What could cause chest pain, and how can it be managed?

Question

Hi doctor,

For the past two months, my husband has been experiencing chest pain. It is likely a muscle strain caused by the exercise machine he uses. The pain is not constant; it comes and goes, and sometimes he feels it on the left side of his back. Please suggest some medications for permanent pain relief.

Answer 1

Hi,

Welcome to icliniq.com.

The likely causes of his chest pain are gastritis and reflux disease. Does he also experience upper abdominal pain, nausea, bloating, burping, increased pain while eating, a sour sensation in the throat, or chest burning? These could be associated symptoms. He should avoid fatty, oily, and spicy foods, and take a walk after meals. It is advisable to have multiple small meals instead of heavy ones, maintain regular sleep habits, and avoid stress. He should include plenty of green leafy vegetables and fruits in his diet while avoiding smoking and alcohol. Elevating the head of the bed or using pillows while sleeping or resting can also help.

He should take a combination of Pantoprazole and Domperidone 40 mg before breakfast once a day for two weeks. If he does not experience adequate relief, you should consider adding syrup Sucralfate or an antacid and anti-gas medication, two teaspoons three times a day for a week.

To evaluate the possibility of muscle strain, does he feel pain when pressing on the chest area, or does the pain reappear with movement? If so, a muscle strain is likely. For muscle strain, he should apply Diclofenac gel two to three times a day to the affected area and take a tablet of Thiocolchicoside 4 mg three times a day for five days.

I hope this helps! Please reach out if you have any doubts.

Answer 2

Hi,

Welcome back to icliniq.com.

An evening occurrence further suggests that reflux may be the cause. Does the pain increase when pressure is applied to the area? If so, we can conclude that it is originating from the skin and underlying muscles or bone. Sometimes, pain from deeper structures can also appear to originate from the skin. Cardiac pain typically occurs with exertion, is relieved with rest, and is associated with sweating and anxiety. Therefore, this does not seem to be cardiac pain.

Additionally, cardiac pain will not increase with inspiration. However, there is no harm in getting an ECG (electrocardiogram) done. Please upload it here so that I can confirm the diagnosis. If the ECG is normal, the likelihood of a cardiac issue is further reduced. Importantly, does he smoke or drink? If so, he should avoid these habits.

Answer 3

Hi,

Welcome back to icliniq.com.

Continued drinking can cause this type of pain. If he is currently drinking, it is advisable for him to stop. I assume he does not have any other illnesses. Thiocolchicoside does not have any serious allergic potential. Initially, he can take it once a day, and if he tolerates it well, he can increase the dosage to twice or even three times a day. It may cause some sedation. Additionally, he should take the tablet Pantoprazole as advised previously.

Answer 4

Hi,

Welcome back to icliniq.com.

Sedation (sleepiness) is not a prominent side effect. However, the first dose can be taken on a holiday, and if sedation is not significant, he can take it safely. Other side effects that may occur include gas and acidity. Tramadol and Paracetamol are acceptable; they should be taken after food to avoid causing gastritis and abdominal pain. Since he is not currently taking it, it will not affect the pregnancy or the baby

I hope this helps you.

Thank you.