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3 days ago I woke up with really sharp pain in my left

Customer Question
3 days ago I...

3 days ago I woke up with really sharp pain in my left shoulder. Not the muscle, more like the joint. I noticed throughout the day that the pain was getting worse. I noticed that it started hurting undearneath my left rib cage at the same time. Now, my shoulder and below the rib cage hurst when I cough, eat, take a deep breath or move forward. I took some Ibuprofen and Aleve but the pain is not going away

Doctor's Assistant: When did you start using Aleve? How severe were any side effects?

2 days ago

Doctor's Assistant: Have you seen a doctor about cough?

I live in Atlanta and every year around this time i cough due to pollen

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

No nothing

Submitted: 1 month ago.Category: Medical
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Answered in 31 minutes by:
3/17/2018
Doctor: Dr. Muneeb Ali, Doctor replied 1 month ago
Dr. Muneeb Ali
Category: Medical
Satisfied Customers: 9,213
Experience: MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
Verified

Hi,

Welcome to JA and thanks for this question. I'm sorry to hear about your symptoms. Actually, there are a few possibilities which can cause this sort of pain. The first one which comes to mind is that you could have developed a problem with the coverings of the lungs which are known as the pleura. This could be inflamed because of a viral infection in a condition known as pleurisy. It can cause pain while coughing or breathing which may radiate into the shoulder as well. It can in severe cases, cause shortness of breath or even a fever. Usually, the diagnosis can be confirmed with the help of a simple clinical examination and a chest x-ray. The treatment would be with steroids to reduce the inflammation.

Another cause of this could be related to the shoulder joint itself, rotator cuff tendinitis can cause this sort of pain which can radiate down into the shoulder and even the ribcage. It is also possible that inflammation of the tendons in the region is also causing compression of the nerves which is leading to the sharp nature of the pain. Usually, a MRI of the region would be diagnostic and in order determine if the nerves are involved or not, an NCV/EMG may be necessary however first we would treat it with regular anti-inflammatory medications along with steroids to try and control the problem.

Another cause can be related to the joint, arthritis along with inflammation of the cartilages of the ribs known as costochondritis can be responsible for this pain. Again a clinical examination would be necessary to make the diagnosis.

At the moment I would advise using ibuprofen at the maximum dose of 800 mg thrice daily, add OTC Tylenol at a dose of 1 g thrice daily along with the application of topical OTC capsaicin gel as well. Apply heat to the area intermittently. But you DO need to get this evaluated as soon as possible especially for pleurisy.

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Doctor: Dr. Muneeb Ali, Doctor replied 1 month ago

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