Why does pain ease with exercise?

For months now Ive had great worries about heart health, various chest pains, sensations of tightness, you name it. Symptoms seems to change quite regularly, for example around christmas I was getting chest pressure on the right side, at the moment its shoulder pain. 2 weeks ago it was left shoulder mostly for the past week its been the left. I can touch a point on my left shoulder and make it hurt a bit.

I've had many resting ECGs, an exercise ECG, 2 echo cardiograms, chest x-ray and blood works done for heart attack signs one time. Also what I assume is full blood tests including thyroid and cholesterol. Had 7 day event monitor and 24 hour recorder also. ONly thing thats not normal is that I have ventricular bigeminy, I'm told its nothing to worry about and I should ignore it - easier said than done!

I often wear a heart rate monitor and it changes to a HR of about 40 when I'm in bigeminy, suddenly jumps back to my 'normal' resting HR of about 80 after usually no longer than 30 seconds or so. Theres no question that when I'm in bigeminy my shoulder(s) hurt, sometimes my chest is tight too. When I say 'Hurt' its never so far been a  bad pain, perhaps a '2' on a scale of 1 to 10. But it worries me greatly and its wearing me down.

My left shoulder was bothering me today, feels like burning. I went for a 2 mile walk and it eased off and seemed to go. As soon as I'm home and rest a bit it came back. My wife bought me an anniversary present today and the pain got a bit worse when I saw I had a surprise. Can this be all in  my mind? My doctor is adamant its anxiety. I went for another 2 mile walk, this time I walked absolutely flat out as fast as I could, for about 20 minutes. No pain, no breathlessness, no nothing.

Please, if anyone has experienced similar or has any ideas why the pain seems to go when I exercise? Also exercise does seem to make the bigeminy worse at the end of the day if Ive been exercising it seems to kick in a lot worse.

[LindaTX]

I can sympathize with you.  I am dealing with a history of 13 yrs of a-fib Had an ablation in Sept., came out with a-fib and a-flutter.  Finall got on the right med to keep me out ob a-fib.  A-flutter is a little harder to recognize and I think I've still had some episodes of it, presents with tightness in chest and a little pain in shoulder and a little shortness of breath, usually occurs when I am rushing to get comewhere.  Doesn't last very long but I know for sure it's not a-fib, which certainly can have the same symptoms.  

I feel like you.....I thought the Dr.s had missed some underlying heart issue when I was first diagnosed with a-fib.  So I started on a never-ending string of anti-arrhythmic medications.  I think they may have contributed to the diastolic dysfunction that I now have.  My electrophysiologist is recommending another ablation for me in April so I am really in a quandary over what to do.  Are you sure you couldn't be having some a-flutter.  The only was I can be sure is to check the numbers on my pulse-ox.

[LindaTX]

Sounds like you have been checked out pretty thoroughly.  How is your blood pressure?  It's good that you are being so vigilant about your health care.  Could you possibly be experiencing Angina?  I would keep pursuing an answer to get to the bottom of all this from your Dr.  Are you seeing a cardiologist? I'm assuming they gave you a stress test, right?

[Pooyan01]

Hi. Exercise ECG is same as stress test I think. Pulse got up to 177 it was a normal test. I worry it's angina but angina gets worse with exercise usually ( unless it's the kind where the arteries spasm) blood pressure is normal, not even borderline, it's often 115/70. I'm seeing a cardiologist, see her next in April. She also seemed unconcerned. Said that I had caused some of my problems by doing too much exercise after a long period of being sedentary. I lost 60lb in the last year and stopped smoking.eat healthy, hardly drink - most of the time feel pretty dreadful!

I've per sued this for months, been to doctors dozens of times, emergency room twice it's the same old story. Anxiety seems to be the common diagnosis, sometimes they say indigestion.

I'm trying to convince MYSELF it's in my mind, sometimes I almost believe it too. Not today I'm afraid. I can't help but think something has been missed. But so many different doctors disagree and say I'm basically ok.

[Pooyan01]

It's been 11 months since this really started. It's a long time to fear for ones life every day. While I try to be positive and assume the doctors are correct I worry what happens if they're wrong.being able to say 'I told you I was ill ' isn't very original lol. I'm at a loss how to proceed. Even if the various symptoms I get weren't my heart the fact remains the symptoms are badly affecting quality of life. I find myself more and more desperate for help and none seems avaiable no matter where i turn.

Oh for a bit or normality

[LindaTX]

I can sympathize with you.  I am dealing with a history of 13 yrs of a-fib Had an ablation in Sept., came out with a-fib and a-flutter.  Finall got on the right med to keep me out ob a-fib.  A-flutter is a little harder to recognize and I think I've still had some episodes of it, presents with tightness in chest and a little pain in shoulder and a little shortness of breath, usually occurs when I am rushing to get comewhere.  Doesn't last very long but I know for sure it's not a-fib, which certainly can have the same symptoms.  

I feel like you.....I thought the Dr.s had missed some underlying heart issue when I was first diagnosed with a-fib.  So I started on a never-ending string of anti-arrhythmic medications.  I think they may have contributed to the diastolic dysfunction that I now have.  My electrophysiologist is recommending another ablation for me in April so I am really in a quandary over what to do.  Are you sure you couldn't be having some a-flutter.  The only was I can be sure is to check the numbers on my pulse-ox.

[Pooyan01]

Hi, thanks for your reply. My symptoms sound similar to yours. I'm not sure how I would tell if I have atrial flutter? Did you tell this from the pulse rate reading? I have a Polar Heart Rate Monitor, it records pulse all the time and does remember the fastest.I think my average pulse of approx 95 is quite high but it never seems to go above 150 unless i really push it and run up 5 or 6 flights of stairs.

I'm seeing doctor on Thursday and will ask if this is a possibility. I have to admit, I do get the impression from all the doctors that thye think nothjing much is wrong or Im making a fuss.

I hope you soon feel well too.

[LindaTX]

Wthout a heart monitor it's hard to tell for sure about the a-flutter. Usually when i have it my pulse might go up to say maybe 87, it's usually in the 60's.  It will show on the pulse ox a spread of 3-4 beats and go up and down, where a-fib is very erratic beats and much higher rate, mine would go up to 150 bpm.  Your average pulse rate seems quite high to me. Your Dr. may want you to wear a 48 hr or even 7-day monitor to get a truer picture of what exactly is going on.  Let us know what the Dr. says. Good luck!

[yarrow]

Speaking as a lifelong gym rat, I often have had the experience that various kinds of pain ease with exercise.  The usual explanation is that endorphins--your brain's own, self-generated painkillers--kick in as a result of a workout (although I have read that it takes a truly unbelievable level of exercise to get this effect).  

Whatever, it seems to work.  In addition, if your pain does not wake you at night, it probably does not have an evil source.  

The fact that you can actually TOUCH the point of pain at least in one shoulder indicates that it's real pain, not referred from somewhere else, like your heart.  That should ease your mind.  The burning nature of your pain, though, makes me wonder if you have ever been checked out for fibromyalgia, an odd condition that for a long time was considered a psych problem, but is now thought to be, at least in part, a kind of disordered processing of pain impulses.  Interestingly, exercise is essential to its treatment.  Fibromyalgia is rarer in men than in women, but I think a rheumatologist would find you an interesting patient.  You might want to investigate this:

http://www.sapj.co.za/index.php/SAPJ/article/viewFile/137/134

Overall, your tests indicate that you are a healthy person. You do sound as though you have problems with anxiety, and it certainly could not hurt to see a specialist about that.  Do you see a downside there?