Thank you for your query at DoctorSpring.com.
I understand your concern. Your symptoms are diverse and not likely to be due to a single condition/diagnosis. The pain in the center-back and chest seems to be due to a musculoskeletal cause. The lower back radiating to legs and feet with tingling could be due to a pinched spinal nerve. The occasional palpitations could be exercise or anxiety induced. Nausea again could be due to anything and needs evaluation.
I would like some additional information in order to give my best opinion.
1. How long have you had these pains?
2. Do you workout? If yes, what type?
3. Coming to your lower back pain, how long have you had this?
4. Any history of trauma or injury to the back?
5. Does the lower back pain, radiating to legs, increase on coughing?
6. Is there any trigger for your palpitations? Do you have any chest pain or dizziness during the palpitations?
7. Is the nausea associated with vomiting/diarrhea/abdominal pain or any urinary complaints?
8. Please mention a complete drug history, including the names of all the drugs, as well as supplements that you are on.
9. Any history of any medical condition?
Please reply to each of these questions in the follow-up.
Awaiting your response,
Patient replied :
I have had these pains for 4+ Months. I dont work out. No history of trauma or injury. No it does not increase when coughing. Palpitations are random, and happen while im doing nothing. i have chest pains during the palpitations. Nausea is not associated with anything. I do not do any drugs or take any supplements. No history of any medical condition.
Thank you for your response.
As I mentioned earlier, the pain in the centre-back and chest pain on pressure seems to be due to a musculoskeletal cause. The cause in your case, can be determined only by examination. Some of the common causes of such pain include spondylolysis and spondylolisthesis, which are defects in the vertebral structure; or scoliosis and kyphosis which are abnormalities in the curvature in the spinal column.
Treatment depends on the cause and can be rest and lumbar bracing; rarely surgery.
Regarding the lower back pain, it appears to be due to pinched spinal nerves, which would explain the radiation of pain to the legs as well as the tingling. Here too treatment is simple with anti-inflammatory analgesics and physical therapy. The condition improves once the inflammation subsides.
As for your palpitations, because they are associated with chest pain, further evaluation is warranted.
Nausea looks to be unrelated to anything else and since it is only occasional and no other symptoms are associated, can be attributed to dyspepsia.
Here are my suggestions:
1. Please consult your GP for evaluation of palpitations. An examination of the heart, along with a work-up including Hemoglobin estimation (to rule out anemia as a cause of palpitations), an ECG etc may be required.
2. Please consult an Orthopedic specialist for examination of spine and lower back for examination and further management of both the upper and lower back pains.
3. For the nausea, you can take an OTC like Omeprazole 20 mg, once a day, at least half an hour before breakfast, for a week.
I hope this was helpful. Let me know if you have further queries.
Patient replied :
Your response was extremely helpful.
It is my pleasure.
Do get back for further queries.