OpenHealth Q&A

Enduring Pain Attacks for Nearly 15 Years Without Answers

I am a 33-year-old female, and for almost a decade and a half, I have been grappling with painful episodes that remain a mystery to medical experts. Despite numerous consultations, no one has been able to pinpoint the cause of my discomfort. Let me elaborate on these episodes, as I have described them many times before: - Currently, the pain strikes me one or two times a month, though there are variations with some months being more intense than others. - In the early years, these occurrences happened infrequently, perhaps every few years, but over time, they have become more regular and severe. - Each episode can last from 30 minutes to 6 hours, with most lasting about 2 to 3 hours on average. - The pain is episodic, intensifying in waves every 10 to 30 minutes, reaching a level that is nearly unbearable before completely subsiding. Interestingly, I often feel perfectly normal in between these waves. - The discomfort consistently originates on the right side of my body, typically beginning in my jaw or sometimes in the upper back just beneath my right shoulder blade. - As the waves progress, I often feel it migrate to the right side of my neck and chest, and frequently into my abdomen. - Alongside the pain, my gastrointestinal system often reacts with gas, bowel irregularities, and heartburn. - Once an episode concludes, I return to feeling normal, albeit slightly fatigued. The pain does not leave residual effects. - The nature of the pain varies, sometimes dull or at other times sharp and stabbing. - There are no discernible warning signs prior to an episode; they usually appear abruptly. - Occasionally, I experience a milder version of this pain that lingers for hours or even days, but it does not escalate into what I consider a true episode. - At its peak, the pain can be incapacitating, rendering me unable to do anything. I would rate it as an 8 or occasionally a 9 out of 10 in severity. To date, I have pursued various medical avenues: - My general practitioner initially attributed the pain to heartburn but later theorized that it could be costochondritis, which was ultimately ruled out. While I do experience heartburn frequently, I wonder if it could really be responsible for such intense pain. - A chest X-ray indicated no abnormalities. - I consulted a cardiologist who affirmed that my heart is healthy. - A neurologist recommended an MRI but did not provide any other insights. - A session with a massage therapist revealed extreme tightness in my jaw and shoulder muscles, which could potentially relate to my pain, whether as a cause or a symptom. There has been a suggestion that my pain may be linked to irritation of the vagus nerve; however, I have no means to investigate this further. Overall, I enjoy good health and do not suffer from any other medical conditions. I would greatly welcome any suggestions or insights regarding next steps, as I feel I have reached an impasse. The healthcare professionals in my area seem to operate with minimal concern and it has been incredibly frustrating to feel dismissed. Thank you for your time and assistance.

Answers (1)

8/28/2025, 2:02:36 AM

OpenHealth AI

Thank you for sharing your experience; it sounds incredibly frustrating to deal with persistent pain without clear answers. Your detailed description helps in understanding the nature and impact of your symptoms. Given the complexity of your pain episodes, let’s explore some potential avenues and immediate next steps that might assist you in managing your situation.

Main Points:

1. Nature of Pain: Your pain is episodic, severe, and originates from the right side of your body, often linked with gastrointestinal symptoms.
2. Previous Investigations: You've undergone various tests with no conclusive findings, including cardiac evaluations and imaging, which is understandably disheartening.
3. Potential Connections: There might be a relationship between your symptoms and muscle tension, irritation of the vagus nerve, or gastrointestinal issues.

Explanation:

Your pain could potentially stem from multiple factors. Conditions like gastroesophageal reflux disease (GERD), musculoskeletal issues, or neuropathic pain are considerations, especially given the combination of jaw and shoulder tightness, gastrointestinal reactions, and the pattern of your pain. It’s notable that stress and anxiety can contribute to muscle tightness and gastrointestinal symptoms as well.

Actionable Next Steps:

1. Keep a Symptom Diary: Document each episode, including the intensity, duration, triggers, dietary habits before episodes, and any stressors. This can help identify patterns that may correlate with your pain and gastrointestinal symptoms.

2. Consult with a Pain Specialist: Since traditional investigations have not yielded answers, consider seeking a second opinion from a pain management specialist who may explore less common causes and suggest tailored treatments like trigger point injections or physical therapy.

3. Physical Therapy Focused on Muscle Tension: Given the tightness in your jaw and shoulder, physical therapy could help release muscle tension and improve posture, potentially alleviating pain triggers. A physical therapist specializing in chronic pain or myofascial pain could provide valuable insights.

4. Explore Dietary Adjustments: Since you're experiencing gastrointestinal symptoms, consider tracking your diet for triggers that may contribute to heartburn or discomfort. Implementing smaller, more frequent meals and avoiding known irritants (like spicy or fatty foods) could help.

5. Stress Management Techniques: Stress can exacerbate muscle tension and pain episodes. Techniques such as mindfulness, yoga, or cognitive-behavioral therapy could offer relief and better coping mechanisms for pain.

Additional Consideration:

If vagus nerve irritation is a concern, consider researching non-invasive treatments that could help with nerve function, like diaphragmatic breathing exercises or other vagal tone-stimulating activities.

Reassurance:

You deserve to find relief and clarity regarding your pain. There may be no definitive answers immediately, but taking actionable steps like these can empower you and possibly lead to new insights into managing your symptoms. Please feel free to reach out if you have more questions or need further guidance.