (except for the tightness in my arm and back). I workout frequently and have not needed to change anything about my routine, but I am starting to worry that my arm pain is a cardiac issue that is being missed.
doctor
Answered by Dr. Alexander H. Sheppe (1 hour later)
Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

Given your history and the negative EKG, I am comfortable saying that this is very, very likely a series of panic attacks, or generalized anxiety. Anxiety and panic create very real physical symptoms, but unlike a heart attack, these symptoms do not indicate a serious underlying medical illness. You did not miss anything by getting it checked out too early or too late -- a single negative EKG around the time of one of these episodes is enough to diagnose you with anxiety. I recommend treatment with an SSRI antidepressant and cognitive behavioral psychotherapy. With time, your anxiety/panic will improve.

Please let me know if there's anything more i can help you with.

In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Alexander H. Sheppe (2 hours later)
Could my anxiety be causing the tightness in my back and arm? I think that is my biggest stress at this moment.

I do want to get CBT but am also wondering if an antianxiety med would be useful. Are they worth the side effects?
doctor
Answered by Dr. Alexander H. Sheppe (1 hour later)
Brief Answer:
Followup

Detailed Answer:
Anxiety could certainly be causing the tightness in your arm and back. This is a common symptom of somatic anxiety.

An anti-anxiety medication could be useful. I recommend treatment with an SSRI antidepressant such as Lexapro.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2236 Questions

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What Causes Dizziness And Tightness In The Arms Along With Panic Attacks?

Brief Answer: Consultation Detailed Answer: Hello, and thanks for your question. Given your history and the negative EKG, I am comfortable saying that this is very, very likely a series of panic attacks, or generalized anxiety. Anxiety and panic create very real physical symptoms, but unlike a heart attack, these symptoms do not indicate a serious underlying medical illness. You did not miss anything by getting it checked out too early or too late -- a single negative EKG around the time of one of these episodes is enough to diagnose you with anxiety. I recommend treatment with an SSRI antidepressant and cognitive behavioral psychotherapy. With time, your anxiety/panic will improve. Please let me know if there's anything more i can help you with. In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers