What Is Fibromyalgia? Causes, Risks, Tender Points, Symptoms, and More

What Is Fibromyalgia?

Fibromyalgia is a non-life-threatening, chronic disorder with widespread pain as its main symptom.

This musculoskeletal condition affects your whole body. When you have fibromyalgia, your brain may process pain signals differently. This could cause you to feel more intense pain. You may also have problems with your bowels, memory, sleep, or mood.

A related, key part of fibromyalgia is the presence of “tender points.” These are areas on your muscles and tendons that are tender when pressed. Typically, tender points are in your neck, back, knee, shoulder, elbow, and hip.

You may also have trigger points with fibromyalgia. These are areas on the muscles around your bones that hurt when pressed. Trigger points may also cause pain or tenderness that you feel in other areas of your body. This is called referred pain. You could have weak muscles, too.

Fibromyalgia Symptoms

Fibromyalgia symptoms may start after you’ve had a physical injury, surgery, infection, or extreme stress. But you may notice symptoms build up over time for no particular reason.

Symptoms may include:

• Muscle pain throughout the body
• Tenderness at certain points
• Pain that:
  • Ranges from mild discomfort to severe enough to limit daily activities
  • Commonly occurs in the neck, upper back, shoulders, chest, rib cage, lower back, and thighs
  • May feel like a burning, gnawing, throbbing, stabbing, or aching
  • Might come on gradually
  • Could seem worse when you try to relax and is less noticeable during activity

Fibromyalgia Causes

The basic cause of fibromyalgia is still unknown. More than one thing may be involved. Possible causes include:

• Problems in the way your brain and nerves process pain. Experts don’t know what causes this. Nerve stimulation may cause you to have high levels of brain chemicals called neurotransmitters. These chemicals lead to changes in how your brain perceives pain. You may feel painful reactions to mild causes.
• Not getting enough sleep
• Physical or emotional trauma
• Infection or other illness

Fibromyalgia Risk Factors

Risk factors for fibromyalgia include:

• Sex: Experts estimate that at least 5 million American adults have fibromyalgia. Of these, up to 90% are women.
• Family history: Fibromyalgia also seems to run in families, so a gene may be at least partly responsible for the condition.
• Age: Most people with fibromyalgia begin to notice symptoms between the ages of 20 and 40, but children and older adults may also get the condition.

Fibromyalgia Diagnosis

The doctor will give you a physical exam and ask you about your pain and other symptoms. If you’ve had widespread pain for more than 3 months that has no other clear cause, you may have fibromyalgia.

Other tests may help your doctor diagnose fibromyalgia or rule out other causes of your symptoms:

• Tender point exam, where the doctor presses down on 18 specific areas of your body to see if you feel any pain with light touch
• Complete blood count
• Thyroid function test
• Blood tests that check for signs of inflammation. These include:
  • Erythrocyte sedimentation rate
  • Cyclic citrullinated peptide test
  • Rheumatoid factor test

Fibromyalgia Treatment

Medications, exercise, diet, therapy, and self-management can help relieve your fibromyalgia symptoms.

Medications

Several drugs can relieve fibromyalgia pain, improve sleep, or treat other fibromyalgia symptoms:

Therapy

Different types of therapy can help you cope with fibromyalgia or manage your symptoms:

• Physical therapy can help you learn to do exercises, such as workouts in a pool, to improve your stamina, strength, and flexibility.
• Occupational therapy can help you learn new ways to do tasks at work to put less stress on your body.
• Counseling or mental health treatment can help you manage stress and learn to cope with fibromyalgia.

Lifestyle changes

Changes to your lifestyle may ease fibromyalgia symptoms and help you manage your condition:

• Regular exercise like walking, swimming, biking, or stretching can relieve fibromyalgia pain. Stick with your exercise routines and build up your stamina a little at a time.
• Try to get enough sleep at night. Don’t take afternoon naps. Set a regular bedtime and stick to it.
• Find ways to manage your stress. Take time to relax. Deep breathing or relaxation exercises may help. Don’t try to do too much in your daily schedule. It’s OK to say no to some invitations or requests.
• Eat a healthy diet of fresh foods. Keep your caffeine intake low.

Alternative therapies

Some people with fibromyalgia use alternative or complementary treatments to relieve pain or improve their symptoms. These treatments may include:

• Yoga and tai chi, exercises that include gentle movement and breathing to help you relax
• Meditation
• Acupuncture, where a trained practitioner inserts tiny needles into the skin at specific spots to ease pain
• Massage therapy, which may help ease pain and relieve stress

Upper and Middle Back Pain | CS Mott Children’s Hospital

Overview

Is this topic for you?

This topic provides an overview of upper and middle back pain. If you have low back pain or neck pain, see the topic Low Back Pain or Neck Pain.

What is upper and middle back pain?

Upper and middle back pain can occur anywhere from the base of your neck to the bottom of your rib cage.

Your ribs attach to a long, flat bone in the center of the chest called the sternum and attach to and wrap around your back. If a nerve in this area is pinched, irritated, or injured, you may also feel pain in other places where the nerve travels, such as your arms, legs, chest, and belly.

The upper and middle back (called the thoracic spine) has:

• 12 vertebrae. These bones attach to your rib cage. They make up the longest part of your back.
• Discs that separate each vertebra and absorb shock as you move.
• Muscles and ligaments that hold the spine together.

See a picture of the spine.

Upper and middle back pain is not as common as low back pain or neck pain, because the bones in this area of the back don’t flex or move as much as the bones in your lower back or neck. Instead, they work with the ribs to keep the back stable and help protect vital organs, such as the heart and lungs.

What causes upper and middle back pain?

Upper and middle back pain may be caused by:

• Overuse, muscle strain, or injury to the muscles, ligaments, and discs that support your spine.
• Poor posture.
• Pressure on the

  spinal nerves
  from certain problems, such as a herniated disc.

• A fracture of one of the vertebrae.

• Osteoarthritis
  caused by the breakdown of cartilage that cushions the small facet joints in the spine.

• Myofascial pain
  that affects the connective tissue of a muscle or group of muscles.

In rare cases, pain may be caused by other problems, such as gallbladder disease, cancer, or an infection.

What are the symptoms?

Common symptoms of upper and middle back pain are:

• A dull, burning, or sharp pain.
• Muscle tightness or stiffness.

More serious symptoms that need to be treated right away include:

• Weakness in your arms or legs.
• Numbness or tingling in your arms, legs, chest, or belly.
• Loss of bowel or bladder control.

How is upper and middle back pain diagnosed?

Your doctor will first ask you about your past health, your symptoms, and your work and physical activities. Then he or she will do a physical exam. Your doctor may also order an imaging test, such as an X-ray or an MRI, to find out if something such as a broken bone or a herniated disc is causing your pain.

You may need more tests to check for other possible causes for your pain.

How is it treated?

In most cases, people with mild to moderate back pain can manage their symptoms with:

• Over-the-counter pain medicines
  , such as acetaminophen (for example, Tylenol) and nonsteroidal anti-inflammatory drugs (for example, Advil, Aleve, aspirin, and Motrin).

• Heat or ice.
• Exercise.

• Manual therapy
  , such as massage, mobilization, or spinal manipulation.

But if your pain gets worse and you’re having a hard time doing your daily activities, you may need to take a prescription pain medicine. Surgery is seldom used to treat upper and middle back pain.

How can you care for yourself at home?

There are several things you can do at home to help reduce your pain. For example:

• Rest. If your back hurts a lot, take a break. But try not to let too much time pass before you get moving again. Instead, return to your activities slowly.
• Use over-the-counter pain medicines, such as acetaminophen (for example, Tylenol) and nonsteroidal anti-inflammatory drugs (for example, Advil, Aleve, aspirin, and Motrin). These can reduce pain and swelling. Be safe with medicines. Read and follow all instructions on the label.
• Use a heating pad or ice pack. Heat can reduce pain and stiffness. Ice can help reduce pain and swelling.
• Exercise. Exercises that stretch and strengthen the muscles in your back, shoulders, and stomach can help improve your posture, decrease your chance of injury, and reduce pain.
• Practice good posture. Be sure to stand or sit tall. Don’t slump or slouch.
• Learn ways to reduce stress. You might try deep breathing and relaxation exercises or meditation.

Cause

In most cases, upper and middle back pain is caused by:

• Overuse, muscle strain, or injury to the muscles, ligaments, and discs that support your spine.
• Poor posture.

• Myofascial pain
  that affects the connective tissue of a muscle or group of muscles.

For example, some people hurt their backs when they:

• Slump or slouch when they sit or stand.
• Play sports or do yard work.
• Get jolted in a car accident.
• Get hit hard in the back.
• Lift something too heavy.

Conditions that put pressure on the spinal nerves also can cause pain. These include:

• Osteoarthritis
  . This occurs when the cartilage that cushions the small facet joints in the spine breaks down. When this happens, the back bones rub together and cause damage and pain. Osteoarthritis is caused by the normal wear and tear of the cartilage as you age.

• A fracture of the vertebrae, which can occur when a lot of force is put on the spine. This force can be from a car or bike accident or a direct blow to the spine. A compression fracture occurs when an injury to the bones in the spine causes them to break and collapse (compress) on each other, such as from a fall. In people who have osteoporosis, which makes the bones brittle and weak, a spinal bone can also break and collapse from only a minor injury or simply moving the wrong way.
• An odd-shaped spine, such as with scoliosis or kyphosis. This can make your back hurt. When you look at a normal spine from the back, it is usually straight. But when a person has scoliosis, the spine curves from side to side, often in an S or C shape. It may also be twisted. When a person has kyphosis, the upper spine is rounded and looks like a hump. In bad cases of scoliosis or kyphosis, a person may have a hard time breathing.

• A herniated disc
  . This occurs when one of the small, spongy discs that cushion your spine bulges or breaks open and presses on the nerves in the spine. A herniated disc may be caused by normal wear and tear of the disc as you age. Or it may be brought on by activities that you do over and over again that cause a lot of vibration or motion (such as using a jackhammer) or by a sudden heavy strain or increased force to your back. In most cases, a herniated disc occurs in the lower back or neck. It can occur in the upper or middle back, but this is rare. See a picture of a herniated disc.

• Spinal stenosis
  . The spinal cord runs through an opening in the bones called the spinal canal. Spinal stenosis occurs when that opening narrows. In some cases, bone, ligament, and disc tissue grows into the spinal canal and presses on the nerves that branch out from the spinal cord. The tissue can also squeeze and irritate or injure the spinal cord itself. In most cases, spinal stenosis occurs in the lower back and neck. It can occur in your upper or middle back, but this is rare.

• Degenerative disc disease
  . This is not really a disease but a term used to describe the normal changes that occur in your spinal discs as you age. Over time, the discs in your spine break down, or degenerate. A loss of fluid in the discs or tiny tears or cracks in the outer layer of the discs can occur over time. The breakdown of the discs can cause back or neck pain, arthritis, spinal stenosis, or a herniated disc. A sudden injury to your back, such as from a fall or a car accident, may also start this process. This problem can occur anywhere on your spine. But in most cases, it occurs in the discs in the lower back and neck.

In rare cases, upper and middle back pain may be caused by other problems, such as gallbladder disease, cancer, or an infection.

Symptoms

In general, symptoms of upper and middle back pain may:

• Feel like a dull, burning, or sharp pain.
• Be felt at a single point or over a broad area.
• Start suddenly or slowly get worse.
• Be constant or come and go.
• Occur with muscle tightness or stiffness.
• Get worse when you do certain activities or move and sit in a certain way.

More serious symptoms that need to be treated right away include:

• Weakness in your arms or legs.
• Numbness or tingling in your arms, legs, chest, or belly.
• Loss of bowel or bladder control.

When To Call a Doctor

In most cases, back pain gets better with home treatment. So unless you have signs of a severe illness, injury, or heart attack, you can give your back pain some time to work itself out before you call your doctor.

Call
911
or other emergency services immediately if:

• Back pain occurs with chest pain or other symptoms of a heart attack. Symptoms of a heart attack include:
  • Chest pain or pressure, or a strange feeling in your chest.
  • Sweating.
  • Shortness of breath.
  • Nausea or vomiting.
  • Pain, pressure, or a strange feeling in your back, neck, jaw, upper belly, or one or both shoulders or arms. See a picture of areas where symptoms may be felt.
  • Feeling dizzy or lightheaded.
  • A fast or uneven heartbeat.
• A person has signs of damage to the spine after an injury (such as a car accident, fall, or direct blow to the spine). Signs may include:
  • Being unable to move part of the body.
  • Severe back or neck pain.
  • Weakness, tingling, or numbness in the arms, legs, chest, or belly.

Call your doctor now if:

• You have a new loss of bowel or bladder control.
• You have new numbness in your legs or numbness in your legs that is getting worse.
• You have new weakness in your legs or weakness in your legs that is getting worse. (This could make it hard to stand up.)
• You have new or increased back pain with fever, painful urination, or other signs of a urinary tract infection.

Watchful waiting

Watchful waiting is a wait-and-see approach. If you get better on your own, you won’t need treatment. If you get worse, you and your doctor will decide what to do next. If your back pain is mild to moderate, it probably will get better on its own. You can try home treatment to relieve your symptoms. If you don’t feel better in 1 to 2 weeks, call your doctor.

Be sure to call your doctor right away if you start to have other symptoms or you have:

• Numbness.
• Weakness.
• Fever.
• Urinary symptoms, such as pain when you urinate.
• Pain that is getting worse.
• Pain that you can’t manage at home.

Who to see

Health care professionals who often diagnose the cause of back pain include:

If your back pain is severe or long-lasting, health professionals who can treat you include:

You can also get care from:

Exams and Tests

Your doctor will first ask you about your past health, your symptoms, and your work and physical activities. Then he or she will do a physical exam. Your doctor may also order an imaging test to find out if something such as a broken bone or a herniated disc is causing your pain.

The type of imaging test you have depends on what kind of problem your doctor suspects. You may have one or more tests, such as:

• An X-ray to look for injuries or diseases that affect the discs and joints of the spine.
• An MRI to look for injuries and diseases that affect the discs and nerves of the spine, such as a herniated disc, a pinched nerve, or a tumor. It can also show whether any part of the spinal canal has narrowed.
• A CT scan to look for a tumor, a fracture, a herniated disc, narrowing of the spinal canal, or an infection. It can also show whether osteoporosis is the cause of a compression fracture.
• A bone scan to look for damage to the bones, a tumor, or infection, or to find the cause of unexplained back pain.
• An electromyogram and nerve conduction study to check how well the spinal cord, nerve roots, and nerves and muscles that control your arms and legs are working. It can help find out what is causing pain, numbness, or weakness in the arms or legs.

More tests may be done to check for other possible causes for your pain.

Treatment Overview

There are many treatments for upper and middle back pain. What works for someone else may not help you. Work with your doctor to find what is best for you.

Treatment for upper and middle back pain is based on:

• How bad your symptoms are.
• How much your symptoms prevent you from doing your daily tasks.
• How well other treatments have worked.

Treatment for mild to moderate pain

In most cases, people with mild to moderate upper and middle back pain can manage their symptoms with:

• Over-the-counter pain medicines
  , such as acetaminophen (for example, Tylenol) and nonsteroidal anti-inflammatory drugs (for example, Advil, Aleve, aspirin, and Motrin), to reduce pain. But if these don’t get rid of your pain, you may need a prescription pain medicine that is stronger.

• Heat or ice to reduce pain and stiffness.
• Exercise to stretch and strengthen the muscles of your back, shoulders, and stomach.

• Physical therapy
  to help increase your flexibility, strength, and balance. Your physical therapist may teach you an exercise program so you can do it at home.

• Massage
  to help reduce muscle tension and pain for a short time and to improve blood flow.

• Spinal manipulation
  to help relieve pain and improve function. It can range from massage and slow pressing to a quick thrust.

• Acupuncture
  . It involves putting tiny needles into your skin at certain points on the body to promote healing and pain relief.

• Capsaicin
  cream may help relieve pain. ^{footnote 1} Capsaicin is a substance contained in cayenne peppers. Capsaicin cream is applied directly to the skin over the painful area.

Treatment if back pain gets worse

If your back pain doesn’t get better or it gets worse, your doctor may recommend:

• Prescription medicines, such as opioids, to help reduce pain.
• Muscle relaxants to help reduce pain and muscle tension and improve mobility. These can help with severe muscle spasms that happen when the back pain starts (acute phase).
• Antidepressants, such duloxetine, to help treat long-lasting (chronic) back pain.

• Steroid shots
  to help reduce swelling and relieve pressure on nerves and nerve roots. But there is little evidence showing that these shots can help control back pain.

In some cases, a back brace may be used to support the bones in the spine after a fracture.

Surgery is seldom used to treat upper and middle back pain. If your doctor recommends surgery, the type will depend on the problem you have. Surgery choices may include:

• Kyphoplasty or vertebroplasty
  . Bone cement is injected through a needle into the broken vertebrae to try to stabilize the bone. These surgeries are not done very often, because most fractures heal on their own. And there is no evidence that kyphoplasty or vertebroplasty are better than nonsurgical treatment.^{footnote 2}

• Herniated disc removal
  . It removes the portion of the disc that is herniated and pushing into the spinal canal. In most cases, herniated discs that occur in the upper and middle back are small and don’t need surgery. But you may need surgery for a large herniated disc that presses on the spinal cord.

• Spinal decompression for stenosis. It widens the spinal canal that has narrowed, and it relieves pressure on the spinal cord or nerves. This procedure is not done very often, because spinal stenosis in the upper and middle back is rare.

Home Treatment

There are several things you can do at home to help reduce your pain. For example:

• Rest. If your back hurts a lot, take a break. But try not to let too much time pass before you get moving again. Instead, return to your activities slowly, and avoid things that make your pain worse. Studies show that bed rest doesn’t relieve back pain better than staying active. And bed rest of more than a couple of days can make your back pain worse and lead to other problems, such as stiff joints and muscle weakness.
• Use

  over-the-counter pain medicines
  , such as acetaminophen (for example, Tylenol) and nonsteroidal anti-inflammatory drugs (for example, Advil, Aleve, aspirin, and Motrin). These can reduce pain and swelling. Be safe with medicines. Read and follow all instructions on the label.

• Use a heating pad or ice pack. Heat can reduce pain and stiffness. Ice can help reduce pain and swelling. You might want to switch back and forth between heat and cold until you find what helps you the most.
• Exercise. Ask your doctor or a physical therapist about what kinds of exercises you can do to stretch and strengthen the muscles in your back, shoulders, and stomach. These muscles help support your spine. Strong muscles can help improve your posture, keep your body in better balance, decrease your chance of injury, and reduce pain.

• Practice good posture
  . Poor posture puts stress on your back. Be sure to stand or sit tall, with your shoulders and your stomach pulled in to support your back. Don’t slump or slouch.

Here are some other things you can do to feel better:

• See a counselor. Cognitive-behavioral therapy can show you how to change certain thoughts and behaviors to control your pain. For more information, see the topic Stop Negative Thoughts: Choosing a Healthier Way of Thinking.
• Learn ways to reduce

  stress
  . Stress can make your pain feel worse. You might try deep breathing and relaxation exercises or meditation.

• Eat nutritious foods. Getting plenty of calcium and vitamin D may help prevent osteoporosis, which can lead to compression fractures and back pain. For more information, see the topic Healthy Eating.
• Don’t smoke. Smoking decreases blood flow and slows healing. If you need help quitting, see the topic Quitting Smoking.
• Take extra care when you lift. When you must lift, bend your knees and keep your back straight. Avoid twisting. Keep the load close to your body.
• Use a
  pain diary . Write down how your moods, thoughts, sleep patterns, activities, and medicines affect your pain. Having a record of your pain can help you and your doctor find the best ways to treat your pain.

References

Citations

1. Gagnier JJ, et al. (2016). Herbal medicine for low back pain: A Cochrane review. Spine, 41(2): 116–133. DOI: 10.1097/BRS.0000000000001310. Accessed June 17, 2016.
2. Esses SI, et al. (2011). The treatment of symptomatic osteoporotic spinal compression fractures. Journal of the American Academy of Orthopaedic Surgeons, 19(3): 176–182. Also available online: http://www.aaos.org/research/guidelines/guide.asp.

Other Works Consulted

• Hansen TJ (2015). Thoracic compression fracture. In WR Frontera et al., eds., Essentials of Physical Medicine and Rehabilitation, 3rd ed. , pp. 211–216. Philadelphia: Saunders.
• Mercier LR (2008). The back. In Practical Orthopedics, 6th ed., pp. 143–184. Philadelphia: Mosby Elsevier.

Credits

Current as of:
November 16, 2020

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP – Emergency Medicine
E. Gregory Thompson MD – Internal Medicine
Adam Husney MD – Family Medicine
Kathleen Romito MD – Family Medicine

Current as of: November 16, 2020

Author:
Healthwise Staff

Medical Review:William H. Blahd Jr. MD, FACEP – Emergency Medicine & E. Gregory Thompson MD – Internal Medicine & Adam Husney MD – Family Medicine & Kathleen Romito MD – Family Medicine

Rib Cramps and Back Pain – Symptoms

Rib cage pain can cause minimal tenderness to painful cramps or a feeling of burning. Often rib pain is caused by a spine issue, even if the chest and abdomen are more affected by the pain. Here are some potential causes of mid-spine rib pain, also known as the thoracic spine, suffering from this pain you need to visit pain management doctors in OKC.

Spinal pain is highly prevalent in the area of the lumbar (lower back) and cervical (neck) and is often the source of many missed working days. The common cause of low back pain is lumbar muscle strain and sprain. The thoracic spine may also cause spinal pain, but the thoracic spinal region is much less commonly damaged than the lumbar or cervical spine because it is much more rigid.

Thanks to its weight-bearing role and involvement in lifting, turning and bending, the lumbar and cervical spine are susceptible to strain. Lumbar muscle strain is caused by abnormally strained or broken muscle fibers. Lumbar sprain is caused by excessively stretched ligaments — the tight muscle bands that bind bones together. Both can be caused by a sudden injury or a chronic overuse.

The soft tissues are inflamed when the lumbar spine is stressed or sprayed. This inflammation causes pain and can lead to spasms of the muscle. While lumbar strain or sprain can be very weakening, neither of them normally require neurochirurgical treatment.

Spinal damage can be caused by more serious issues that may need to be treated surgically. They typically involve spinal pain that radiates from the back to the anterior chest into the arms, legs, or around the rib cage.

Symptoms Are Here

Non-surgical low back or cervical or thoracic pain affects the soft tissue of central and para-spinal without radiating around the neck, chest or legs. On the opposite, pain from the spine into the extremities or chest wall suggests systemic pinching of the spine nerves that may require surgical opinion if the condition with non-surgical symptomatic care does not improve within days to weeks.

Other Symptoms –

• Stiffness in the low back area, reduced movement distance.

• Inability due to fatigue and/or discomfort to maintain normal posture.

• Movement and rest spasms of the muscle.

• Pain that lasts for 10-14 days at most.

• Significant loss of motor function such as tiptoe and heel walking ability.

Fractured or displaced rib

A traumatic injury, like a collision causes fractures or displaced rib in which it interacts with thoracic spine. If the rib is pushed, it can cause cramps in rib muscle between, such as in the back or front. It can also squeeze the intercostal nerve and transfer pain, tingling, numbness along the rib, into the chest, and less typically into the abdomen.

Thoracic herniated disc

While rare, a thoracic herniated disk can cause inflammatory proteins to leak from the disk and inflame a thoracic spinal nerve, causing pain along the nerve path. Pain, tingling, and/or numbness can radiate to the chest or abdomen anywhere from the herniation site in the upper back along the rib. With certain forms of operation, such as intense exercise or bending, discomfort can come and go and may intensify.

Thoracic osteoarthritis

Osteoarthritis thoracic occurs when protective cartilage in the thoracic spine begins to break down within the facet joints. Osteoarthritic joints are inflamed, and bones tend to rub together, which can cause bone spurs to increase.

Visit a Doctor

Call for medical attention if intense discomfort is serious enough in the rib cage region to restrict movements or does not ease with rest. However, any kind of radiating discomfort, tingling, numbness, or fatigue needs an immediate medical examination. The earlier it begins; care is usually more successful. An accurate medical diagnosis is crucial, rather than trying to ignore the pain.

Contact Longevity Institute for pain management doctors in OKC.

**Disclaimer: This content should not be considered medical advice and does not imply a doctor-patient relationship.

Symptoms, Causes, Risk Factors & Complications

The upper back consists of the thoracic spine (bony structures called vertebrae surrounding the nerves of the spinal cord). Between the vertebrae are spongy sacs of cartilage called discs that act as a cushion and provide a range of motion to the back. Muscles, tendons and ligaments provide additional support. Any of these structures in the back can become irritated or inflamed in response to a variety of mild to serious conditions.

A common cause of mild to severe pain in the upper back is a sudden movement during sports activities or home improvement projects. Upper back pain can also be due to more serious conditions, such as fibromyalgia, spondylitis (a type of arthritis of the spine), or disc herniation. A bulging disc can put pressure on the nerve roots coming out from the spine, resulting in upper back pain. Although the lower back is a “hot spot” for bulging, or herniated, discs, the discs in the upper back can also deteriorate and rupture.

In addition, a problem in another part of the body, such as the heart, can radiate to the upper back. This is called referred upper back pain.

Structural causes of upper back pain

Thoracic back pain can be due to injury, inflammation, or infection of the bones and tissues including:

Life-threatening causes of upper back pain

In some cases, back pain may be due to a serious or life-threatening condition that should be evaluated as soon as possible or in an emergency setting. Possible life-threatening conditions that involve upper back pain include:

• Heart attack

• Kidney stones and disease (although this pain is usually below the rib cage)

• Multiple myeloma

• Spinal tumor or cancer (the tumor can be noncancerous, also known as benign)

What are the risk factors for upper back pain?

Although anyone can experience upper back pain, there are certain risk factors that make you more likely to develop it. Being older than 30 years of age and leading a sedentary lifestyle are the most common risk factors. These and other risk factors include:

• Congenital (present at birth) or acquired back deformities (such as scoliosis)

• Family history of back pain or spine disease

• Increasing age

• Obesity

• Poor posture

• Sedentary lifestyle

• Smoking

• Stress and anxiety

• Weak abdominal (core) muscles

What are the potential complications of upper back pain?

The complications associated with any kind of back pain depend on the underlying disease, disorder or condition. Most cases of upper back pain are not due to serious diseases and do not lead to long-term complications. Physical therapy, basic self-care measures, and following the treatment plan outlined by your doctor can help treat many causes of back pain and relieve pain. However, upper back pain may become chronic and overwhelming. If you are struggling, ask your doctor about advances in back pain treatment.

Over time, upper back pain can lead to complications including:

• Absenteeism from work or school

• Permanent nerve damage (due to a pinched nerve) including paralysis

• Physiological and psychological response to chronic pain

• Poor quality of life

Mid back and rib pain

Are you suffering pain in your chest? Does it spread down your arm, around your ribs or and into the front of your chest?

Rib misalignment is often the culprit.

Rib pain occurs as the result of restrictions associated with the costosternal and costovertebral  joints. In the upper to mid back region, each rib forms two joints with the thoracic spine, as well as an additional joint in front where they connect with the sternum or breastbone. If any these joints becomes restricted and inflamed you may experience severe pain in the chest or back.  Often radiating pain along the rib cage in a specific distribution is experienced. This may occur as the result of injury (athletic injury, a fall or whiplash from a car accident), prolonged positioning (such as sitting in front of a computer, television, reading, etc.), or may come on without warning.

It will usually feel like a severe muscular ‘knot’  to the left or right of the spine, close to the shoulder blade. The muscles of the back spasm and tighten to protect the misalignment.

This pain can be severe and often people will end up rushing to hospital emergency rooms because they are convinced they are having a heart attack or other cardiac event. As rib inflammation and restriction can be experienced by difficulty breathing, pain into the neck, and radiating pain/tingling/numbness down the arm or into the hand.

Patients with fever, severe cough or breathing difficulties with frontal chest pain should consult their medical practitioner.

Rib pain may be called costo-transverse sprain, intercostal neuralgia or costochondritis and is often due to years of poor rounded (kyphotic) posture. Typically sloughing postures at desks, over laptops, ipads or on sofas are common causes.

Mid back pain can result following spinal misalignment of the mid back or misalignment of the neck or low back .The spine itself can become misaligned exactly where it hurts, irritating nerves, muscles and ligaments in that area. Pain in the mid back can occur from misalignment of the low back and pelvis, or in the neck. Underlying mechanical problems elsewhere in the spine need to be addressed in order to gain long term relief and prevent reoccurrence.

At Springwood Chiropractic we will obtain a full case history and carefully examine the musculoskeletal system and assess particularly the movement of individual ribs. We are able to detect mechanical sources of pain and thus the cause(s) of your presenting symptoms. We then create a treatment plan to reduce inflammation and restore normal joint motion as well as improving strength and stability .This is accomplished through a comprehensive treatment consisting of chiropractic care, physical rehabilitation, postural and lifestyle advice.

Costochondritis – NHS

Costochondritis is the medical term for inflammation of the cartilage that joins your ribs to your breastbone (sternum). This area is known as the costochondral joint.

Cartilage is tough but flexible connective tissue found throughout the body, including in the joints between bones.

It acts as a shock absorber, cushioning the joints.

Costochondritis may improve on its own after a few weeks, although it can last for several months or more.

The condition does not lead to any permanent problems, but may sometimes relapse.

Tietze’s syndrome

Costochondritis may be confused with a separate condition called Tietze’s syndrome.

Both conditions involve inflammation of the costochondral joint and can cause very similar symptoms.

But Tietze’s syndrome is much less common and often causes chest swelling, which may last after any pain and tenderness has gone.

Costochondritis also tends to affect adults aged 40 or over, whereas Tietze’s syndrome usually affects young adults under 40.

As the conditions are very similar, most of the information below also applies to Tietze’s syndrome.

Signs and symptoms of costochondritis

When the costochondral joint becomes inflamed, it can result in sharp chest pain and tenderness, which may develop gradually or start suddenly.

The pain may be made worse by:

• a particular posture, such as lying down
• pressure on your chest, such as wearing a seatbelt or hugging someone
• deep breathing, coughing and sneezing
• physical activity

When to seek medical help

It can be difficult to tell the difference between the chest pain associated with costochondritis and pain caused by more serious conditions, such as a heart attack.

But a heart attack usually causes more widespread pain and additional symptoms, such as breathlessness, feeling sick and sweating.

If you or someone you’re with experiences sudden chest pain and you think there’s a possibility it could be a heart attack, dial 999 immediately and ask for an ambulance.

If you have had chest pain for a while, do not ignore it. Make an appointment to see a GP so they can investigate the cause.

Causes of costochondritis

Inflammation is the body’s natural response to infection, irritation or injury.

It’s not known exactly why the costochondral joint becomes inflamed, but in some cases it’s been linked to:

• severe coughing, which strains your chest area
• an injury to your chest
• physical strain from repeated exercise or sudden exertion you’re not used to, such as moving furniture
• an infection, including respiratory tract infections and wound infections
• wear and tear – your chest moves in and out 20 to 30 times a minute, and over time this motion can lead to discomfort in these joints

Diagnosing costochondritis

If you have symptoms of costochondritis, a GP will probably examine and touch the upper chest area around your costochondral joint.

They may ask you when and where your pain occurs and look at your recent medical history.

Before a diagnosis can be confirmed, some tests may need to be carried out to rule out other possible causes of your chest pain.

These may include:

If no other condition is suspected or found, a diagnosis of costrochondritis may be made.

Self-help for costochondritis

Costochondritis can be aggravated by any activity that places stress on your chest area, such as strenuous exercise or even simple movements like reaching up to a high cupboard.

Any activity that makes the pain in your chest area worse should be avoided until the inflammation in your ribs and cartilage has improved.

You may also find it soothing to regularly apply heat to the painful area, such as using a cloth or flannel that’s been warmed with hot water.

Treatments for costochondritis

Painkillers

Painkillers, such as paracetamol, can be used to ease mild to moderate pain.

Taking a type of medication called a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen and naproxen, 2 or 3 times a day can also help control the pain and swelling. 

Aspirin is also a suitable alternative, but should not be given to children under 16 years old.

These medicines are available from pharmacies without a prescription, but you should make sure you carefully read the instructions that come with them before use.

NSAIDs are not suitable for people with certain health conditions, including:

Contact a GP if your symptoms get worse despite resting and taking painkillers, as you may benefit from treatment with corticosteroids.

Corticosteroid injections

Corticosteroids are powerful medicines that can help reduce pain and swelling.

They can be injected into and around your costochondral joint to help relieve the symptoms of costochondritis.

Corticosteroid injections may be recommended if your pain is severe, or if NSAIDs are unsuitable or ineffective.

They may be given by a GP, or you may need to be referred to a specialist called a rheumatologist.

Having too many corticosteroid injections can damage your costochondral joint, so you may only be able to have this type of treatment once every few months if you continue to experience pain.

Transcutaneous electrical nerve stimulation (TENS)

TENS is a method of pain relief where a mild electric current is delivered to the affected area using a small battery-operated device. 

The electrical impulses can reduce the pain signals going to the spinal cord and brain, which may help relieve pain and relax muscles.

They may also stimulate the production of endorphins, which are the body’s natural painkillers.

Although TENS may be used to help relieve pain in a wide range of conditions, it does not work for everyone.

There’s not enough good-quality scientific evidence to say for sure whether TENS is a reliable method of pain relief.

Speak to a GP if you’re considering TENS.

Find out more about transcutaneous electrical nerve stimulation (TENS)

Community content from HealthUnlocked

Page last reviewed: 24 April 2019
Next review due: 24 April 2022

Disc Prolaps of Upper Back

What is spinal disc herniation (prolaps) of the upper
back?

Spinal disc herniation (disc prolaps), or herniation of the
nucleus pulposus (HNP), occurs when part of an intervertebral disc bulges
out; it is most commonly seen in the lower back (lumbar vertebrae)
or in the neck (cervical vertebrae), but can also occur in the
upper back (thoracic vertebrae). When the intervertebral disc
bulges out, it puts pressure on a nerve root. This can cause the
nerve root to become irritated or trapped, leading to symptoms in
the area of the nerve root. The herniation can also put pressure on
the spinal cord, resulting in pain.

Causes

Ageing can cause the inner part of the intervertebral disc to
bulge out and a tear may even occur in the outer layer of the
intervertebral disc. This causes the inner part of the
intervertebral disc to be pushed forwards in the direction of the
spinal canal, which is
exactly where the nerve root is found. These age-related changes in
intervertebral discs are normal and happen to everyone. Therefore,
anyone can suffer from a herniated disc of the upper back. A
herniated disc of the upper back is also seen more frequently in
certain families. Smoking appears to influence the development of a
herniated disc, particularly the severity.

Signs and symptoms

The major symptom in a herniated disc of the upper back is the
radiating pain in the chest. This pain in the chest usually occurs
before or at the same time as the pain in the upper back. The pain
worsens with coughing, sneezing or straining while defecating, but
the symptoms in the chest can also worsen upon stretching or
turning sideways or bending the upper back. A sharp and stabbing
pain is often felt. In addition, there may be a loss of feeling,
tingling sensations, or muscle weakness. If the herniated disc puts
pressure on the spinal cord, this may cause pain in the legs and
interfere with the coordination of the legs.

How is spinal disc herniation diagnosed?

If you have a radiating pain in the chest, which worsens upon
coughing, sneezing or straining, there is a strong chance that you
have a herniated disc of the upper back. The neurological examination
includes several tests that can confirm this. In addition to the
neurological examination, the movements of the upper back are
checked for limitation and pain. The upper back is also examined in
order to feel which vertebrae are painful when pressure is put on
them.

Do I need any additional examinations?

• Diagnostic examination for other non-physical factors important
  for your pain, have already been done by yourself trough filling
  out your pain questionnaires.

• Additional examinations are not always necessary since the
  neurological examination usually confirms the diagnosis. It is
  important to note that an MRI
  scan can reveal herniation of an intervertebral disc in many
  people who do not have symptoms. It is also possible for a person
  with radiating chest pains, whose doctor suspects a herniated disc,
  to have an MRI scan of
  the upper back that does not show a herniated disc.

• An MRI scan is only useful in cases where there are doubts
  regarding the diagnosis, or when surgery is considered. An MRI scan
  visualises the herniated disc and may show other possible
  causes.
• A CT scan is not
  usually worthwhile, since this only provides good images of the
  bones.
• A muscle scan (EMG)
  can be performed in order to discover which nerve root in the upper
  back is causing the pain.
• Nerve
  root test blocks are used to discover which nerve root is
  causing the pain in  your arm.

What are my treatment possibilities?

Multidisciplinary Treatment

Depending on the cause of your pain, your pain specialist will
decide whether or not to embark on physical treatment. Based on the
results of the completed pain questionnaire, additional
examinations can be carried out and, apart from physical treatment,
other methods of treatment will be suggested.

Non-physical Treatments

If the results of your pain questionnaire are abnormal, your
pain specialist will offer you one of the non-physical treatments
listed below:

Physical Treatments

Medication

Interventional Pain Treatments

Invasive treatment

In case of neurological symptoms and/or problems such as pain in
the legs and disturbed coordination of the legs, due to spinal disc
prolaps in the upper back, you will be referred to a neurosurgeon
for an operation.

90,000 Pain in the thoracic spine. Pain and burning between the shoulder blades. Reasons, treatment

In this article:

Cause of pain: hernia or not?

The easiest place to start would be with “fashionable” herniated discs. But our many years of practice (as well as world experience) have shown that disc herniation in the thoracic spine is a great rarity. Below is an MRI of a herniated disc of the thoracic spine – an extremely rare case.

If a hernia is detected on an MRI of the thoracic spine, then, as a rule, it is not the main cause of pain.

What to do with pain in the thoracic spine and burning between the shoulder blades?

1. A neurological examination of the patient is required to clarify the level of pain.
2. It is necessary to compare the clinical data with the MRI examination of the thoracic spine.
3. If the neurological examination does not reveal absolute indications for removal of herniated disc , it is necessary to find the true cause of back pain.

Diagnostics and treatment are carried out in the same building at the Meddiagnostika Center at the addressKiev, left bank, 250 m from Darnitsa metro station, Stroiteley lane, house 4, see the map.

Most common causes of pain in the middle part of the back (in the thoracic spine)

Spondyloarthrosis

The most common cause of pain in the thoracic spine is the pathology of the joints: intervertebral and costo-vertebral. More often it is spondyloarthrosis . Spondyloarthrosis is a degenerative process in the joints of the spine.

Aging of the joints, a decrease in the height of the cartilage tissue in the joints of the thoracic spine leads to inflammation of these joints.This is the so-called painful facet syndrome m . This pathology is common and is accompanied by a burning pain between the shoulder blades or a burning sensation between the shoulder blades.

We have studied in detail mechanisms of facet syndrome back in the 80s of the last century. This was the time when the formation of vertebro-neurology to Uraine took place, as a specialty .

Muscle spasm

Pain between the shoulder blades and in the chest washes increased due to secondary overstrain of the paravertebrates.Studying the state of the paravertebral muscles in facet syndrome, we were able to find patterns in how these muscles change over time.

It turned out if the so-called. muscle spasm is not treated in time, the muscles from the state of spasm pass into a state of prolonged contracture, and then gradually degenerate into long cords. These “muscle cords” are painful to palpation and can be a source of independent pain.

Such changes in the deep muscles of the back are possible because there are many so on in their muscle tissue.n. red fibers that can remain in a state of spasm for a long time. These “red” muscles hardly get tired. But even in a state of prolonged spasm, they cannot stay forever. Therefore, they hurt.

This muscle spasm is pain in the ribs and in the spine, more often between the shoulder blades.

Other muscle problems that cause back pain in the area of ​​the shoulder blades and neck

Pain can occur when the spine is overloaded from prolonged sitting. This happens when a person sits with their back straight.Bent over as in the photo below. In the absence of his own muscle corset, a person cannot keep his back straight for a long time. The muscles are overstretched, their spontaneous prolonged activity occurs and muscle pain in the back occurs.

In case of violation of posture

Pain in the back and shoulder blades with scoliosis

Pain in the thoracic spine occurs with scoliosis. They often begin after puberty, when weight increases and the spine becomes more mobile.These pains are caused by overloading the joints of the spine and paravertebral muscles.

Spine instability

Increased mobility of the spine is called instability.

N The instability of the spine leads to pain more often with axial (vertical) load, when there is a persistent displacement in the joints and the paravertebral muscles are overstrained.

Osteoporosis

In elderly people, burning pain between the shoulder blades and in the thoracic spine can be caused by osteoporosis , a compression fracture of the vertebral bodies.

With osteoporosis, rib fractures can hurt, which can also give pain between the shoulder blades and in the paravertebral regions.

Tumors of the chest level

Possible tumors in the thoracic spine (see MRI below).

For pain in the thoracic spine, MRI is definitely recommended to exclude tumors and metastases (MRI scan below).

Reflected back pain

In elderly people, pain in the spine is possible with atherosclerosis and myocardial infarction .These are reflected pains that can initially be mistaken for back pain.

Back pain can be a consequence of the pathology of the organs of the chest cavity: heart, lungs, esophagus. Also, pain in the thoracic spine and in the chest can occur with diseases of the stomach, pancreas, small intestine and some areas of the large. For example, a stomach ulcer or stomach cancer usually gives rise to reflected back pain. The approximate zones of localization of these pains are shown in the figure below:

1. Lungs, heart
2. Liver and gallbladder
3. Heart and small intestine
4. Aperture
5. Pancreas and stomach

Back pain and between the shoulder blades should be taken seriously, with a thorough history, orthopedic tests and hardware diagnostics to establish a diagnosis.

Diagnostics of the causes of pain in the thoracic spine, causes of burning in the interscapular region

Diagnosis of pain in the thoracic spine is facilitated by the fact that, unlike the lower back, this section is palpable. The most informative methods for examining the thoracic spine are X-ray and MRI. Moreover, these methods in no way duplicate each other, but only supplement. The biomechanics of the spine can be assessed clinically and using X-ray.In some cases, this will require X-rays with functional tests, both with and without axial load.

MRI does not provide such data.

Suspicion of osteoporosis requires densitometry – determination of bone density. And also clarification of the cause of osteoporosis, taking into account the testing of some endocrine glands that control calcium metabolism. If osteoporosis is suspected, in addition to X-ray, densitometry (check of bone density) is indicated.

For the diagnosis of osteoporosis and control of its treatment, the Meddiagnostika Center has a digital X-ray and densitometry.

For a full diagnosis, laboratory tests and ultrasound may be required if indicated.

Diagnostics and treatment at the Meddiagnostika Center are carried out in the same building.

Treatment

Treatment for facet pain syndrome in the thoracic spine is more often carried out by restoring the topography of the spinal motor segment using the methods of manual medicine or chiropractic . Often it is necessary to remove the inflammatory process in the joints themselves or nearby soft tissues by means of local anti-inflammatory procedures – medically or with the help of physiotherapy.

In case of instability of the thoracic spine, the tactics are determined by the X-ray, which specifies the levels of hypermobile and blocked segments of the spine. In any case, stabilization of the spine is shown due to its own muscle corset.

Special tactics for osteoporosis . Osteoporosis requires correction of calcium metabolism to increase bone density. And this applies not only to the intake of calcium, but the correction of its absorption, regulation of excretion and stabilization of the hormonal function of the thyroid and parathyroid glands.Sometimes the pituitary gland.

If atherosclerosis, angina pectoris, myocardial infarction, which may be accompanied by back pain, are suspected, an atherosclerotic test is performed (they examine the vessels in the most affected areas) and a stress test is performed in the absence of contraindications ( treadmill + ECG ).

If pain in the thoracic spine is caused by abdominal pathology, then in addition to MRI and X-ray of the thoracic spine, it is advisable to conduct an ultrasound of the abdominal organs and undergo laboratory tests (which are decided by the doctor in each case).Reflected pain in the pathology of internal organs is stopped by treating the underlying disease.

Remove disc herniation only if there are absolute indications for surgery, more often myelopathy ( see absolute indications for removal of disc herniation ). However, it must be remembered that surgery to remove a disc herniation in the thoracic spine is associated with great risks. Therefore, methods of non-surgical treatment of pain in the thoracic spine and in the area of ​​the shoulder blades are more often used.

Pain in scoliosis is considered as an instability of the spine and is treated with symptomatic therapy, plus by stabilizing the spine using your own muscular corset. We have developed special methods for shaping posture and stabilizing the spine, which have been used at the Center since the early 80s of the last century. Stabilization methods are constantly being improved.

Pain in arthropathies, arthritis, spondylitis of the thoracic spine is treated according to the standards for each of these diseases.Also, rehabilitation methods are used, which are widely represented in the Meddiagnostika Center.

Treatment tactics depend on the established diagnosis.

Treatment of pain in the thoracic spine is carried out:

Gongalsky Vladimir Vladimirovich

Doctor of Medical Sciences, orthopedist-traumatologist, neurologist, vertebral neurologist

Kopyl Evgeny Gennadievich

Orthopedist-traumatologist, vertebrologist

Maximov Grigory Alexandrovich

Assistant Director

Read more about why “ Back hurts under the scapula, in the interscapular region: causes and methods of treatment ”

Doctor of Medical Sciences, Professor NMI

V. V.Gongalsky

(!) Controversial and difficult issues at:

• pain in the interscapular region,
• burning between the shoulder blades,
• for pain in the costal arch,
• heart pain with unchanged ECG (diagnosis and treatment of vertebrocardiac syndrome), etc.

Consultation of Doctor of Medical Sciences V.V. Gongalsky

Treatment can only be effective if the diagnosis is correct.

Diagnostics and treatment of pain in the thoracic spine, pain and burning between the shoulder blades, pain in the ribs and other pain syndromes of orthopedic and neurological properties are carried out in

Center “Meddiagnostika”Kiev, left bank, 250 meters from Darnitsa metro station, at the address: Stroiteley lane, 4.

Cost of services

To make an appointment
How can I get to

90,000 The doctor of the “red zone” spoke about the most frequent early symptoms of COVID-19

Coronavirus, getting into the human body, sometimes makes itself felt long before the onset of typical symptoms – cough, fever and loss of smell, doctors are sure. For example, a doctor from the “red zone” told Gazeta.Ru that the onset of infection can be determined by the appearance of fatigue, weakness, body aches and a feeling of congestion in the chest.What other early symptoms indicate the disease COVID-19, says “Gazeta.Ru”.

General practitioner working with COVID-19 patients Maxim Yudichev told Gazeta.Ru about the earliest symptoms of coronavirus. Some of them appear long before the temperature rises.

So, according to the physician, patients complain of fatigue, weakness, body aches and a feeling of congestion in the chest.

“People often come and say that they have a feeling of heaviness, as if a slab was placed on their chests,” the specialist explained.- Although it would seem that this symptom should be late, but very many from the very beginning complain of pain in the area of ​​the shoulder blades, and also often in the shoulders. As a rule, patients with such pains then go to pneumonia. ”

Meanwhile, Spanish scientists from the University of Barcelona on November 24 published the results of a study on the medRxiv website, during which they found that even before the loss of smell and other symptoms of covid, patients experience dryness and discomfort in the nasopharynx.

Scientists studied a group of 35 people with a mild form of COVID-19. In parallel with this, a “healthy” group was observed. About 70% of participants in the coronavirus study reported strange sensations and dryness in the nose. These symptoms lasted for about 12 days, coinciding with or preceding the loss of smell and taste.

“The presence of these nasal sensations can be taken into account both for diagnosis and for purposes of social distancing, especially in mild cases,” the article says.

According to the authors of the study, this dryness is associated with damage to the SARS-CoV-2 epithelium of the nasopharynx.

The coronavirus attacks special cells scattered throughout the epithelium of the respiratory and intestinal tracts. These cells secrete a receptor enzyme, which binds to the virus protein, allowing it to enter healthy cells of the human body. They also produce mucins, a component of mucus secreted to protect the respiratory tract from viruses. Accordingly, after damage to these cells, mucus ceases to be produced.

Earlier, researchers from the US National Institutes of Health said that a metallic taste in the mouth may indicate infection with coronavirus, the Express reported.

Scientists described the case of a 59-year-old woman who was admitted to the clinic with COVID-19. For several days she had symptoms typical for coronavirus – shortness of breath, weakness. But at the same time, there was a loss of appetite, which appeared a week before entering the clinic – earlier than other signs of the disease.

“A week before hospitalization, the foods she liked seemed tasteless and metallic,” the article said.

Imperial College London medics also published their research in The Express. After a review of 36 studies on COVID-19, which involved thousands of infected patients, scientists found that one in five patients experienced intestinal problems.

“Stomach pain can be caused by many reasons, but one of them is a virus infection,” said Dr. Mitch Wilson. She stressed that digestive problems often indicate that the patient is sick with something serious.

Also another early symptom, the researchers called conjunctivitis, which develops in about three percent of patients with COVID-19. This usually happens when the infection spreads to the lining of the eye.

Meanwhile, an urgent need to see a doctor is necessary for the following symptoms – shortness of breath and persistent high temperature, therapist, adviser to the general director of the International Medical Cluster Foundation Yaroslav Ashikhmin is sure.

“In case of a serious deterioration in health, when there is shortness of breath, the body temperature remains above 39 ° C for two or three days, then you need to call an ambulance.The system, despite the overload, still works. Let it be with a serious delay, but the doctors come to the house, ”he told Lente.ru.

At the same time, allergist-immunologist Vladimir Bolibok, in a conversation with the National News Service, noted that the blue edges of the lips, the blue of the nasolabial triangle, an increase in the breathing rate at rest indicate a lack of oxygen in the human blood. These signs should also be a reason to call an ambulance, the doctor is sure.

He stressed that it is impossible to treat COVID-19 on your own, you must definitely consult a doctor.Bolibok noted that this infection is very dangerous and takes different forms, proceeds in different ways in the same family.

“There is no need to hesitate, bad symptoms develop quickly enough. Today, the person was doing fine, but tomorrow he is already in the intensive care unit “on the tube”, ”the immunologist concluded.

Osteochondrosis of the thoracic region

Why is chest osteochondrosis called “chameleon”?

The thoracic spine has a peculiarity – the ribs are attached to it.Thanks to this, it is less mobile than the neck and lower back. Consequently, osteochondrosis in the thoracic region develops less often, according to the principle: “less mobility – less wear and tear.” But less often it develops – this does not mean it flows easier. And indeed it is. Indeed, among other things, osteochondrosis of the thoracic region gives a person a lot of excitement and anxiety. It is about chest pains. Since the painful area of ​​the thoracic spine coincides with the area of ​​the heart, the symptoms of osteochondrosis of the thoracic spine are often confused with angina pectoris or myocardial infarction.It is not for nothing that they say about thoracic osteochondrosis that it is a “chameleon”. After all, he can pretend not only to have a heart disease, but also a disease of the lungs, liver, stomach, gall bladder or pancreas. And here you cannot make a mistake and overlook a heart attack or other serious disease, for example, the pathology of the mammary glands in women. Mistakes like these are costly, even if the end result is nothing. After all, this can “drive” a person into severe stress. That is why it is very important to find an experienced and knowledgeable doctor who will understand everything and distinguish the symptoms of osteochondrosis of the thoracic region from other pathologies.

It is very important to find an experienced and knowledgeable doctor.

Symptoms of osteochondrosis of the thoracic region are usually divided into two categories – radicular and reflex.

Radicular symptoms of osteochondrosis of the thoracic region

They arise due to the effect on the nerves leaving the spine.

Spinal nerves

Many nerves emerge from the spine.They are called spinal nerves. Each such nerve gradually branches and follows in a specific area of ​​the body with clearly defined boundaries. This area is called the segmental innervation zone. Each vertebra, disc, nerve and zone are numbered strictly corresponding to each other. If the nerve is exposed, then the symptoms will appear in the zone of segmental innervation corresponding to this nerve, and not anywhere – in an arbitrary place.

The radicular symptoms of osteochondrosis of the thoracic region include:

• Reduction or loss of reflexes;
• Violation of sensitivity;
• Muscle weakness;
• Radicular pain.

Zones of innervation of the thoracic segments

Osteochondrosis D1 – D2 – causes pain in the shoulder, collarbone and armpit.

Osteochondrosis D3 – D6 – causes pain, encircling in the upper chest. Simulates heart pain, angina attack. In women, it causes pain in the mammary glands.

Osteochondrosis D7 – D8 – causes girdle pain at the level of the solar plexus.Simulates pain in the stomach, liver, gallbladder or pancreas. Reduces upper abdominal reflexes.

Osteochondrosis D9 – D10 – causes pain in the hypochondrium and upper abdomen. Sometimes it imitates the so-called “sharp” abdomen – a sharp pain in the abdomen. Reduces medium abdominal reflexes.

Osteochondrosis D11 – D12 – causes pain in the groin area. Simulates pain in female diseases, appendicitis, bowel diseases. Reduces lower abdominal reflexes.

Reflex symptoms of osteochondrosis of the thoracic region

Unlike radicular symptoms, reflex symptoms do not have clear boundaries. These can be: difficulty breathing, shortness of breath, pain when inhaling and exhaling, chills and “chills” on the skin, intercostal neuralgia, girdle pain in the chest. Dyspepsia is often noted – appetite worsens, nausea, heartburn, abdominal distension, and stool disturbances occur. Because of the pain, sleep is disturbed, insomnia and the feeling of not getting enough sleep occur.Difficulty moving around, especially in the morning. Coordination of movements is impaired – this is reflected in the gait. General weakness, weakness. Disorders in the genital area. Irritability. Fast fatiguability. A variety of pains occur. Pressing pain in the chest. Pain between the shoulder blades. Pain in the hypochondrium. Pain on raising arms. Pain when bending over or trying to straighten up. Pain between the shoulder blades. In general, pain in osteochondrosis of the thoracic region is usually divided into two types.

Dorsalgia – moderately severe prolonged pain in the back and chest with periods of increase and decrease.

Dorsago – acute painful “lumbago” in this area.

• Symptoms of osteochondrosis of the thoracic region depend on the stage of osteochondrosis.
• Symptoms of osteochondrosis of the thoracic region are aggravated by slouching or trying to straighten.
• Symptoms of osteochondrosis of the thoracic region are more often manifested after 35-45 years.
• Symptoms of osteochondrosis in women appear about 3 times more often than in men.

You, of course, noticed that the radicular symptoms are defined quite clearly, and the reflex symptoms are very vague and vague. And as you know, everything that does not have clear definitions serves as a convenient cover for professional helplessness. This applies, in particular, to reflex symptoms and such a favorite concept of doctors as “age-related changes”. Surely many of you are familiar with the situation when the doctor explained the problem by “reflex” or “age” processes. Most people at such moments rightly believe that the doctor simply cannot figure out what is happening and is trying to veil his incompetence in the fog of these “magic words.”

At one time, there was a popular phrase: “Every accident has a name, surname and position.” So every disease has its own unique symptoms. And the doctor’s duty is to know them clearly. And then there will be no need to admit a fog and blame osteochondrosis of the thoracic region for everything. Now you understand how important it is to find an experienced and knowledgeable doctor.The correct diagnosis and good treatment results will depend on this.

When choosing a clinic, the main thing is to get to an experienced and knowledgeable doctor.

Diagnosis of thoracic osteochondrosis – the key to correct treatment

Today there are a number of modern methods of hardware diagnostics of osteochondrosis. The most accurate of these are MRI and CT. But the main method is still clinical diagnosis – this is when an experienced doctor compares data from at least three sources – from the patient’s complaints, MRI results and those symptoms that were identified by him during the examination. This allows for the most accurate diagnosis and formation of an effective individual treatment program.

Treatment of osteochondrosis of the thoracic region

As you understand, osteochondrosis is a real “tangle” of symptoms, which, having unraveled, the doctor will relieve you of pain and anguish. But it is not possible to eliminate changes in the vertebrae and discs. Therefore, the words “treatment of osteochondrosis” must be understood correctly. If you are interested in eliminating pain and other suffering, then yes – it is quite possible.And if you conduct an academic discussion on the topic of returning the vertebrae and discs to their original appearance, “like a newborn child,” then no – the past cannot be returned. You need to be realistic, and then you will not fall for the bait of scammers.

Don’t fall for the scammers’ bait!

It is impossible to restore the original appearance to the vertebrae and discs!

What is the main treatment method?

Soft manual therapy is the main treatment for thoracic osteochondrosis. It is like an antibiotic for pneumonia – you cannot do without it. The rest of the types – massage, medicines, physiotherapy and exercise therapy – are auxiliary.

How does mild manual therapy work?

The nutrition of the discs is directly related to the muscles surrounding the spine. In addition, the back muscles themselves are one of the integral causes of pain in osteochondrosis of the thoracic region. Mild manual therapy is a special technique that allows muscles to return to their natural physiology, eliminate spasms, muscle clamps and improve disc nutrition.

The intervertebral discs are the only part of the body that does not have blood vessels and is nourished by proper muscle function.

In addition, when treating with the hands, the chiropractor:

• relieves the load from the affected vertebrae and discs and distributes it correctly;
• will relax your muscles and help them return to normal;

Thereby:

• relieves the patient from clamps;
• will improve drive power;
• will restore the motor functions of the body;
• normalizes blood circulation.

Manual influence mobilizes the internal forces of the body and triggers self-healing mechanisms.

Treatment is absolutely safe.

Prevention of osteochondrosis of the thoracic region

To avoid relapses, make yourself comfortable sleeping and working conditions. Monitor your weight and proper nutrition. Maintain your physical activity. But the main thing is not to neglect your health and not save on it.Do not let things take their course. After recovery, try to do at least one supportive gentle manual therapy session every three to six months to reduce risk factors. Do not forget that neglected osteochondrosis leads to complications – protrusion and disc herniation. Remember: first of all, you need your health!

Launched osteochondrosis leads to complications – protrusion and disc herniation.

90,000 Upper back pain

The upper back is the area between the base of the neck and the lower rib. There are 12 bones that make up the upper back, which doctors call the thoracic spine. The first bone of the upper back starts at the base of the neck, and the 12th bone ends just below the rib. Back pain can appear anywhere between these bones.

Pain in the upper back is usually the result of poor posture, muscle fatigue, or injury. Most people describe upper back pain as a burning sensation.

Back pain is a common occurrence that anyone can experience.However, there are several risk factors that can cause upper back pain. These include:

• obesity or overweight;
• lack of physical activity, this can lead to poor muscle tone or weak muscles in the back and abdomen;
• age;
• Chronic stress or depression
• Improper lifting, repetitive movements, and poor posture;
• Cigarette smoking reduces blood flow through the spine and the healing time of injuries.

Together with pain in the upper back may occur:

• weakness in the arms or legs;
• tingling or numbness of hands, feet, chest or abdomen,
• Loss of bladder or bowel control.

Improper use of muscles and poor posture

Incorrect or infrequent use of the back muscles can cause pain. Over time, the weakening of the muscles can lead to pain in the area as they are overextended or irritated.When a person bends down, there is pressure from the force of gravity and the body itself presses on the spine, neck, discs and ligaments. Over time, this pressure can lead to pain and other complications.

Muscle tension

Overworked back muscles are another common cause of back pain. This usually happens through repetition of the same movements. Treatments for muscle pain usually begin by allowing them to rest and using heat or ice to increase circulation to the muscle tissue.A physical therapist may recommend exercises to develop flexibility.

Injury

Traumatic injury can lead to back pain. The trauma is sometimes obvious, and pain appears immediately after the incident. Traumatic injuries can be serious, and problems associated with injuries, such as vertebral fractures, put a person at risk of long-term complications, including chronic pain, nerve damage, and paralysis.

Herniated disc

The discs in the spine prevent the vertebrae from rubbing against each other.Herniated discs are more common in the lower back, but can sometimes appear in the upper back as well. Discs are soft, rubbery cushions between each vertebra. Herniated discs occur when a piece of this pillow is pushed and pressed against the spine. Even a small amount of pressure can lead to significant pain in the middle of the back, as well as other symptoms, including numbness or weakness in the arms or legs.

Compressed nerve

A herniated disc can slip far enough to compress the surrounding nerve.A pinched nerve in the mid-back can cause:

• numbness and pain in arms or legs;
• problems with urination control;
• weakness or loss of control in the legs;

Osteoarthritis

The source of back pain is sometimes not muscles, but problems with bones and joints. The cartilage that protects bones can wear out as we age. This may be due to osteoarthritis. Osteoarthritis can cause the cartilage between the bones to wear out completely, causing the bones to rub against each other.It can also press on the nerves in the spine, causing numbness or tingling sensations in the hands and feet.

Myofascial pain

Pain can also result from problems in the connective tissue of the back, which doctors call fascia. Myofascial pain can begin after injury or overuse, but chronic myofascial pain can last long after the initial injury.

Spinal infection

Rarely, an infection can cause upper back pain.A spinal epidural abscess is a collection of germs and pus that forms between the spinal cord and the bones of the spine. The abscess can grow and swell, resulting in pain.

Lung cancer

Back pain may be due to lung cancer, but in very rare cases.

Pancreatitis

Pancreatitis, or inflammation of the pancreas, causes pain in the upper abdomen. This pain can radiate to the upper back and get worse after eating.Acute pancreatitis can also cause: fever, nausea, vomiting, heart palpitations, and bloating.

Kidney stones

When a kidney stone leaves the kidney, it can cause dull, one-sided pain in the upper abdomen. This pain can spread to other parts of the body, including the lower abdomen, groin, side, and upper back. Additional symptoms include painful urination, foul-smelling, cloudy urine, brown, pink, or red urine, frequent urination, passing small amounts of urine, nausea, and vomiting.

Heart attack

A heart attack is a blockage that prevents blood flow to the heart. Symptoms are different for everyone, but it can cause chest pain that spreads to the neck, jaw, or upper back. Other symptoms may include chest tightness, shortness of breath, tiredness, dizziness, nausea, cold sweats, heartburn, and abdominal pain.

To diagnose the cause of upper back pain, physician:

• will discuss medical history;
• will ask about symptoms;
• will do a physical examination.

The following diagnostic methods may be needed: blood test, X-ray, computed tomography, MRI, EMG test.

Specific conditions affecting the spine or muscles and causing upper back pain:

• scoliosis;
• fibromyalgia;
• spinal deformity;
• problematic kyphosis;
• endometriosis;
• bladder infections;
• pancreatitis;
• kidney stones;
• osteoarthritis;
• heart attack.

If upper back pain occurs, a physical therapist should be consulted for diagnosis and treatment.

It is imperative to see a doctor if, along with pain in the upper back, the following symptoms appear:

• Loss of bowel or bladder control;
• fever;
• pain that started after a fall, accident, or sports injury.

It is not possible to prevent all causes of back pain, but a few simple prevention methods can be used.These include:

• Regular breaks from sitting and lying down to stretch and move various muscle groups,
• frequent breaks while working at the table;
• Allowing a few minutes to stretch muscles or warm up the body before any physical activity;
• avoid heavy lifting and frequent twisting of the back;
• Perform regular massages to help relieve muscle tension;
• Work with a physical therapist to strengthen weak muscles and equalize pressure on joints;
• Avoid carrying heavy backpacks;
• Maintain correct posture.

90,000 Back pain: 7 alarming symptoms. Professor of the Russian Academy of Sciences Natalya Suponeva says

8 out of 10 people experience back pain throughout their lives. Of course, there is no need to run to the doctor for the slightest problems and undergo an examination, and this is not necessary. The whealth.ru correspondent spoke with a neurologist about when back pain should not be ignored.

Most of the unpleasant sensations are mild and short-term pain in the lumbar region, which have no pathological basis and are caused by normal muscle strain.We are interested in cases when the cause lies in diseases of the spine.

Pain does not go away for a long time

Usually, pain in the back disappears after a short rest or taking anesthetic. If there is no improvement within a month, pain interferes with normal daily activity, it is worth going to the doctor.

Pain extends to an arm or leg

If, in addition to the back region, pain spreads to any limb, this is a sign of irritation of the spinal cord root or even the presence of a herniated disc.

Natalya Suponeva adds: “This symptom may not mean a serious lesion of the intervertebral disc, but it is still worth consulting with a neurologist: there are many non-surgical treatments. Massage, physiotherapy, manual therapy, gymnastics to strengthen the muscle corset, stretching, can help. drug blockade or kinesio taping (application of a special elastic patch). The tactics are selected individually. You can count on a positive result if you seek qualified medical help in a timely manner. “

The appearance of numbness, tingling or weakness in the arm or leg

“Long-lasting sensory disturbances in the limbs (feeling of numbness or stiffness of the skin, tingling with needles) indicate persistent damage to the nerve fiber. Decreased muscle tone in the lower extremities or the appearance of lameness also a formidable symptom indicating impaired motor function, “says the expert.

Read more …

Why there can be chest pains – blog of the ON Clinic medical center

Sore chest. The first thing that comes to mind is a heart attack. Of course, chest pain cannot be ignored. But it should be remembered that this symptom does not always threaten health.

Pain in the chest. The first thing that comes to mind is a heart attack. Of course, chest pain cannot be ignored. But it should be understood that this symptom has many causes and does not always threaten health.

Chest pain is caused by diseases of the lungs, esophagus, muscle spasm, broken ribs, or nerve damage.Some of these diseases can be life threatening, some are not harmful to health and go away on their own. If you feel chest pain and you don’t know what caused it (you didn’t fall, you didn’t be hit in the chest), the only way to find out the cause is to ask your doctor.

You can feel chest pain anywhere from the lower neck to the apex of the abdomen. Chest pains (thoracalgia) are:

• acute;
• blunt;
• stinging;
• whining;
• stabbing;
• pressing.

Below are some of the most common causes of thoracalgia.

Causes of chest pain: heart problems

Although the symptom is not always associated with the heart, it is the heart that most often causes chest pain.

Ischemic heart disease (IHD). It is accompanied by blockage of the arteries that feed the heart. Less blood is supplied to the heart muscle – hypoxia and myocardial ischemia occur. This causes burning and pressing pain, which is medically called angina pectoris.Angina pectoris is a reversible circulatory disorder of the heart, not accompanied by the death of the myocardium. But this is the first signal that a heart attack is possible in the future.

Cardialgia (heart pain) with an attack of angina pectoris extends to the left scapula, shoulder, hand, jaw and back. Sudden cardialgia occurs during or after physical exertion, sex, excitement, excitement, experiences of fear. The symptom goes away with rest.

Myocardial infarction. These are irreversible disorders of the heart muscle due to the arrest of blood circulation in the coronary arteries.Myocardial cells die off, and a scar forms in their place after 1-2 weeks. With a heart attack, pain in the region of the heart is more pronounced and acute than with angina pectoris. Thoracalgia is localized to the left or center of the chest and does not go away with calmness. A heart attack is accompanied by fear of death, sweating, nausea, weakness, and disorientation.

This is a medical emergency that requires medical attention. The first sign of a heart attack is burning, pressing, or constricting chest pain that spreads to the left shoulder blade, shoulder, arm, and back.Unlike angina pectoris, thoracalgia in myocardial infarction lasts longer than 15 minutes and is not eliminated by nitroglycerin. If you find these symptoms, call an ambulance.

Myocarditis. This is inflammation of the heart muscle. In addition to chest pain, myocarditis is accompanied by fever, exhaustion, heart palpitations, and shortness of breath. With myocardial inflammation, the coronary arteries are not clogged and the heart is well supplied with blood, but chest pain with myocarditis can resemble a heart attack.

Pericarditis. This is an inflammation of the heart sac, which protects the organ from mechanical damage and displacement. The disease provokes thoracalgia, which resembles an attack of angina pectoris. However, pericarditis has some peculiarities:

• pain occurs along the neck and shoulder muscles;
• pains may be sharp or aching;
• Chest discomfort worse at inspiratory height, while eating or lying on your back.

Hypertrophic cardiomyopathy. It is a hereditary disease that causes excessive thickening of the heart muscle.Sometimes cardiomyopathy interferes with cardiac blood flow, but more often it provokes thoracalgia and shortness of breath with exertion. When the heart muscle expands to its limit, heart failure occurs. The heart needs more oxygen and energy to push blood into the aorta and pump it around the systemic circulation. Hypertrophic cardiomyopathy, in addition to thoracalgia, is accompanied by dizziness, fainting, and fatigue.

Mitral valve prolapse. Pathology is accompanied by the fact that the heart valve cannot close properly: when the muscles of the heart contract, it protrudes into the left atrium and part of the blood rushes back into the atrium.

Mitral valve prolapse is manifested by chest pain, palpitations, and dizziness. Prolapse does not appear at the initial stage of development.

Coronary artery dissection. This is a deadly disease in which a dissection occurs in the coronary artery – a tear in the vessel wall followed by hemorrhage and myocardial infarction. The dissection causes severe and acute thoracalgia that spreads to the back, abdomen, and neck.

Causes of chest pain: lung problems

Lung diseases can cause chest pain.Here are the reasons related to the pulmonary system.

Pleurisy. This is an inflammation of the pleura that covers the lungs and separates them from the chest. With pleurisy, thoracalgia occurs during a deep breath, sneezing, or coughing. The disease usually develops due to a bacterial or viral infection, pulmonary embolism, or pneumothorax. Less common causes are lung cancer, systemic lupus erythematosus, and rheumatoid arthritis.

Pneumonia or lung abscess. Diseases cause pleurisy, thoracalgia and deep chest pain.Pneumonia develops quickly and suddenly: body temperature rises, chills and cough with purulent discharge occur.

Pulmonary embolism. A migratory blood clot can enter the lungs. This causes severe chest pain, difficulty breathing, and heart palpitations. The condition is accompanied by fever and disorientation. The likelihood of pulmonary embolism increases in patients who:

• previously suffered from deep vein thrombosis;
• transferred the operation;
• have or have had cancer.

Pneumothorax. This is a pathology in which air accumulates in the pleural cavity. It most often occurs with severe injury to the ribs, sternum or spine with internal damage to the lungs, from which air enters the chest cavity. Pneumothorax is accompanied by chest pain at inspiratory height, low blood pressure, shortness of breath, and bouts of dry cough.

Pulmonary hypertension. The pathology is characterized by high pressure in the pulmonary arteries. This increases resistance – the right heart has to work hard to push the blood out.Pulmonary hypertension causes thoracalgia, which is similar in nature to an attack of angina pectoris.

Bronchial asthma. An acute attack of bronchospasm (narrowing of the bronchi) is accompanied by difficulty breathing, wheezing with a whistling, wet cough, and chest pain.

Causes of chest pain: gastrointestinal diseases

Gastroesophageal reflux disease (GERD). The disease appears due to a defect in the esophageal sphincter, as a result of which food and hydrochloric acid from the stomach enters the esophagus.Acid reflux causes heartburn in the chest, sour belching and a sour taste in the mouth. The disease is triggered by obesity, smoking, spicy foods and a sedentary lifestyle. Chest pain occurs because the esophagus is closely adjacent to the heart – irritation is transmitted to the organs of the chest through the nervous system

Hypersensitive reflux syndrome (hypersensitive esophagus). Pathology is accompanied by increased sensitivity to chemicals and mechanical movement of food. The processing of nerve signals is impaired: sensitivity increases with the slightest pressure or contact with food, up to the occurrence of chest pains.

Dyskinesia of the esophagus. The disease is characterized by impaired esophageal motility. In this case, food moves to the stomach more slowly, and the pressure rises in the esophagus itself. This leads to chest pain.

Perforation of the esophagus. It is characterized by sudden sharp pain behind the sternum, which usually appears after vomiting or ingestion of a large amount of food. May rupture the esophagus.

Peptic ulcers. These are defects in the mucous membrane of the stomach or duodenum.They are provoked by alcohol, spicy and fatty foods, psychoemotional stresses and large doses of pain medications (ibuprofen, aspirin, analgin, diclofenac). Pain from peptic ulcers is transmitted from the stomach and intestines to the chest.

Hernia of the esophagus. This is a pathological prolapse of a part of the stomach into the lumen of the esophageal tube. In most cases, it goes without manifestations, but occasionally causes reflux symptoms, heartburn and sternum pain, which becomes worse if you lie on your back.

Pancreatitis. Inflammation of the pancreas causes pain in the upper and middle abdomen that extends to the chest wall. The pain increases if you lie on your back or lean forward, with vomiting and physical exertion.

Pathology of the gallbladder. Do you feel heaviness in the right hypochondrium and lower abdomen after eating fatty foods? If so, chest pain may be due to gallbladder disease. If you have any of the above symptoms, you should consult a gastroenterologist.

Causes of chest pain: problems with bones, muscles or nerves

Thoracalgia occurs due to damage to the chest as a result of injuries, after impacts and overuse of muscles.

Rib problems. A rib fracture can cause severe thoracalgia that is aggravated by inhalation, coughing, and sneezing. Pain is often confined to one area and worsens when pressed. The fracture can cause arthritis in the joint between the rib and sternum. This will cause pain.

Muscle spasm. The muscles can become inflamed or damaged, and the ligaments can stretch. This reflexively contracts the muscles of the chest, and a strong and prolonged muscle contraction causes pain.

Shingles. It occurs when the body becomes infected with the herpes zoster virus. The disease causes acute thoracalgia that runs along the affected nerve. The appearance of a rash a few days after the onset of pain confirms the diagnosis of shingles.

Other possible causes of chest pain

Feeling uncomfortable and thoracalgia can be caused by increased anxiety, fear, or panic attack.Additional symptoms: dizziness, sweating, disorientation, shortness of breath, heart palpitations, hand tremors, tingling and numbness in certain parts of the body.

When to see a doctor about chest pain

Call an ambulance at 103 if chest pain:

• burning, sharp and pressing, lasts longer than 15 minutes and is not relieved by taking a nitroglycerin tablet;
• applies to the jaw, left limb, back, or left shoulder blade;
• appears suddenly and causes breathing difficulties;
• causes confusion and increased sweating;
• is accompanied by a rapid drop in blood pressure;
• is accompanied by a slowdown in the heart rate;
• occurs with fever, cough with green mucus, impaired swallowing.

If you are unsure about the origin of chest pain that lasts longer than 2 weeks and does not go away after dietary changes, pain relievers and moderate physical activity, see your doctor for advice.

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How to recognize a “silent heart attack”? And is it possible not to notice it at all?

October 30, 2019

Photo author, Getty Images

Acute chest pain, sudden pressure surge, sudden onset of shortness of breath. This is approximately how we imagine the symptoms of a heart attack – and often this is exactly what happens.

Other signs that can recognize an acute heart attack include cutting pain in the arm or neck, dizziness, and profuse sweating.

But what if the attack passes without such obvious symptoms – so that the patient himself does not even know that he has experienced a heart attack?

As a study from Harvard University shows, this happens much more often than doctors expected.Almost half of all cases of acute heart attack (45%) occur in the so-called silent or imperceptible infarction (SMI – silent myocardial infarction), which often affects men.

“Symptoms of SMI can be so mild and last so short that they are often mistaken for ordinary discomfort or other less serious problem – so they are often ignored by men,” explains George Platzky, professor of hospitals at Harvard University.

For example, men can often attribute fatigue or physical discomfort to overwork, poor sleep, or even just age-related changes in the body. And a mild sore throat or chest area will be mistaken for symptoms of heartburn or indigestion.

In addition, it is often difficult to determine exactly where the pain is coming from. For example, a sharp pain in the left side of your chest is likely to make you suspect a heart attack, but a “silent heart attack” can cause only slight chest discomfort in general.

Warning signs and reasons for concern:

• discomfort in the center of the chest (slight sensation of pressing pain), which does not go away for several minutes or quickly disappears, but comes back again;
• General discomfort in the upper body in general – for example, discomfort in one or both arms, in the back, abdomen, neck or lower jaw;
• Difficulty breathing before or after chest discomfort;
• sudden cold sweat, dizziness or nausea.

“Sometimes a person generally feels completely normal – both during and after SMI – which only increases the risk that alarms will not be noticed,” – warns Professor Platzky.

This is why the results of the Harvard Medical Study published in the Journal of the American Medical Association are particularly alarming.

Men at risk

Doctors examined almost 2000 men and women aged 45 to 84 who did not have cardiovascular diseases, and 10 years later they made another MRI of the heart in the same patients.

8% of them had scars on their hearts, indicating a previous myocardial infarction – while 78% of patients who survived the attack did not even know about it.

Photo by Science Photo Library

Men experienced a “silent heart attack” five times more often than women.

Judging by the results of the study, the risk factors for SMI are exactly the same as for a regular heart attack: smoking, being overweight, lack of exercise, high blood pressure, cholesterol and diabetes.

“As a result of SMI, the heart starts to work worse, it starts to scar,” explains George Platzky.