Patient: I get sharp shooting pain on the side of my body below my armpits when I pick something up even if it not heavy sometimes even if I run. The pain is very sharp and happens on both sides, it’s just started happening the last few month. I am also wondering three years ago I had frozen shoulder pain felt similar is it related?
Doctor: Thank you for writing to us.The type of pain you are describing occurs due to irritation to the nerve. The irritatio n is at the nerve but the pain appears to be at the sides of the body. For example, you may have disease or compression near the spinal cord but it would feel like pain was on the side.If possible, do describe the pain in greater detail. These are points that will help:Is the pain continuousIs it movingDoes it hurt when you touch the areaDo you have any other disease (Hypertension, Diabetes etc)Here are possible causes of your pain:DiabetesKidney failureSome drugsHerpes/ShinglesInjuriesIf have or had any of these then it may be the possible cause. Since you have also given history of a frozen shoulder, I assume that you may have diabetes. This is because frozen shoulder is common in diabetes.,My advice will be to get a complete biochemistry test panel done. These would include these tests:Liver function testsKidney function testsChest X-raySonography abdomenECGBlood glucoseBlood countsThis should help reach a diagnosis or at least point in some direction. Hope this helps. All the best.
Comments / Follow Ups
Patient: The pain is continuos, takes about 5 to 10 minutes to subside. Generally starts at one armpit shoots down my side and then moves to the others side. But the feeling starts and ends pretty much under my armpit now.
Last time it happened when I ran a little briskly, and I can trigger it if I bend over to pick up something not too heavy or I lie flat on my back and try and pull myself up. So it feels very mechanical to me the triggering.
The first time it started when I was working out a lot and doing a lot of pull-ups. I could feel it was where my deltoid or tres major muscle is and a similar pain on my side started. At that time I could touch and feel pain, now I have stopped working out it starts under the armpit and I can’t really touch a tender place where the pain is.
I am not diabetic (since last tested 6/8months ago) but I know I truly have type II genetics for it. Hypertension also since last tested I didn’t have. But again I know I waiver, although this time I had been very healthy based on improved eating habits and losing weight through regular exercise.
Let me know if there is any other insight you can give me ? I will try your test recommendation besides blood related ones on the list the other tests is there any that I should prioritize right away?
If you could describe a little further how does diabetes affect this? And if it is diabetic response would it subside as I improve?
Doctor: Thank you for the follow up.
Nerve damage in diabetes happens because of several mechanisms. One way is direct metabolic damage because of high glucose levels in the body. Another mechanism is damage due to reduction of blood supply through the blood vessels. Diabetic neuropathy does not get cured even after you do not have diabetes. And thus, you may still be having it.
Based on your follow up, I think that you may have exertion related pain which is close to the chest. You should get an ECG done. This will help you rule out heart related diseases.
I recommended that you get all the tests done because we cannot sufficiently rule out other diseases and it would be easier to rule out by doing a general check up. You can talk to a Doctor about this with an examination to decide which investigations are needed clinically.
Hope this helps.