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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31329
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Hi I am a 33 year old female who is overweight and was diagnosed

Resolved Question:

Hi I am a 33 year old female who is overweight and was diagnosed in December with low iron i was having a dull chest pain above my left breast when i was diagnosed went to the hospital twice and both times they ruled out my heart, well the pain has since returned but now i have pain in my shoulder and down my left arm and my shoulder and form arm and upper chest is very sore when you press on it. What could this be? Thanks Jessica
Submitted: 4 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 4 years ago.
Hello and welcome Jessica.

Following are the possibilites (since cardiac cause is ruled out);

1) Pinched nerves in neck
2) Myofascial pain syndrome
3) Costochondritis.

Pinched nerves can be due to;

a) disc disease in neck.
b) degenerative arthritis in neck.

Physical therapy, neck traction and neck brace are the mainstay of the treatment.

Myofascial pain syndrome is another possibility. These are hyperirritable tender spots in palpable tense bands of skeletal muscle that refer pain. This can be associated with degenerative disc disease in neck causing pinched nerves. Trigger points may develop after an initial injury to muscle fibers. This injury may be a noticeable traumatic event or repetitive microtrauma to the muscles. The trigger point causes pain and stress in the muscle or muscle fiber. As the stress increases, the muscles become fatigued and more susceptible to activation of additional trigger points. The treatment is following;


1) passive stretching of the affected muscle after application of sprayed vapocoolant.

2) physical therapy; simple muscle stretch, augmented muscle stretch, post-isometric relaxation.

3) deep electrotherapy; iontophoresis, phonophoresis, short wave diathermy, electrical stimulation, high voltage galvanic stimulation, biofeedback.

4) local analgesic patch / ointment / spray

5) anti-inflammatory analgesics; Ibuprofen (Motrin / Advil)

6) ischemic compression therapy; pressure on the points

7) massage

8) steroid shots

9) acupuncture


Costochondritis; it is inflammation at the junctions of rib and cartilage or with the breast bone / sternum. Local analgesic ointment, or spray, chest brace and warm compresses with Ibuprofen is helpful. Another possibility is muscle sprain. Please read about the costochondritis;

Please feel free for your follow up questions.


I would be happy to assist you further, if you need any more information.


Dr. Arun
Customer: replied 4 years ago.
Since you wrote this
Following are the possibilites (since cardiac cause is ruled out);

I havent had a stress done but have had several EKG's and had a ultrasound of the heart and everytime i went to the ER that said there was no sign's of heart attack in my blood stream could this still be heart related since the pain is above the left breast and left arm. can costrochondritis hurt in the shoulder and arm and into the upper left shoulder blade
thank you
Expert:  Dr. Arun Phophalia replied 4 years ago.
You are very welcome, Jessica.

The pain in shoulder, arm and upper left shoulder blades are likely due to pinched nerves in neck (called as cervical radiculopathy). EKGs, blood test for cardiac enzymes and ultrasound with a physical examination are reasonable way to rule out heart related pain, in your case. Over weight, is a risk factor for the heart attack, but in your age group and in females, it is relatively uncommon. So it seems to be musculoskeletal disease. But no harm in getting this reconfirmed by an EKG.

It is privilege assisting you.

Dr. Arun
Dr. Arun Phophalia and other Health Specialists are ready to help you
Customer: replied 4 years ago.
Thank you Smile
Expert:  Dr. Arun Phophalia replied 4 years ago.
You are very welcome.