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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 33867
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Gripping pain shooting around my chest wall up my back to my

Customer Question

Gripping pain shooting around my chest wall up my back to my shoulder and r) under jaw lasts 10 mins eases off eventually like a cramp
JA: Thanks. Can you give me any more details about your issue?
Customer: Happened 8 years ago first time I thought heart attack but no enzymes when went to go. Specialist said I'm fine. Past year more frequent. Twice this year. I have to stop moving and shallow breathe til it passes but today I fell immediately asleep very drowsy then nearly swolliwed me tongue which jolted me awske
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Submitted: 1 year ago.
Category: Health
Customer: replied 1 year ago.
I need a medical professional. I'm a health Prof myself so I need more comprehensive uptodate advice please. More info it happens quickly but I can feel it coming on as everthying starts to tighten and feels like breathing is restricted like someone sitting in chest. Checked my pulse it wad normal. Tingling arms fingers light headed overwhelming tiredness and slept feel better except for asking up choking swollen nearly my tongue spun out. Should I be worried? Is this angina?
Expert:  Dr. Arun Phophalia replied 1 year ago.


I am Dr. Arun and will be helping you today.

I am sorry that your question was unanswered for long.

Your symptoms are suggestive of;

1) Pinched nerves in neck.

2) Myofascial trigger point.

Both of these can be concomitant. 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. When predisposing factors combine with a triggering stress event, activation of a trigger point occurs. Myofascial trigger point is a hyperirritable spot, usually within a taut band of skeletal muscle or in the muscle fascia which is painful on compression. The treatment is following;

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

2) physical therapy

3) deep electrotherapy; iontophoresis, phonophoresis, short wave diathermy, electrical stimulation

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

Please feel free for your follow up questions.

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

Thanks for using Just Answer.

Customer: replied 1 year ago.
u believe the gripping pain that immobilises my chest is musculsckeletal and not angina?
Customer: replied 1 year ago.
I I dont think you have clarified explained where the or not this is a cardia related probellem sorry not much use to me
Expert:  Dr. Arun Phophalia replied 1 year ago.

This is likely to be musculoskeletal as during similar pain; your investigations related to heart/angina were normal. No harm in keeping high index of suspicion and repeating them for the caution.

These are the other causes of the pain experienced by you;

1) Esophageal spasm
2) Esophageal motility disorder
3) Esophagitis

Following treatment may help you in the case of above;

a) Calcium channel blockers (diltiazem, nifedipine) decreases the spasm and improves the movements of the esophagus.
b) Relaxation techniques.
c) Noncardiac chest pain in the setting of esophageal spasm and esophageal movement disorder (dysmotility) often shows good response to antireflux therapy, even in the absence of typical gastroesophageal reflux symptoms.
d) Reassurance and control of anxiety is extremely important.

Expert:  Dr. Arun Phophalia replied 1 year ago.

Please feel free to discuss anything further.

A severe chest pain usually warrant categorical ruling out of heart associated issues. But 50% of chest pain are non heart related.

Having more of the following risk factors increases risk of heart disease.

  • A previous heart attack or stroke.

  • A family history of heart disease.

  • Elevated total and LDL cholesterol levels.

  • Low HDL level.

  • High blood pressure.

  • Cigarette smoker.

  • Uncontrolled diabetes or high blood pressure.

  • Physical inactivity.

  • Obesity or being overweight.

  • Raised high sensitivity CRP (hsCRP)

As discussed; you may get an EKG and treadmill test with Troponin, just for the caution.

Expert:  Dr. Arun Phophalia replied 1 year ago.

A comprehensive work up for angina is by following;

1) 24 hours EKG; Holter monitoring.

2) Echocardiography

3) CT scan angiography

4) Thallium nuclear scan.

5) Treadmill test

6) HsCRP

So you may ask your doctor to get this work up if you have risk or coronary artery disease for your symptoms.

If this is ruled out; you would require to look for non cardiac chest pain causes.

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.

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Thank you.

Wishing you all the very best in life.

Expert:  Dr. Arun Phophalia replied 1 year ago.

Thank you for the opportunity to answer completely your Question. Please make sure to rate me because that is how I am credited for my work.

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