Patient: From last 2 months my sister is suffering from back rib cage pain. On December 2014 she felt it for first time but after taking some pain killer she got relief. But in the first week of February 2015 the same pain was back but was much more severe. The pain is surrounding in entire back rib cage and shoulder. Sometimes she is shivering in pain and also experiencing pain during eating food or drinking water. Sometimes the pain is so severe that she cannot even breathe properly. Sometimes she is also chocking during drinking water. She is also having dry cough. What could be the possible reason for these symptoms? Please help… It’s urgent
Doctor: Hello,Welcome to Ask The Doctor.I understand your concern.I have following diagnosis for you:1. Muscular Pain2. Cardiac Chest pain.3. Acid reflux.It is important to differentiate between the all as the treatment course is entirely different.The Muscular chest pain aggravates with movement. It is dull, diffuse and continuous in nature.However, the Cardiac chest pain is severe and crushing in nature. It increases on activity like walking, exercising. It also radiated to left arm.In such scenario, i would advise to get an ECG and Chest Xray done. This will give an idea that pain is cardiac in nature or not.If the ECG and Chest Xray are normal, the pain is probably Muscular or due to Acid reflux.Chest Xray would reveal if there is any pleural effusion.For acid reflux, i would advise you to take a combination of Pantoprazole and Domperidone once a day.I advise following to my patients in case of Muscular pain:1. To do hot fomentation over the involved area 3-4 times a day.2. To apply Diclofenac Gel locally over the involved area.3. To take anti inflammatory and analgesic pain killer like Ibuprofen , Etoricoxib.On taking this treatment, this usually resolves in 5-7 days.Share my opinion with your doctor before acting upon it.I hope it helps.Stay Healthy!