Dr. Sugreev Singh
Internal Medicine
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am a 31-year-old male. I have a history of a general anxiety disorder, hypertension, high cholesterol, and GERD. I am taking Amlodipine, Atenolol for hypertension, and Atorvastatin for cholesterol. I have shoulder pain, back pain, and arm pain every time when I step out of my house. When I am inside the home, I do not experience anything. But when I go for a walk or travel to someplace, I start getting pain that comes and goes on the shoulder, arms, and back near or around the shoulder blades. I get nervous and I am worried about whether I am facing issues related to my heart. The pain seems to be like nerve pain rather than muscle pain.
Hi,
Welcome to icliniq.com.
I understand your concern and I have gone through the reports (attachment removed to protect patient identity). There is a slight elevation in TSH (thyroid-stimulating hormone) levels and triglyceride is not so high. There is nothing to worry. All these symptoms are associated with anxiety alone. Do not worry and you do not have any heart pathologies. Pain in the shoulder and back can occur due to hypertension. Acid reflux can lead to heartburn and abdominal pain. I would suggest you take tablet Pantop 40 mg (Pantoprazole) once a day before taking a meal. Please mention your blood pressure.
Patient's Query
Thank you doctor,
I have a blood pressure of 124/88 mmHg and a pulse rate of 88 beats per minute. My doctor suggested me to take Omeprazole for acid reflux and he told me to take it only when I have acid reflux. I do not take it every day.
Hi,
Welcome back to icliniq.com.
Omeprazole is good for acid reflux. If 20 mg does not help you, then you can take Omeprazole 40 mg before a meal. Your blood pressure and heart rate are absolutely normal. Do not worry. To overcome anxiety, I suggest you spend time with your friends and do not think about heart issues. Because you have done the tests and everything is normal and there it is nothing to worry about it. You try to do physical exercise on a daily basis. Try to have a healthy diet with juices and vegetables. Please mention from when do you experience these symptoms.
Patient's Query
Thank you doctor,
I am experiencing this pain for six months now. I have shared the X-ray of the neck. I am a software engineer and I spend a lot of time in sitting in front of the laptop. Does the neck X-ray indicate pain in the shoulder, arms, and back?
Hi,
Welcome back to icliniq.com.
Yes, you have mild spondylitis and this X-ray is taken before two years. Yes, the pain is associated with it. I suggest you take an X-ray once again and send me the reports. Please use neck support when you are in front of the computer. For the pain, you can apply Diclofenac gel or spray 0.01 percent on the neck once a day when you have pain.
Patient's Query
Thank you doctor,
I will do an X-ray once again and I will share it with you. For now, I apply Diclofenac gel as you suggested. Thank you doctor.
Hi,
Welcome back to icliniq.com.
Yes, you can send me the reports after taking an X-ray and I will go for further treatment.
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Internal Medicine
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