Archive for July, 2006
Shingles (Herpes Zoster) is a burning, aching pain usually on one side of the chest wall. We know where the pain is coming from as soon as we recognize shingles, for a skin eruption usually
Fig. 66. Breast Pain. Caused by several different disease possibilities, pain in the breast probably will afflict almost all women at some time or other. By comparison the undeveloped male breast is only seldom the seat of any trouble. Most people are surprised to learn that breast pain hardly ever means cancer, but that pain usually means a benign (non-malignant) condition, like “cystic disease of the breast.” Breast pain never means heart disease.
shows up over the course of the pain in just a few days to a week. Also, in shingles, pain is produced by pressing with the finger along the course of the nerve, between the ribs, and we know now that any kind of pain produced by pressing against the chest wall, in any area, is never recognized as pain originating from the heart.
Chest pain coming from tumor growths of the chest wall itself, is extremely rare. Because of the rarity and difficulty in attempting to describe such tumor growths, we will only say that the enlargement of the tumor will certainly be noticed much before the pain. This alone should bring the patient to his physician. Chest pain of great importance may originate from the swallowing tube (esophagus) running from the throat to the stomach.
Fig. 67. Shingles Pain. Often called Herpes Zoster, the pain of shingles is due to soreness of a nerve itself. The pain typically burns, aches and stabs, and follows the nerve route between the ribs (generally the 4th, 5th and 6th ribs). The usual shingles skin eruption may appear within a few days, itching furiously and inviting constant scratching.
This type of pain is worthy of special study in the age-fifty group, because it is so common and so often severe. Real pain of the esophagus which might be confused with heart pain, is nearly always that of heartburn (reflux-esophagitis or achalasia). In heartburn, the acids normally in the stomach back up into the esophagus and cause intense burning pain. Being situated deep in the chest, in the heart region, this chest pain is named heartburn, a well-known name among chest pains.
Let us study next, pain in the chest originating from bone, muscle and ligament of the chest wall. Pain of this sort is usually regularly produced by certain movements of the body, such as sneezing, bending, coughing or lifting. These pains are likely to be of arthritic origin or pressure on nerve roots from the spine, around the neck and chest, and commonly respond to heat and Aspirin.
Pain and soreness of ligaments is common, especially following unusual or heavy work. Such work just before aches and pains begin, usually tells the patient what type of difficulty has brought about his pain. Also, pain and soreness of muscles and ligaments which seems related to damp or cold weather, is referred to frequently as myalgia, neuralgia, fibrositis and other names. Such difficulties
Fig. 64. Muscle Pain. Pains, aches and soreness of muscles are made worse if the sore muscles are worked. Usually a “come and go” story, muscle pain is related to cold, damp weather, and may be relieved by aspirin and heat application. If-as a test-pain is produced when the involved muscle is pressed, it cannot be coming from the heart.
seldom worry a person that the pain may be originating in the heart.
Pain sometimes found in the front of the chest and thought to be heart pain is called Tietze’s Syndrome. This is a pain produced from an irritation or soreness of the cartilage joints, joining the front of the ribs to the breastbone or sternum. This pain is produced easily by pressing on the ribs in front of the chest. It can never be mistaken for heart pain because we will now know that pain produced by pressing on any part of the chest wall, never originates from the heart.
Chest pain due to breast inflammation, irritation or tumor growth is fairly easy to recognize. Here the breast, as the offender, presents painful breast situations which may come and go for all women, and occasionally in men. This pain and soreness tends to be steady, with occasional periods of increased trouble. These sensations, though considered chest pain, usually worry people more about cancer than about heart disease. It is
Fig. 65. Chest Wall Pain. Pain of the front chest wall-referred to as Tietze’s Syndrome-is fairly common. Like any other joint, the cartilage joining the rib to the breast bone may become very painful; unlike other joints, it cannot be rested unless breathing is stopped. There is a definite sore spot (usually over the heart) and pressing on it causes great pain. This eliminates the possibility of heart pain which cannot be produced by pressing anywhere on the chest wall.
a comforting fact to know that painful breasts are rarely any indications of cancer, and even less often caused by heart disease.
Of interest is one particular form of pain in the male breast. It is breast pain caused by administration of hormone, for the treatment of cancer or bone difficulty elsewhere in the body. Knowledge of the foregoing hormonal treatment usually clears up the issue for the patient and the doctor, so that he may know the pain is not originating in the heart.