Deep pain in the shoulder radiated to the chest aggravated with breathing

Patient

Q: Hi! as crazy as this sounds, I get a pain in my right shoulder every 6 months that starts out as a deep pain in my right shoulder and lasts for about a week, and during the course of the week my chest hurts when I breathe lime theres alot of pressure on me and alot of pressure in my ears, and it is usually the worst around mid week and than slowly goes away! But is been every 6 months for about ten years, I can't even lay down or anything cause the pressure I feel is unbearable! But it all starts and ends with the shoulder pain! It doesn't hurt to move my arm or lift anything, it's just a pain deep in the join or something! But it's every 6 months and no sooner no later, I just find it very weird!

Doctor

A:   The pain in the shoulder may be or not related to the chest pain, and might be due to a rotator cuff problem, now the chest pain as you described it may be due to a Intercostal neuralgia , which is a condition that causes pain along the intercostal nerves. Intercostal nerves are located between your ribs. They go all the way from front to back following the correspondent rib. Intercostal neuralgia may produce episodes of acute pain or pain that is dull and constant. The pain is often described as stabbing, tearing and sharp, spasm-like, tender, aching or gnawing. It typically feels like the pain wraps around your upper chest in a band-like pattern and may be radiated to the back. The pain may intensify during exertion or with sudden movements involving the upper chest, such as coughing, deep breathing or laughing. Intercostal neuralgia may resolve on its own or it may require treatment. Treatments include: nerve blocks, anti inflammatory medication (“Motrin”, “Aleve”), Capzaicin cream apply locally to relieve pain, local moist warm compresses, and vitamin B complex to help the nerve to recover.

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