Sudden pain in left side of rib cage shoulder and arm
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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Believe it or not, there are many conditions that can do this!
Aortic dissection presents with the sudden onset of a severe 'tearing' pain. The site of the pain depends on that of the dissection and will change as the dissection progresses. Often, the pain starts in the anterior or posterior chest or in the abdomen, and nearly always involves the upper back. The neck, arms, trunk or legs may also be involved. The patient often appears shocked - pale, sweaty, and a racing pulse.
Alternatively, presentation may be with acute abdominal pain, a stroke affecting one whole side of the body with paralysis, or a heart attack (due to involvement of the coronary arteries reducing the blood supply to the heart.
Pericarditis is inflammation of the lining layer of the heart. The most common cause is viral e.g. Coxsackxie virus. Other causes include heart attack, pneumonia next to the heart, Dressler's syndrome (inflammation of the lining of the heart occurring about weeks after a heart attack), kidney failure, tuberculosis, an underactive thyroid, trauma, connective tissue disorders e.g. systemic lupus erythematous, rheumatoid arthritis, polyarteritis nodosa, breast or lung cancer invading the lining of the heart, and radiation therapy.
Possible symptoms include chest pain that is sharp, localized, relieved by leaning forward, and. Sometimes pain may spread to left shoulder, or down the arm or into the abdomen.
The brachial plexus is the network of nerves that originates in the neck and travels to the arm. Inflammation of this group of nerves, while rare, may cause sudden rib, shoulder, and arm pain.
Patients with neck disorders such as herniated or bulging discs may also experience pain in the rib cage with radiation to the shoulder and arm.
Sudden blockage of an artery in the upper arm may also present with rib cage as well as arm pain. The affected arm may run blue or red and the arm will be distinctly cooler than the other arm.
Occasionally, abdominal disorders, if they irritate the diaphragm, may also cause rib cage and arm pain. This is because the diaphragm shares nerve innervation with the chest and arm.
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