What does one do if she experiences major chest pains and medical examinations reveal no heart or BP abnormalities? This is a particularly good question because it applies to all fields of medicine, and to all people who at some time in their lives will become patients (Yes, even doctors). If a person is experiencing symptoms that are not accompanied by signs of disease, or evidence in the form of an abnormal test, the diagnostic work-up will sometimes cease. Yet the patient still has the symptoms. What should be done? First, were all the elements of your complaint dealt with? Please see my prior posting about preparing for a visit to a cardiologist . It is appropriate for a visit to any physician. Second, what constitutes a full work-up for chest pain? This is actually different depending upon the likelihood of different processes causing the discomfort. Arteriosclerotic coronary artery disease is quite unlikely in very young people (but congenital disease may be more ...
Sometimes back pain is not strictly related to spinal structures. Sometimes back pain comes from other places, specifically internal organs. In a process called referred pain , internal organs can send pain signals to other parts of the body. For example, when someone is experiencing a heart attack, the left arm may ache. Nothing is wrong with the arm, but this limb hurts because the heart is referring pain to it. The neck, mid-back and low back are also potential targets for referred pain. Here are two examples when "back pain" has nothing to do with spinal problems.
Gallbladder : The gallbladder is a small organ tucked up near the liver that helps with digestion. Within this internal organ problems can arise like a blockage from a stone, an infection, or just an inflamed gallbladder attack. Sometimes the symptoms clearly point to a problem with the gallbladder. These classic symptoms include right upper quadrant abdominal pain just underneath the right chest wall, nausea, gas, ...
Back pain - nonspecific
Low back pain
Pain in any part of the back
Pain may radiate to the buttocks or upper leg(s)
Signs and tests
A physical examination focused on the back, the abdomen, and the extremities may confirm back pain or muscle spasm , but the examination does not reveal a specific cause (such as a herniated disk) or any neurological problem (such as weakness or change in sensation).
X-rays of the spine are usually normal. Further work-up may include a CT scan or MRI of the spine .
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