General Practitioner Questions General Practice

Musculoskeletal discomfort?

I'm a 36 (almost 37) year old male, 6'2, 167 lbs, non-smoker, not overweight, casual drinker. In mid-February (it's June now) I started noticing what felt like a strained muscle in my upper right chest area just under/around the collarbone, but it mostly only occurred when taking deep breaths or sort of "activating" my chest muscles with certain positions or movements. I am fairly active athletically, so thought perhaps I'd strained something. However, it never went away... and it wasn't sensitive to the touch, really, like a sore muscle would be (if I press with some firmness near the area I can sense some mild discomfort though). I notice that in some positions I can almost assuredly cause some discomfort (such as the pushup position, just for example). Now in June it additionally sometimes causes some neck discomfort and every now and then some slight discomfort near my right shoulder blade, especially if I sleep on my right side (so I try to avoid doing that).

I was diagnosed with GERD in 2013 but haven't had significant flair-ups for some time (only if I really overdo it with certain food or drink). In any case, I've taken some PPI's for the last month or so...it hasn't made a difference. I have continued to train athletically - not overdoing it, but I guess that's all relative. My main activity is running and cycling, with a bit of weight training every now and then. The pain is not sharp. It is dull. I wondered if it might be persistent costochondritis. I can pop or crack my sternum dozens of times per day (which sometimes helps the discomfort just slightly), especially when straightening from a period of slouching. This has been going on for years, with varying frequency (but never goes away). But from what I understand costochondritis means that the area would be sensitive to the touch (which it isn't, or not much).

I am concerned that this is some kind of cancer - perhaps lung or - due to the GERD, esophagus cancer (or something else I don't know). Could a growing tumor be causing this? Could it be musculoskeletal? A doctor when I was a teen suggested I might have a touch of scoliosis...but it's never caused problems. I scheduled an appointment with a new family doc, but it's only in Sept - as there's a delay in seeing new patients.

Male | 36 years old
Complaint duration: 4/5 months.
Conditions: GERD

6 Answers

GeneralPractitionerGeneralPractice
Thank you for sharing the details of your concern its understandable that persistent discomfort would make you worry.

Based on what youve described, this pattern of dull, positional chest discomfort, occasional neck and shoulder blade involvement, and relief with movement or stretching sounds more consistent with a musculoskeletal cause, such as

Costochondritis inflammation of the chest wall cartilage which can persist without obvious tenderness

Postural strain or myofascial pain from training, cycling posture, or prolonged slouching

Muscle imbalance or mild thoracic outlet involvement due to posture or repetitive motion

Your history of GERD likely isnt directly related, especially since PPI treatment hasnt helped.
Also, the lack of sharp pain, systemic symptoms like weight loss, persistent cough, night sweats, or worsening despite activity makes serious conditions like cancer less likely though only a proper evaluation can rule them out completely.

Its good youve scheduled a doctors visit. In the meantime

Monitor for any red flag symptoms unexplained weight loss, persistent cough, shortness of breath, night sweats, or worsening pain not related to movement

Consider seeing a physical therapist or sports medicine doctor sooner if possible they may help address postural or musculoskeletal causes

Focus on posture correction, core strengthening, and avoid repetitive aggravating movements

If youd like, I can help you with safe stretches or exercises to try while you wait for your appointment.
I’m sorry to hear about the discomfort you’re experiencing. It’s understandable to be concerned, especially when symptoms persist for several months. It’s great that you’ve scheduled an appointment with a new family doctor. They can perform a thorough examination and possibly recommend imaging tests or refer you to a specialist if needed.

If your symptoms worsen or you experience new symptoms like severe pain, difficulty breathing, or significant weight loss, consider seeking medical attention sooner.
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I suggest you see a physician trained in integrative, or, functional medicine. GERD is most often due to systemic Candidiasis and delayed onset food sensitivities. These issues are easy to treat and you will feel better.




Ronald Peters MD

480.607.7999http://www.MindBodyMC.com
This sounds musculoskeletal. It would not be from cancer from the esophagus. See a sports medicine doctor/orthopedist if the PCP is not able to help.
It is imperative to get few tests: X-rays of your rib case, CT of chest and MRI of thoracic spine. We certainly can examine your and give your an opinion without the scans, but these test would certainly help to rule out few important possible problems
I think scheduling a physical exam is the best thing to do. I would try to seek an earlier appt especially with persistent symptoms. If taking anti-inflammatory medication helps you reduce your pain. If so it is likely a musculoskeletal pain. Costochondritis tends to hurt when you take a deep breath or move quickly and that is typically a sharp pain. We also have our lymphatic system which helps our immune response. We have many cervical and thoracic lymph nodes chains we can check during an exam, including the ones that lie under the collar bone area. If abnormal we order further diagnostic testing. If you experience increased pain or worsening symptoms it is best to be evaluated in the emergency department.