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Q. I have chest soreness and radiating pain. Is this due to pleurisy or costochondritis?

Answered by
Dr. Rahul Rathee
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 21, 2014 and last reviewed on: Oct 09, 2018

Hello doctor,

  • I am a 36 year old, otherwise healthy (as far as I know) female.
  • I was a smoker earlier. No history of heart disease.
  • My mother has COPD, but has been a long time smoker. 
  • Two and a half weeks ago, I went on a hayride with my sons.
  • I have a short stature. To get on and off the hayride, I literally had to pull myself up onto the trailer. (Imagine pulling yourself out of a swimming pool).
  • The next morning, I woke up with chest soreness.
  • I had pain in the upper left chest area, a few inches to the left of sternum.
  • That was a radiating pain over the breast towards armpit.
  • Pain worsened on bending over.
  • Also, I could locate very tender spots when pressing on the area with fingers.
  • I had no pain during regular breathing, but very deep breaths caused pain to worsen (from the left of sternum radiating across and to the left breast). 
  • Over the past two and a half weeks, pain has improved, but still not completely subsided.
  • Most of the pain (while bending) is gone, but I still have tender areas across upper left chest when poking around with finger (trigger points?).
  • I have some minor discomfort on taking deep breath, but greatly improved from what it was.
  • And now pain is just in an area to the left of my left breast.
  • Now, pain is mostly towards armpit area and may be slightly radiating to the upper, bottom side of arm.
  • I do not have much pain as it was in the beginning, but more of soreness.
  • It is not constant, it occurs mostly just when I move in a certain way or tense my chest.
  • Also I am noticing upper left back discomfort, not really pain. 
  • Local FNP suspects strained muscle. No x-rays were done.
  • I have no cough, no shortness of breath, no loss of appetite, no indigestion or heartburn.
  • Otherwise I feel fine. My concern is that I still have some pain and discomfort after almost 3 weeks.
  • Shouldn't a muscle strain be healed by now?
  • I am a bit concerned as it may be something more serious than a strained muscle, perhaps pleurisy or costochondritis?

 

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Hello,

Welcome to icliniq.com.

You are right, muscular pain will not last so long.

Pleurisy:

  • It is an inflammation of the outer covering of lungs.
  • It is most commonly caused by infections in which condition there will be fever which is not present in your case.
  • Rarely it can also be caused by chest trauma i.e, what has happened in your case.
  • Get a Decubitus chest x-ray to rule it out.
  • Treatment is by simple analgesics such as tablet Ibuprofen thrice a day for 2-3 weeks.

Chostochondritis:

  • This is caused due to physical strain/injury/arthritis/infections.
  • Symptoms of pleurisy and costochondritis are the same i.e, pain during deep respiration/tenderness on applying pressure.
  • Treatment here also is the same i.e, analgesics.

Another possibility is that you might have a rib fracture.

Start taking analgesic and hot fomentation 2-3 times a day for the painful region.

Use a thoracic belt to restrict movements of the affected part. 

Get a chest x-ray done immediately and revert back to a general practitioner online --> https://icliniq.com./ask-a-doctor-online/general-practitioner


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