Help! I have a sharp pain below my left breast and chest

Dr Flo,

I have been feeling pain below my left breast. Sometimes the pain goes through the chest to the back and my heart beats faster. I feel so tired that I have to remove my bra. The pain can go away for a long time before it’s back. I sought help and took the medication prescribed, but I still experience the fast heartbeat on and off. I had pneumonia from 2016 to 2017 and since then my nose is always blocked and runny. I have had two chest X-rays with no change. I need my health back. What could be the problem with my chest?

Stella

Dear Stella,

You have several concerns, which may not necessarily be related. Firstly, the pain on the left side of the chest may arise from any of the organs and tissues located on the left side of the chest. These include bones, cartilage, muscle, nerves, lungs, the heart, the oesophagus (food pipe) and the breasts. You can even have a painful rash on the skin causing the pain. The weight of the breasts, the kind and type of bra you use can also contribute to the chest pain. To determine the source of the problem, there is need for a comprehensive history of the symptoms, a thorough examination and appropriate tests to check the different systems such as blood and stool tests, breast ultrasound and electrocardiogram (a heart test). Since this problem has been recurrent, it would be good for you to be seen by an internal medicine specialist/physician for proper review and a way forward.
Secondly, palpitations is the name given to the noticeably fast heartbeat you’re experiencing. These can be a result of a heart problem, thyroid disease, low blood level, excessive intake of alcohol intake and drugs, smoking, caffeine, some medication, stress, anxiety and vigorous physical activity. It can also happen in pregnancy. It would be advisable for you to visit a physician when you are having the palpitations, so that relevant tests such as a heart test can be done to determine the heart rhythm.
The recurrent runny nose and nasal blockage is unlikely to be related to the pneumonia that was treated several years ago. It may be due to an allergy to either dust, dander, pollen, strong smells, fur, cold among others. It may also be due to chronic sinusitis, where there is inflammation of the lining of the sinuses, leading to accumulation of mucus within the sinuses and nasal blockage. Allergies cannot be cured, but can be managed with antihistamine medication and sprays. Sinusitis is best managed by an ear, nose, throat (ENT) specialist with medication and/or surgery. Also, monitor your surroundings and yourself to identify the possible triggers, so that you can avoid them.

Dr Flo,

I sometimes feel pain on the left side of my back. It is a sharp pain I feel when I twist my body in certain directions. It has been there for quite some time now. I don’t know what the problem could be since an X-ray did not pick up anything. I am also allergic to the cold. Can you recommend medication for me for the allergy?

Mburu

Dear Mburu,

The back has bones and muscles that help to support the upright posture and movement. This makes it easy for it to get injured, most commonly by poor posture and also due to repetitive activity, carrying weights, trauma and from being overweight/obese. Over time, this can lead to muscle spasms, arthritis, disc prolapse (bulging of the cushions between the bones of the spine) and nerve entrapment. Since the pain you are experiencing is triggered by movement, most likely it is due to poor posture or mechanical injury from the work you do, how you sit or walk. Before the complications arise, usually, X-ray examination will be normal.
It is advisable for you to be reviewed by an orthopaedic specialist for correct diagnosis. You may be referred for an MRI scan to better visualise the back. You may also benefit from physiotherapy, stretching and strengthening exercises and practising good posture. You may also get advice on the kind of chair or mattress you should use. In addition, there is medication you can take to manage pain and relax the muscles.
About the second question, our bodies have different mechanisms to deal with irritants to protect us from harm. For example, when there is a lot of dust, the mucus lining the respiratory system traps the dust, and you either sneeze to remove it or a lot of mucus is produced so that you blow the nose and remove the dust particles. When you have an allergy, the body usually has an excessive reaction to an irritant by going beyond the protective function, therefore becoming a problem. For example through repeated sneezing and blowing the nose every time you are exposed to cold. This excessive reaction to an irritant is inborn and can be passed down genetically from a parent to a child, so it cannot be cured or done away with. But, it can be managed, by identifying and avoiding the trigger (for example, covering the face and nose with a scarf when it is cold or living in a warm area) and by using anti-allergy medication to control the symptoms. An ear, nose, throat (ENT) specialist can recommend medication to manage the allergy, either tablets, nasal sprays or both.

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