Can Angina Cause Pain Between Shoulders when Brisk Walking?
If every time you go for a walk you feel pain between your shoulders, this actually could be a sign of heart trouble, namely angina.
In fact, the odds of this being a musculoskeletal problem aren’t particularly high, since soft tissue or joint problems that cause pain between the shoulders would be triggered by different activities and movements, not just merely walking.
This would be especially true if your brisk walks don’t involve a hardy arm pump that may conceivably strain deconditioned upper back muscles.
Angina is highly suspect if:
- Other movements that involve retraction or pulling back of the upper back muscles don’t cause pain.
- The pain is predictable when you go on fast walks – especially if it is between the shoulders and kicks in almost immediately.
If the pain between your shoulders tends to dissipate as the walk goes on (even at a quicker pace), this doesn’t mean it can’t possibly be heart related.
Angina usually subsides when the physical exertion ceases. But there are cases in which it subsides with continuation of the activity.
This doesn’t mean you’re in safe territory. If you have angina, even if it vanishes as the walking or other activity continues, you STILL have blocked coronary arteries! You can’t ignore this!
Angina Can Cause Pain Where You Least Suspect It
“Angina can absolutely cause pain between the shoulders when someone is walking briskly or doing any kind of similar physical activities,” says Charles C. Cummings, MD, Interventional Cardiologist, LifeBridge Health Cardiovascular Institute in Baltimore, MD.
“This would be considered an atypical symptom because people do not usually associate this type of pain with having angina.
“Typical symptoms of angina involve a squeezing pain or pressure in the chest that radiates to the left arm and shoulder or jaw.
“In general, atypical pain is most often experienced by women and people with diabetes, but men may also experience it.”
The pain between your shoulders while walking fast or even slower, that disappears soon after or once the walking ceases, is suspect for angina ALSO if any of the following applies to you:
• Overweight
• Smoker
• Junk food diet
• Poor sleep habits
• High blood pressure
• Diabetes
• Chest pain with exertion
• Feeling more fatigued lately without explanation
• Strong family history of heart disease
• Age: men over 45; women over 50
These are risk factors for heart disease. Exertional angina occurs when there’s not enough blood flowing through the heart due to clogged coronary arteries.
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Another risk factor for coronary artery disease is a lifelong absence of at least moderate effort aerobic exercise.
Or, to put that another way, you’re a “newbie” when it comes to structured cardio exercise.
Even a neighborhood walk can trigger angina in those with bad-enough coronary heart disease.
The absence of chest discomfort does not exclude angina as the cause of pain between the shoulders.
Dr. Cummings holds several cardiovascular device patents and is board certified in internal medicine.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Africa Studio
Angina Back Pain vs. Musculoskeletal Back Pain: Comparison
Blocked arteries can cause back pain and so can strained muscles; unfortunately the pain from both can feel very similar.
However, there are clues…
“It’s not always easy to differentiate between angina back pain and musculoskeletal back pain, but there are clues,” says Charles C. Cummings, MD, Interventional Cardiologist, LifeBridge Health Cardiovascular Institute in Baltimore, MD.
How to Tell Difference Between Angina Back Pain and Muscle Back Pain
Dr. Cummings explains, “For example, if you put your arm in one specific position and it causes pain, but in another position, the pain completely goes away, it’s less likely to be a cardiac issue.
“Also, if you press on the same area of your chest or arm and it hurts, but it goes away when you stop, that’s more likely to be musculoskeletal…not 100 percent but more likely.
“Another example of pain that can be cartilage-related and not angina can be with people who have arthritis who move into a certain position and can duplicate the pain and stop it when they change positions.”
Whether the pain in one’s back is one-sided or seemingly equal on both sides is not indicative of likelihood of a heart problem.
Furthermore, muscle related strains or pulls may be one-sided or bilateral.
Got “Costo”?
“Additionally, there is a condition called costochondritis,” continues Dr. Cummings.
This condition, which many bodybuilders and muscle-building athletes are familiar with, “is inflammation in the joint between the sternum and the ribs that causes pressure which is not cardiac related.”
The discomfort is typically in the chest but can affect the back.
Spasms
“Another atypical type of angina is called Prinzmetal angina,” says Dr. Cummings.
“This is when there is a coronary spasm that’s not from a fixed blockage from arteriosclerosis (also called hardening of the arteries).
“This type spasm frequently happens at night when someone is lying down, and all of a sudden, he or she experiences severe pain. Prinzmetal angina is relatively rare compared to the typical angina.
While the above examples may not be [typical; clogged arteries] angina, without proper testing, there is no way to be absolutely certain.”
Physical Exertion Is Very Telling
Dr. Cummings explains, “What is more certain is that when individuals have chest, shoulder, arm or back pain while exerting themselves, that’s more typical of angina.
Shutterstock/MikeSaran
“Additionally, if someone is sitting down, completely relaxed and has chest pain, that could be an indication of a severe blockage to the heart, and if it gets worse, the artery may be very severely blocked.”
This is called unstable angina and is a very serious condition that needs immediate medical attention.
If you’re an athlete who’s been getting along fine and have had your share of musculoskeletal back pain, but this time the issue seems to have no traceable cause, you should get your heart checked out just to play safe.
Musculoskeletal back pain that does not involve cartilage or tendons – just the muscle as far as soft tissue – should begin resolving soon after avoiding the suspected offending activity such as overdoing it with the deadlifts.
Muscle related back pain, including in the upper region, can be quite painful, and depending on the mechanism of injury and type of injury, can take weeks to subside.
This type of pain is very responsive to movement, though may still hurt when you’re sitting still. Slight movements can set it off.
This descriptor of the back pain points heavily towards a musculoskeletal cause rather than angina.
Dr. Cummings holds several cardiovascular device patents and is board certified in internal medicine.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Muscle Knots: Don’t Worry, but Here Are Causes & Solutions
Muscle knots can cause anxiety over possibly having a serious disease, but it’s a benign condition that has different causes and treatments.
Do not panic if the professional who’s massaging your back, shoulders or neck suddenly says, “You have a big knot in your muscle.” Don’t worry; this doesn’t mean a serious disease.
The massage therapist will then proceed to “work out the knot.”
In minutes you’ll feel relief. Don’t let the layperson term “knot” scare you.
What is a muscle knot?
• “Muscle knots are areas of a muscle that are excessively tight and overly contracted, many times to the point of being painful,” says Dr. Tom Carpenter, corrective exercise specialist, certified personal trainer and chiropractor, inventor of Stand Corrected™, a portable harness-like stretching tool that helps alleviate back, neck and shoulder pain. The contracted muscle fibers are not able to release.
• They thus remain in a tightened or tense state.
• They are very local, and the spot that’s tender upon pressing has a small surface area – up to the size of a quarter.
• “Some knots are only painful when direct pressure is applied, and these would be considered to be latent trigger points,” says Dr. Carpenter.
• There may be multiple knots in a specific area.
• The medical term is myofascial trigger point.
Origin of Muscle Knots
• “Muscle knots can be caused by overuse, heavy lifting or repetitive movements,” says Dr. Carpenter.
• “Also prolonged poor posture from, for example, too much texting or being hunched over a computer resulting in strains which produce tight and knotted muscles.”
• Dr. Carpenter also explains, “Spinal misalignments can many times result in associated myofascial trigger points as well, and this should be checked by a chiropractor.”
• Don’t be surprised if your massage therapist, upon beginning to work your neck and shoulder area, asks if you’ve been under a lot of stress lately.
Dr. Carpenter points out, “Emotional and mental stress shouldn’t be ruled out either when experiencing this problem.”
• Nutritional deficiency
Treatment for Muscle Knots
“Some solutions would be to massage the painful areas and try to work them out as well as using a heat pad on the area, assuming the pain is not from a recent acute injury,” says Dr. Carpenter.
Massage therapy such as deep tissue massage will work wonders. The caveat is that it’s not cheap.
However, rather than having hour-long massages you can have 30 minute sessions to save money yet still reap the treatment benefits.
As the therapist “works out” the knot, it usually hurts (tenderness), but then it starts feeling good. The therapist can then press upon the area where the knot was, and you’ll no longer feel the pain.
However, rather than having hour-long massages you can have 30 minute sessions to save money yet still reap the treatment benefits.
Foam rollers. If you use a gym, you’ve probably seen on many occasions people rolling a body part against a foam roller on the floor.
I’ve done this with the area where the butt muscle ties into the upper hamstring (“glute tie-in” or “hamstring-glute junction”).
And it actually works when you’re patient and relaxed, rhythmically rolling.
Improve posture. Avoid slumping in your computer chair and slouching while standing.
“Gentle stretching of the muscle can also be helpful,” says Dr. Carpenter.
Take your hands off the treadmill. Holding onto the treadmill creates an unnatural walking gait that skewers posture.
This can contribute to or cause undue tension in the neck, shoulder and upper back muscles.
If you think you’ll fall off without holding on, slow the speed and/or lower the incline.
Stand Corrected™
Dr. Carpenter recommends seeing a chiropractor if the above treatments fail to resolve your muscle knots.
Muscle knots are very common, especially in athletes, workout enthusiasts and muscle builders. Do not fear them; just treat them.
Photo credit: Aleesia Forni
Based upon 30+ years of experience, Dr. Carpenter’s practice approach reflects his belief that restoring optimum health and function will enable his patients to enjoy a much greater amount of vitality and wellness. Chiropractic care is true health care, not sick care!
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Top image: Shutterstock/Leszek Glasner
Melanoma & Mole Borders: Signs of Cancer vs. Normal
There’s far more to knowing about the borders of a melanoma than what you think.
First of all, a jagged border of a mole doesn’t always mean melanoma.
There are many variables to consider when scrutinizing the borders of your moles.
“Benign mole borders are usually smooth and well-defined,” says Caroline A. Chang, MD, a board certified dermatologist and founder of the Rhode Island Dermatology Institute.
Dr. Chang explains, “Suspicious mole borders are often fuzzy, scalloped, irregular, asymmetric.
“I have often heard melanomas recalled as having a fuzzy border or looking like a ‘splotch.’”
Using Magnifying Lenses to Inspect Moles
When you examine your moles for your monthly self-inspection, it’s advisable to abstain from using a magnifying glass, as this will accentuate jaggedness in the border of a benign mole that looks pretty normal without magnification.
Viewing magnified moles, which accentuates their features, can cause a lot of anxiety.
The more magnified a mole, the more “uneven” or “notched” the border appears to the layperson.
Every year I undergo elective serial digital dermoscopy, in which moles are photographed; the images are input into a computer database and rated for index of suspicion for melanoma.
I’ve seen my normal moles magnified on a computer screen – big images. The borders appear quite jagged under this magnification.
Even a simple magnifying glass can make a benign mole look suspicious for melanoma – to the untrained eye.
So don’t get into the habit of using magnifying glasses during self-exams. The only exception to this guideline is if you have presbyopia: blurry up-close vision that requires reading glasses.
This eye condition usually starts setting in in the mid-40s. It will prevent you from crisply viewing a mole if you’re up close and personal to it, such as with moles on your shin or forearm.
But people with good up-close vision really should not use any magnification lenses.
Has the Mole Always Had a Jagged Border?
If a mole’s border looks rather uneven or erratic to the naked eye, this is suspicious, but it doesn’t always mean melanoma.
Have a dermatologist inspect it with a dermatoscope. All moles, too, should be viewed through this dermatologist’s tool.
Conversely, sometimes melanomas have smooth borders. Or, the melanoma can be starting up in the center or inside the border of a mole that has a round smooth border.
Once you get acquainted with your moles, make a note of the ones with uneven or irregular borders.
The longer that time passes during which you don’t detect any changes in these moles, the more reassuring this will be that they’re benign.
But if you continue to worry, request a biopsy. It’s normal to keep wondering if a mole has always had particular border features.
Serial Digital Dermoscopy
You do not need to have a large number of moles or “funny looking” moles to have serial digital dermoscopy.
If you’ve been diagnosed with dysplastic nevi (funny looking moles), your insurance may cover serial digital dermoscopy.
If your insurance doesn’t, have it done anyways. The peace of mind is incredible, and this technology really does make a difference. The cost will be around $250.
The computer database may rate a mole in the “suspicious” category, leading to a biopsy that confirms a very early melanoma that was not evident to the naked eye or even through a dermatoscope.
The computer software can detect if a mole’s border needs further evaluation.
Dr. Chang practices general and cosmetic dermatology, and has particular expertise in melanoma and the use of dermoscopy for mole monitoring.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Doctors Explains How Fast Uterine Cancer Grows
Many uterine cancer patients want to know how fast this disease grows, and many women who fear they might have it also want to know its growth rate.
So just how fast can uterine cancer grow? (more…)
Can Ovarian Cancer Cause Numbness in a Leg?
If you’re experiencing unexplained numbness in a leg, this could be caused by ovarian cancer.
But is it most likely ovarian cancer?
The answer depends on whether or not you’re experiencing other symptoms that are classic for this disease, such as loss of appetite, a distended and bloated stomach, pelvic or lower abdominal cramps and heaviness on one side of the pelvis.
Leg Numbness Not Caused by Ovarian Cancer: Still Potentially Serious
“Leg numbness should be immediately evaluated because this can be due to serious medical problems such as nerve compression in the pelvis, either from a spinal abnormality, neuropathy or tumor compressing a nerve,” says Mylaine Riobe, MD, founder of Riobe Institute of Integrative Medicine.
Dr. Riobe, who’s board certified in ob/gyn and integrative medicine, is the author of “The Answer to Cancer.”
“Ovarian tumors large enough to compress the nerves in the pelvis can cause leg numbness,” says Dr. Riobe.
If this isn’t frightening enough, there are cancers other than ovarian that can cause a numb sensation in a leg by pressing on nerves.
These include cervical cancer and tumors on the spine.
Do not confuse a “tingling” sensation in a leg with actual numbness.
It’s normal for legs to tingle or “feel numb” from time to time as a result of external mechanical pressure on a nerve.
And when this happens you can still actually feel your legs with your fingertips, even though you might think, “My leg feels numb.”
The tingling or prickly feeling is usually caused by innocent nerve compression from sitting on a toilet for too long, sitting in your computer chair or TV sofa for too long in the same position, prolonged leg crossing or perhaps a prolonged compressing position during sleep – which can make your leg feel “dead.”
And you’ll notice that the tingling or “pins and needles” disappears after the source of external compression is removed.
While some women fear ovarian cancer might be causing numbness in a leg, other women (and men) may panic over the idea of a DVT: deep vein thrombosis.
Dr. Riobe says, “Leg numbness can also be caused by a blood clot in a major blood vessel or nutritional deficits leading to poor nerve conduction or circulation.”
Data Non-Existent
There is no data that gives a percentage of likelihood of what’s causing numbness in a leg.
For example, nobody can say, “Okay, the odds that numbness in a leg is being caused by ovarian cancer is 23 percent; the odds that it’s being caused by diabetes is 55 percent; fibromyalgia, four percent.”
However, the likelihood that numbness in a leg is being generated by an ovarian tumor increases if other suspicious symptoms are present, such as, as mentioned, abdominal distention (from fluid buildup in the abdominal cavity caused by the tumor), pelvic cramps and loss of appetite.
Other Non-Cancerous Causes of Leg Numbness
• Meralgia paresthetica (affects outer thigh)
• Lumbar disc hernia
• Lumbar degenerative disc disease
• Lumbar spinal narrowing
• Spondylolisthesis (structural problem with vertebra)
• Spinal tuberculosis
• Tarsal tunnel syndrome (yes, just like carpal tunnel except affecting the foot)
• Trauma
• Spinal cord inflammation
• Marfan syndrome (genetic disorder characterized by tallness)
If your leg numbness comes and goes in synch with certain body positions on seats, sofas and beds or in a motor vehicle, immediately resolving when you exit the offending position, you can be reassured that this symptom is not being caused by ovarian cancer.
But if you’re having other suspicious symptoms that point to this disease, have your ovaries checked out.
Dr. Riobe has helped thousands of patients overcome difficult illnesses by addressing root causes, not just masking symptoms. The Riobe Method focuses on the prevention of disease, not the prevention of death from disease. She has 20+ years’ experience using integrative techniques to treat diverse patients.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Miss Ty
Detailed Exercise Guidelines After LEEP
Many women are eager to return to exercise after LEEP but do not have exercise guidelines.
Here are detailed guidelines so that you can feel confident during your recovery.
LEEP stands for loop electrosurgical excision procedure.
A woman who’s been sticking to a workout regimen will wonder just how soon she can return to it following the LEEP.
Exercise Guidelines Following LEEP
“Generally, it’s not advised to do any rigorous exercise for 48-72 hours after LEEP,” says Mylaine Riobe, MD, founder of Riobe Institute of Integrative Medicine.
Dr. Riobe, who’s board certified in ob/gyn and integrative medicine, is the author of “The Answer to Cancer.”
“It’s important for the surgical area to heal and stop bleeding before rigorous activity,” continues Dr. Riobe.
“During a LEEP procedure a significant portion of the cervix is removed and cauterized to stop bleeding.
“A liquid ‘band-aid’ called Monsel’s solution is usually applied by most gynecologists following LEEP to stop bleeding.
“The cervix is a highly vascular tissue and bleeds easily. A scab forms on the cervical bed and, if disrupted, can cause significant bleeding.”
Wait 48-72 Hours to Resume Your Deadlifts and Squats
Shutterstock/Oleksandr Zamuruiev
“After 48-72 hours, you can usually gradually resume activities,” says Dr. Riobe.
Just to play safe you should use a little less weight than what you were normally doing prior to the procedure – if for no other reason muscle loss will have occurred after 72 hours of no exercise.
Maybe hold off on any gut-wrenching routines and instead perform them at 80 or 90 percent intensity for that first workout after the LEEP.
If you’re a runner you can return to that 48-72 hours post-procedure.
If you’ve been doing HIIT workouts, maybe go up to your highest sub-optimal interval for your first post-LEEP HIIT session.
In that same timeframe you can return to your group fitness classes, karate, hiking and yoga with confidence.
Of course, says Dr. Riobe, “Once the scab is formed, it’s generally safe to exercise. Ask your doctor for specific instructions, as each case is different.”
Don’t be vague with your instruction request such as, “When can I get back into exercise?”
If you’re into CrossFit, mention that, and you’ll need to explain how intense it is if your doctor is not familiar with it.
If you do heavy and strenuous weight workouts with your lower body or do martial arts, tell your doctor that.
Dr. Riobe continues, “The scab usually falls off at seven days and some people can see some light bleeding when the scab separates from the cervical bed.
“It’s generally not advised to lift over 5-10 pounds for the first 48-72 hours following LEEP for the same reasons cited above.
“If all is okay following this period and there is no further bleeding or infection, you can usually gradually resume your activities as tolerated.
“Again, ask your doctor for specific instructions, as every case is different.”
This all is pretty good news for women who are eager to get back into their exercise regimen following LEEP.
