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What Causes Pain In Upper Right Chest Area?

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Posted on Mon, 16 Feb 2015
Question: I have a deep dull aching sensation in upper right chest that started three days ago. It can occasionally feel like a throb in the right axilla, The pain becomes a sharp pain when I roll to my right or if I try to push myself up from bed pushing downward on my right arm. I can elicit the pain by sitting upright and looking down and to my right. I have good energy. no shortness of breath and the pain is not increased by taking a deep breath. If anything, it feels better with a deep breath. I am a 67 year old 6 foot Caucasian male 240 pounds, water aerobics 3-5 days a week. Gradually developed high blood pressure over 5 years which is managed by lisinopril-HCTZ 20 12.5 mg once a day. Gradually became prediabetic 2 years ago but blood work has been normal for last 2 years with exercise but no meds. Regular checkups 2X per year. In last two years had two ~1 month bouts of pain radiating from upper left upper neck and scalp likely due to an irritated greater occipital nerve. Tender trigger spot between left C1-C2. No other lifetime medical problems. No major surgeries or any hospital admissions for health problems . Cardiac stress test, cardiac imaging and carotids were normal two years ago. Former Medical School gross anatomy and neuroscience professor, now with my own biotech company for 7 years. Research expertise in chronic pain, i.e. PHN, fibromyalgia, CRPS, diabetic neuropathy, etc.
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Answered by Dr. Suresh Heijebu (2 hours later)
Brief Answer:
Possible compressive cervical disc disease?Needs Confirmation.

Detailed Answer:
Hi Sir.

I understand your query and concern.

As per your suggested history,the likely attribute to your symptoms is Cervical Disc disease.

This is causing you the pain along the arm,radiating into the axilla left upper neck and the scalp.

Cervical disc pain is also known to cause postural variations.

Disc diseases are to known to progress over a time period causing spinal cord and nerve root compression .

Hence it is very essential in your case to rule out the disc disease first and then proceed to other organ systems like heart which can present with similar symptoms.

I am keeping heart disease 2nd in the order of evaluation,considering the due fact given to the earlier normal imaging 2 years ago.Its also important to get the similar check up again afresh.

Hence to detect the disease,its very important that you get a Cervical spine MRI-high resolution,fast spin echo type to detect any changes of cord compression at the earliest .

Further management depends on the test results.Usually the management is surgical in presence of documented compressive disc disease.

Thank you.



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Suresh Heijebu

Psychiatrist

Practicing since :2010

Answered : 3646 Questions

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What Causes Pain In Upper Right Chest Area?

Brief Answer: Possible compressive cervical disc disease?Needs Confirmation. Detailed Answer: Hi Sir. I understand your query and concern. As per your suggested history,the likely attribute to your symptoms is Cervical Disc disease. This is causing you the pain along the arm,radiating into the axilla left upper neck and the scalp. Cervical disc pain is also known to cause postural variations. Disc diseases are to known to progress over a time period causing spinal cord and nerve root compression . Hence it is very essential in your case to rule out the disc disease first and then proceed to other organ systems like heart which can present with similar symptoms. I am keeping heart disease 2nd in the order of evaluation,considering the due fact given to the earlier normal imaging 2 years ago.Its also important to get the similar check up again afresh. Hence to detect the disease,its very important that you get a Cervical spine MRI-high resolution,fast spin echo type to detect any changes of cord compression at the earliest . Further management depends on the test results.Usually the management is surgical in presence of documented compressive disc disease. Thank you.