Dear Readers,

Bev writes from Mocho, Clarendon. Bev is a 46-year-old lady who does her own housework. She has noticed recently that she has been experiencing chest pains whenever she is hanging out the washed clothes on the line. Whenever she raises her arms up to the clothes line, she experiences quite severe chest pain. She sometimes also experiences stabbing pain to her left side at the same time.

Bev only experiences chest pain and side pain when she is stretching up which involves stretching her chest and abdominal wall muscles. The pain she experiences is felt only with movement of the chest and abdominal muscles. She does not complain of pain at rest or even with exertion which does not involve stretching movements.

The pain Bev is experiencing seems likely due to chest wall muscle strain.

Muscle strain occurs when muscle fibres become stressed and over stretched or are required to bear too much weight for too long a time. Making sudden jerking or pulling movements to groups of muscles on their tendons can result in muscle strain, also called 'pulled muscle'. The most common complaint when the muscles are strained is localised aches and pains which interfere with regular movement. The involved body area might also be inflamed and swollen. Strained muscles sometimes also spasm resulting in significant pain.

Treatment of a muscle strain should involve the following steps:

❒ Application of an ice pack to the painful area for 30 minutes, soon after the strain occurs, which helps to reduce inflammation and swelling and to relieve pain.

❒ After 24 hours heat applications should be used which will relax stiff, sore muscles and make movement easier.

❒ The use of over-the-counter pain relievers such as Tylenol, Advil, Matrin and Paracetamol will help relieve mild to moderate pain. However, if pain is severe then prescription pain killers may be required eg. Cataflam, Voltoren, Feldene, Celebrex, pretige, Viox and others.

❒ Muscle relaxants might also be useful where muscle spasm is present. Examples of these are scutamil Mydacalm, norgesic and valium.

Strained muscles usually heal on their own over days to weeks but resting the muscles involved is necessary. Any activity which brings on the pain should be avoided for several weeks.

If Bev's chest pain does not respond to the above mentioned method of treatment, then she should see a doctor to confirm that she does have chest wall muscle strain and to authorise prescription pain killers and physiotherapy or, to consider the many other possible causes of chest pain and to investigate Bev as is necessary.

Write Lifeline

P.O. Box 1731

Kingston 8