Question

Sir I am 27 year old male I have symptoms of left shoulder and wrist pain while walking so I went to doctor doctor do following reports blood test - normal with hgb -16.2
creatine - 0.71 mg/dl
egfr -140.4 ml/min hba1c 5.60%
mean blood glucose 114 mg/dl
serum cholesterol - 117 mg%
hdl -43.5 mg%
hscrp - 2.5
ecg - t wave abnormality, consider inferior ischemia echo normal with lvef 60 %
tmt with 193 bpm with 100 percent of max predicted
max workload - 10.1 mets exercise time - 8 min 4 sex comments - baseline t wave inversion no st- t changes present no arrithimia noted no angina moderate effort tolerance
tmt negative for inducible ischemia sir please can you evaluate that my pain is from heart or not.

Dr.Julie Mercy J David · Accepted Answer

It looks like cervical pain that's the reason you have pain in the shoulder and along side until wrist. You need to take rest and you need to consult physiotherapist you need to do intermittent cervical traction and also inferential therapy treatment which will help you to get subsided with pain. Neck pain
cervical spondylosis– chronic condition with radiating pain
this is cervical pain (neck pain) and that's the reason the pain radiates until the shoulder blades. If you keep ice that would help and along side you can do hot water fermentation. You shall use cervical collar which would help you to reduce the radiating pain ie. Due to the nerve compression.
You have to go for traction and also you can do ift. Please consult the near bytherapist for quick relief. Use collar will definitely be helpful for him to maintain the good posture. And also cervical pillow can be used which might make you to have better posture of the shoulder neck and arm.
Neck tilt: from the sitting position, tilt your head down so your chin touches your chest. Hold this position for 5 second s. Return to the starting position and repeat. Do this five times.
Side-to-side neck tilt. From the same starting position, tilt you neck toward one shoulder, leading with your ear. Hold for 5 seconds and then return to the starting position. Do this five times on each side.
Neck turn. Look straight ahead, then turn your head to one side, keeping your chin at the same level. Do this five times on each side.
Neck stretch. Holding the rest of your body straight, push your chin forward, stretching your throat. Hold for 5 seconds. From the same starting position, push your chin backward and hold for 5 seconds. Do the forward and backward stretch five times each.
If any of these exercises cause severe pain or weakness in your hands or arms, stop right away and talk with your doctor. We suggest you to wear cervical collar which will help you to improve the cervical angle and also it definitely helps you to improve the neck posture due to which your neck pain is triggered more. The importance of wearing cervical collar is to give good stability to the neck and also it definitely prevents you to have excess neck movements which makes the condition worse. If you wear cervical collar you cannot turn your neck as you like which itself will help you to have better functioning of the cervical spine.
This cervical soft collar what we are suggesting for you is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall (using whatsapp) and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it.
Pushups
this one may seem basic, but there’s no denying that pushups are one of the best ways to strengthen the pectoral muscles. These can be done on the knees or toes. If you’re not ready for full pushups, start with your hands resting on a solid surface higher than your feet — like a very sturdy coffee table or the edge of a couch, cushions removed, that’s pressed up against a wall — and start on the toes.
Having your hands higher than your feet and your body at an angle can be a good way to start a pushup regimen. As you get stronger, you can begin to lower the angle of your body. This will help you transition to full pushups more easily than going from knees to toes. A full plank engages the muscles differently, even at an angle.
When doing pushups, aim for 2 sets of 10 reps per day.
1.start in plank position with your hands under your shoulders and your core engaged.
2.as you lower, inhale.
3.as you engage your muscles to push yourself up, exhale. Keep your elbows hugging in close to your body. Keep your focus on slowly breathing as you do these, and on engaging the pectorals while keeping the core tight.
Don’t just crank these out to get them done — this can compromise your form and do more harm than good. If the movement is really tough, break the sets into three or five to start, or find a higher point to begin after a week of exercise. If necessary, you can even stand and do pushups pushing against a wall.
Chest fly
for this exercise, you’ll need a bench or exercise ball as well as some dumbbells. If you don’t have weights, you can always use the old standby: a soup can in each hand. Just keep in mind that dumbbells are easier to hold and you can get more out of using them, as even 5-pound weights are heavier than your heaviest canned goods.
1.lie with your upper and middle back on a bench or ball, with your legs at a 90-degree angle. Hold a weight in each hand and extend your arms to the sky, elbows slightly bent.
2.as you inhale, lower your arms out wide, until your elbows are at shoulder height.
3.as you exhale, raise your hands until they meet above your chest again.
4.do 2 sets of 10.
If that feels pretty easy, up it to 2 sets of 15 or increase the weight you’re using.
Dumbbell row
strengthening your back muscles is an important component of treating pectusexcavatum. The dumbbell row targets your lat muscles. The way it’s described below also strengthens your core, another important component of treating the condition. You’ll need some dumbbells to complete this move — err on the lighter side if you’ve never done a row before.
1.hold one dumbbell in each hand with your arms extended. Hinge at the hips until your upper body reaches a 45-degree angle.
2.keeping your neck in line with your spine and your gaze straight down, pull your elbows straight back and squeeze between your shoulder blades.
3.extend your arms back to the starting position. Complete 2 sets of 10.
Dumbbell rear delt fly
another move to strengthen your back, a dumbbell rear delt fly also focuses on the lats, as well as the rhomboids and the traps. Choose a light pair of dumbbells to complete this move and ensure that you’re pinching your shoulder blades together at the top to get the most out of it.
1.hold one dumbbell in each hand with your arms extended. Hinge at the hips until your upper body reaches a 45-degree angle and bring the dumbbells together.
2.keeping your spine and neck neutral, inhale and push the dumbbells out and up to the side until your arms are parallel to the floor.
3.exhale and return to the start in a slow and controlled motion. Complete 2 sets of 10.
Exercise is a key component to treating pectusexcavatum. By strengthening your chest, back, and core muscles and stretching your chest cavity, you can combat the condition’s effects. Aim to complete these exercises several times a week to maximize results.
Anterior pelvic tilt
1.lie on the back with the knees bent and feet flat on the floor, hip-width apart.
2.squeeze the buttocks and tilt the pelvis upward.
3.the back should feel as though it is flattening to the ground. 4.return to normal pelvis position.
5.repeat 10–12 times.

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