What Causes Pain In Left Arm, Shoulder And Back?

Posted on Thu, 2 Jun 2016

Question: After a few visits to the ER for left arm and shoulder/back pain i had my coronary Ctangiogram last week snd my results were normal. I am still having pain mainly when i first get up and feel stressed. Is there something that could be missed?

Answered by Dr. Rajesh Teli (26 minutes later)

Brief Answer:
you should look for non cardiac cause

Detailed Answer:
Hello,
I am Dr.Rajesh Teli,MD.
Thanks for using HCM.
Going through your short history I can assure you that your pain is not because of heart disease.But as pain is persistent we have to search for definitive cause.I would like to know following details
1.Do you have Hypertension or diabetes ?
2.Do smoke or consume alcohol ?
3.Do you have any past history of hospitalisation or major illness ?
4.How has been your menstrual cycle ?Do you take contraceptive pills ?
5.Do you work on Computer or use XXXXXXX for long hours ?
First thing I can suggest you is to get your x-rays of Cervical spine (AP and lateral views) to rule out possibility of early cervical spondylosis causing pain.
Meanwhile I suggest you to use thin pillow and take simple analgesic like Aceclofenac sodium 100 mg twice a day for temporary relief,
I would be glad to guide you further once you revert back with details I have asked for.
My best wishes
Dr.Rajesh Teli,MD.

Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Rajesh Teli (30 minutes later)

I feel more confident about it not being due to my heart, but everytime it pops up the reminders of left side pain being associated with heart attacks come back to mind. Would pain that is worse in certain positions be more likely to be muscular?

Answered by Dr. Rajesh Teli (15 hours later)

Brief Answer:
Yes, postural related pain is more likely to be muscular

Detailed Answer:
Hello,
Your posture related pain may be muscular. As I asked you earlier, about your work on computer and sitting postures, it may be improper position causing stress on muscles and can lead to pain. You must avoid undue anxiety about heart. In my 25 years of experience I have seen that it is fear of heart attack which produces more discomfort rather than pain itself (Non cardiac pain)
So stay assured and try to search from your day to day activity the activity causing muscular stress.
My best wishes
Dr.Teli

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Rajesh Teli (10 hours later)

I realized that I didn't answer your questions.

I do not have hypertension or diabetes - my blood pressure actually runs low at times. I also do not have high blood lipids of any sort. I do not smoke and I only consume alcohol on weekends (3-4 drinks all weekend). My only hospitalization came recently when I was having left arm, jaw, chest, and back pain and was monitored for around 7 hours to make sure I wasn't having a heart attack. I have a normal menstrual cycle and work a very sedentary job (but I do work out for around 60 minutes daily - both cardio and strength training).

Is it possible that the left side pain could still be heart related if the CTA was normal? Maybe a valve or rhythm issue? I have had an echo (about 7 years ago) that was normal. I also tend to be fine while I work out.

Answered by Dr. Rajesh Teli (13 hours later)

Brief Answer:
Your pain is not likely to be heart pain

Detailed Answer:
Hello,
Your pain is not heart pain.Heart pain i.e angina is aggravated by exertion.Very fact that your are exercising daily and work out 60 min a day is proof that it is not Angina.You should get fresh echocardiogram just to rule our any valvular lesion like MVP. But as your echo was normal few years back ,I am quite sure that it will be normal.
Once CT angio is normal you can be sure that there are no blocks in arteries supplying blood to heart and your pain is not angina.
I still feel your pain is either related to posture or related to your neck. Kindly correct your faulty posture (if any) while sitting on computer. Get your X rays Cervical spine done.
Yoga and meditation would certainly help you. Have any stress ? Then manage that too...

My best wishes
Dr.Teli.

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Deepak