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Respiratory Disorders  (Expert Forum)
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Pain in my left side when breathing deeply.
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Pain in my left side when breathing deeply.

by nyckz, Apr 13, 2009 01:32PM
Yesterday I went to the ER to have some tests done. I have been having chest pain for a number of weeks and needed a diagnosis. He ran an ECG and my heart would jump from 90 to 130 in a matter of seconds. Blood work was done and he ruled out everything. The tests were negative. He was still slightly concerned with my heart rate.
He told me the chest pain was due to costochronditis. He sent me for X-Rays and everything turned out fine.

In the last 7 months I've lost over 60 pounds and I am still losing weight. I am 17 and smoke cigarettes.
I weighed 239 pounds in about September/October and I am now 178. I have not changed any routine, I do not exercise regularly, but I have cut back on eating and picked up chain smoking. I have cut back on smoking in these last 2 months and I'm just looking for some answers to help me settle my mind.

I was given some lorazepam to reduce my anxiety and I haven't taken any because I'm suddenly having back pain that I've never felt and doubt this is anxiety related.
I woke up this morning with incredible back pain which is felt below the last rib(left). I can feel it when I take a deep breath and it's very painful. I was told I need to relax and stop worrying about the wrong things. I would be able to relax if my back wasn't killing me after every breath I take. I find relief by putting pressure on the muscle beside the spine (left side, mid back). The pain extends from lower-mid to mid and seems to be settling down a little.

Could this be costochronditis spreading to my back, or possibly pleurisy?
The doctor listened to me breathe for about 2 minutes, told me my lungs and heart were fine and that I am just having extreme anxiety.

I can only sleep on one side without experiencing back pain, but it's the side that's in pain.
I'm confused, a little scared, and need some answers.
Thanks.

by National Jewish Health, Apr 22, 2009 03:09PM
Your initial chest pain could well be on the basis of costochondritis, as diagnosed and this typically occurs without X-ray changes.  Costochondritis typically, but not always, is associated with tenderness to touch at the junction of the bony rib, with cartilage, near the breast bone (sternum).   Your back, as described, is of a different quality and, in any case would not be caused by costo-chondritis;  it sounds pleuritic in nature (pleurisy) but could be hard to distinguish from musculo/skeletal chest wall  pain, with or without rib fracture or intercostal ligament strain.  

You should definitely have a chest X-ray to rule out rib fracture(s) and lung and/or pleural inflammation.  

Another cause of such pain is inflammation or compression of the sensory nerves that serve the areas of pain.  If deemed a possibility by the examining doctor, he/she should pay special attention to your spine on the lateral X-ray view.  Finally you have lost a lot of weight.  That is really to your credit and evidence of your determination, but losing a lot of weight, no matter how desirable, can also be accompanied by musculoskeletal problems and that should be kept in mind.  

This is not the time for you to try to quit smoking but, when your current problems are resolved, you really should engage in efforts at smoking cessation.

Granted, your pains may be secondary to anxiety but it is appropriate to rule-out physical causes, before assuming that.  In addition, your pains could also make you more anxious.  

The pain and your anxiety should be considered as separate health problems, until proven otherwise.  

Wide fluctuations are common with anxiety, as well as with pain.  This should also be reevaluated with resolution of your pains.

Good luck
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