chest and back pain again: I’ve just spent... - PMRGCAuk

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chest and back pain again

WillOllier profile image
38 Replies

I’ve just spent afternoon in A & E with same problem I had a couple of years ago - sharp chest pain that then moves to middle of my back . Once again I had ECG chest x ray and blood test snd everything was fine . Symptoms eased after an hour. Last time it was accompanied by acid reflux and there has been some of that this time but mild. I’m on a 3 to 2.5mg taper from pred and I take omeprazole daily. I had just played tennis before this happened today but hadn’t the last time this happened. I was concerned last time and ended up having an endoscopy and that was all clear . Any thoughts? Or just perhaps bad indigestion as side effect of the pred ?

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WillOllier profile image
WillOllier
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38 Replies
Nextoneplease profile image
Nextoneplease

Hi WillOllier 😊

Sorry you’ve had this experience.

I have something similar but it tends to last only 10-15 mins and is due to acid indigestion. I keep gaviscon on me at all times, take some immediately it starts and it eases up.

My other thought is it may be costochondritis?

Always wise to get chest pain checked out. Glad you’re okay 😊

WillOllier profile image
WillOllier in reply to Nextoneplease

many thanks it seems to be indigestion and will get some gaviscon . It’s still there a little this morning, I’m also inclined to increase my omeprazole for a few days that was advised by chest nurse last time this happened. Not heard if chostocondritis will check that out 👍

Ridge profile image
Ridge

It sounds similar to an acute indigestion I occasionally get and have done for years. I can’t take any of the indigestion remedies without feeling sick. The very best is original Coca-Cola! When you feel an attack take little sips and keep upright! Obviously it is good to get it checked out thoroughly as you have done.

WillOllier profile image
WillOllier in reply to Ridge

coca cola ?! I will give that a go too. Glad it just seems to be indigestion which I know can be due to pred

Roltuba profile image
Roltuba

look up Oesophageal Spasm. Had investigation for the same as you several years ago, no heart problems and found the spasm description that exactly matched it, so have stopped worrying. A small drink of very cold water makes it stop.

WillOllier profile image
WillOllier in reply to Roltuba

again thanks very much it’s good to know others have this will try the very cold drink

Daffodilia profile image
Daffodilia

Have you had scan for gallstones - my pain for these sounds like yours - it is not in the usual place - I try to eat low fat food which seems to help and take paracetamol as soon as pain starts

PMRpro profile image
PMRproAmbassador

Is it between your shoulder blades when it is in the back? Gallstones springs to mind - and that can last just a few minutes or longer.

"Gallstones may cause pain to occur in several different places, including:

the upper right area of your abdomen

right below your breastbone

between your shoulder blades

in your right shoulder

The amount of time you experience pain from gallstones can last for a few minutes to several hours. You may also experience symptoms such as nausea or vomiting."

Do you take calcium supplements along with your pred? That can cause gallbladder problems.

WillOllier profile image
WillOllier in reply to PMRpro

oh that’s interesting yes I am taking calcium everyday. No one this time or last mentioned gallstones, only ulcers hence the endoscopy. I’m going to follow up with my GP. Thank you once again .

PMRpro profile image
PMRproAmbassador in reply to WillOllier

There are several on the forum who have had varying degrees of stones/grit due to taking calcium supplements. I had bladder problems, jinasc developed gallstones/grit - we both improved when we cut the calcium supplements

WillOllier profile image
WillOllier in reply to PMRpro

I’ve never questioned my calcium intake but will take that up with my GP too. It’s all too easy to just carry on taking these tablets without question. Thanks for that

PMRpro profile image
PMRproAmbassador in reply to WillOllier

It is less the calcium itself- you do need it from somewhere - but the form, calcium carbonate is cheap and cheerful but can lead to grit and stones forming if too much is sloshing around rather than being used up.

Do you know what your bone density is like? Have you had a dexascan?

WillOllier profile image
WillOllier in reply to PMRpro

I’ve got an appointment for a dexa scan in November . Last one was 3 years ago and I was then in the osteopenia category. I currently take 2x600mg tablets a day they are called calcium cholecalciferol (vit D3)

PMRpro profile image
PMRproAmbassador in reply to WillOllier

As I wrote the last reply I had a lightbulb moment! The people I know who have had sludge/grit/stone problems with calcium supplements have mostly had good bone density that didn't deteriorate with pred I wonder if there is a connection. Other forms of calcium supplement seem to have fewer problems.

WillOllier profile image
WillOllier in reply to PMRpro

thanks I’m going to take this up with my GP I’ve just assumed the calcium in that form is ok

PMRpro profile image
PMRproAmbassador in reply to WillOllier

It seems to be fine for many - but some of us are delicate flowers!!!

Predsharer profile image
Predsharer

I am about in the same place with my taper as your are WillOllier, about to go down to 2mg and getting the same symptoms as you. I don’t take Omeprazole because it makes me nauseous, but I did try it again a few weeks ago when I started to have acid reflux. I stopped again because it really doesn’t suit me and began taking simple Rennies. I now have covid and two days ago , like you, ended up in A&E with chest pains. Everything checked out fine (apart from the obvious covid symptoms) but the main problem identified was acid reflux, something I’ve never experienced until recently. I am beginning to think that maybe the Pred has permanently damaged my stomach. I have been so careful how I take it with Yoghurt etc. as suggested by the good people here. I was beginning to think my GP had been right to warn me that if I didn’t take Omeprazole I would end up with a stomach ulcer! but then you have been taking it and still feel as I do. I wish I could throw some light on it, as I am sure you do too Willollier.

WillOllier profile image
WillOllier in reply to Predsharer

thanks for replying yes I do think upping omeprazole does work for me maybe but I’m concerned like you of damage to my stomach if the pred. Going to talk to my GP as don’t want to just ignore this .

WillOllier profile image
WillOllier in reply to WillOllier

hope you are now feeling better post Covid ?

PMRpro profile image
PMRproAmbassador in reply to Predsharer

Stopping omeprazole or any other PPI suddenly will usually result in a rebound production of acid - far worse than normal. You either need to taper the dose - though not as slowly as with pred - or start taking a different form of acid-inhibitor like famotidine or cimetidine which are easier to get off. Gaviscon is probably better than REnnies.

WillOllier profile image
WillOllier in reply to PMRpro

yes I won’t stop the omeprazole in fact I’ve just doubled the dose to 40mg for a few days which seemed to settle things last time

Ridge profile image
Ridge in reply to Predsharer

I don’t like Omeprazole either but I have been told by GP and Rheumy that I can dip in and out of it without being irresponsible to my gut. I have gone back on it when I increased to 10mg and I’ll stay on it a bit.

Do try Coca-Cola for acid reflux. Little sips from a small bottle of original, flat if it has been opened a while, seems to work wonders. Not only me but friends I have suggested it to.

WillOllier profile image
WillOllier in reply to Ridge

great I will give that a go 👍

cmToddy profile image
cmToddy

Hi. I have been through this and have several episodes of oesophageal spasaming. 1000mg of Paracetamol stops the pain. Also keep Ibuscapan in hand, as that clears it almost instantly. This was advice from the hospital and worth a try. Good luck.

WillOllier profile image
WillOllier in reply to cmToddy

yes the hospital did say if it happens again take pain killers. To be honest as long as it’s nothing serious I can cope as it only last about an hour . But do want to make sure I’m not unnecessarily exacerbating things leading to further damage.

Rostom profile image
Rostom

I have had bouts of a similar pain and at the last decided that perhaps I should be checked out. I contacted my GP who called an ambulance and I was whisked off to A and E within minutes and kept overnight! I do have an arrhythmia so once mentioned, I suppose it was right to check me out.

My pain began in the central front upper chest then quickly progressed to the same spot but in my back violently pulsating up and down dissipating after 10 - 15 minutes. Sometimes it returned an hour later in a more minor way.

I also had many tests but nothing of importance was found. My troponin level - the blood test for heart attacks - was initially raised but settled too fast to have been a heart attack and the consultant eventually pondered if it could be ' digestive' in nature. Prednisolone was not mentioned as a possible cause for the acute pain.

I am grateful for being checked out as, particularly if it happens at night with the pain being quite severe, it was worrying. I was on varying doses of prednisolone, being on around 15 mg when it first happened and down to 9 mg at the last 'attack'.

One last thing - I have had my gallbladder removed, so in my case, that couldn't have been the cause of the pain and yes, gallbladder pain is pretty horrible too! I diagnosed my gallbladder problem as eating high-fat food (in my case ice cream) brought on the gallbladder pain whereas when trying extremely low-fat food for a week, I had none.

Of course, all the above was relevant to me and I am not suggesting that you do anything other than take medical advice!

Wishing you better.

PMRpro profile image
PMRproAmbassador in reply to Rostom

Did you know removal o the gallbladder desn't mean you can't have gallstones? Strange but true ...

"About 1 in 7 people with gallstones will develop stones in the common bile duct. This is the small tube that carries bile from the gallbladder to the intestine.

Risk factors include a history of gallstones. However, choledocholithiasis can occur in people who have had their gallbladder removed."

mountsinai.org/health-libra....

Rostom profile image
Rostom in reply to PMRpro

Gosh, thanks for this information, PMRpro. Who knew?!

I mentioned my gallbladder removal to the A &E/Cardiology staff but no one suggested that there could still be a problem with stones (perhaps they didn't know...?).

I will bear your information in mind for the future - 'just in case'!

Many thanks.

WillOllier profile image
WillOllier in reply to Rostom

many thanks good to know others are identifying similar episodes although not fir them !

Dubuquer profile image
Dubuquer

I'm sorry I missed that you had your gall bladder removed. My mother also had hers removed years ago and was having similar symptoms for years. They finally did a procedure called an ERCP. They discovered her bile duct was filled with sludge.

Since then she has been symptom free! Good luck!

9lives profile image
9lives

I started getting back pain, sort of sharp pain , many many years ago , before prednisone, which was indigestion, I was really worried the first time I had it. I still get it but more like reflux/ heartburn since being on prednisone. I take gaviscon which helps. I. also get full up quickly now, which doesn’t help. It’s always good to check these things out xx I’ve tried to change my eating habits as I know spicy food and carbohydrates make it worse xx hope you find some relief x

Carole

WillOllier profile image
WillOllier in reply to 9lives

many thanks Carole I feel better today but am grateful to this group for all the invaluable support and advice. Next time I will be fully tooled up!

WillOllier profile image
WillOllier

still got my gall bladder thank goodness but I hope to get to the bottom of this soon

jessiem profile image
jessiem

I had this when on calcium supplements. I stopped taking them and it went away. I had a Dexa scan recently and my bones were above average for my age so I’m not worried about not taking the supplements. I do drink a lot of milk!

WillOllier profile image
WillOllier

That's good to hear. I'm gong for a dexa scan in November but in meantime I'm going to chat with my GP about this and see if there is another way to take the calcium. Like you I do drink lots of milk!

PMRpro profile image
PMRproAmbassador in reply to WillOllier

Keep a diary, weigh/measure your food and use google to work out how much calcium you are getting. You may not need a calcium supplement - I don't take one now but DO take 4000 IU vit D which is probably more important and eat a lot of cheese ...

piglette has an app that works it out for you - hope she sees this and shares.

piglette profile image
piglette in reply to WillOllier

The app is MyNetDiary. It checks on nutrients, calories etc. There is a free version. I find it useful in that I tend to use it to plan my meals and so in fact it stops my wasting food too as I now know what I need to buy in advance. Particularly during current times.

WillOllier profile image
WillOllier

Great I will get the app ! Over this week since my acute pain I’ve had mild indigestion so that does seem to be the culprit. Taking gaviscon which is helping but I’m now going to monitor calcium intake 👍

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