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Dr. D. Evans
Dr. D. Evans, Doctor (MD)
Category: Health
Satisfied Customers: 4464
Experience:  MS in ENT and Head and Neck Surgery , Attachment to Neurosurgery.
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What could be causing vise-like gripping pain around my ...

Resolved Question:

What could be causing vise-like gripping pain around my lower chest [diaphgram] and back? Nothing indicates irregularities with my heart.
Submitted: 9 years ago.
Category: Health
Expert:  Dr. D. Evans replied 9 years ago.
Hi,
Since you are online, could you please give some more information:

Any fever?

Any coughing?

I am available online to help you further after I get this info.
Customer: replied 9 years ago.
Reply to Dr. D. Evans's Post: No fever. Some dry non-productive coughing - not severe.
Expert:  Dr. D. Evans replied 9 years ago.

Hi,

The possible causes are:



Acid reflux : this seems the most likely cause. Such pains can be associated with lying down and are usually more at night..

Chronic cholecystitis : the pain is usually associated with indigestion, flatulence and often with fever and vomiting. A pain from the gall bladder may be aggravated by deep breathing or lying down as the diaphragm touches the gall bladder.

Pleurisy : An inflammation of the lining of the lungs. This is a likely cause but it is usually associated with some sort of cough and often sputum. Without this, it is less likely.

Costochondritis: If the pain is aggravated by touching, it could be due to costochondritis, an inflammation of the cartilage joint of the ribs.

Esophageal spasm: may be associated with difficulty in swallowing and heart burn. link

Cardiac causes: Cardiac causes of such pain could be due to ischemia (due to blockages - including both stable and unstable angina and acute heart attack and coronary artery spasm), pericarditis (inflammation of the sack around the heart), myocarditis (inflammation of the heart)

Psychological causes of chest pain are common and include panic attacks, anxiety, stress and mental duress


For you, acid reflux is the most likely cause. You should try initially with some antacid, like Mucaine gel (OTC) 2 tsf three times daily and Tab. Zantac 150 mg once daily assuming it to be acid reflux. If this does not help and pain continues more than 5 days, then you have to go for a medical check up. Link1 Link2

 

I hope this answer was helpful. If you need more information, feel free to ask. For accepting this answer, please click on the green 'accept' button below. Feedback/Bonus will be warmly appreciated.

Customer: replied 9 years ago.
Reply to Dr. D. Evans's Post: I already take prilosec once daily. I would be willing to increase the number of times I take that daily. I also sleep with my head elevated as well.

I will take a serious look at the psychological causes.

Truth is the pain happens toward morning almost nightly. Heat soothes the pain about as much as anything I can do. Getting up and walking around helps as well but who wants to do that at 3:00 AM?

Can you offer more information on costochondritis? Thanks!
Expert:  Dr. D. Evans replied 9 years ago.
Pain occuring towards the morning is typical of pain due to acid peptic disorders. You should get yourself checked for this, you could be having not just simple acid reflux but also duodenal ulcer.

Costochondritis affects the joints between the cartilaginous joints of the sternum, the bone in the middle of the chest. Costochondritis typically affects the joints of the ribs at the breast bone, it can also affect the ribs and intercostal muscles at the back.

You can look up here:

http://www.mayoclinic.com/health/costochondritis/DS00626
http://www.emedicinehealth.com/costochondritis/article_em.htm



I hope this answer was helpful. If you need more information, feel free to ask. For accepting this answer, please click on the green 'accept' button below. Feedback/Bonus will be warmly appreciated.


Dr. D. Evans and 2 other Health Specialists are ready to help you