Dear doctor;

Whenever I lift heavy objects my chest pains me for days. This has scared me from going to the gym to work out. Please advise.

Moses

Dear Moses,

You have not specified your age and the type of pain felt. Tight constricting chest pain occurring after lifting heavy objects can be due to angina, a mild form of ischemic heart disease. Due to blocks in the vessels supplying blood to the heart, while doing heavy work, the heart is not able to pump the extra blood required, hence the pressure like pain.

The pain may radiate to arm, jaw and even upper back on left side. It lasts for few minutes and subsides spontaneously as the person abandons the heavy object being lifted and rests for a moment. Advancing age, obesity, lack of exercise, smoking, alcohol, stress, hypertension and diabetes, are some of the risk factors which make one vulnerable to ischemic heart disease.

Along with pain, there may be sweating, palpitations, nausea, dizziness any one or more of these symptoms. This can be diagnosed easily by tests like electrocardiogram, cardiac echo and response to anti angina drugs.

A young adult may get muscular pain while lifting a heavy object. Sometimes if the weight is very heavy it can cause a tear of muscle fibers causing severe, excruciating pain. Any previous fracture of rib or chest injury can be aggravated by lifting heavy weight causing much pain. One may have pain in the upper part of breast bone which is painful on touching.

This occurs due to anxiety. Anxiety/stress can also cause muscular pains which may be severe depending on the underlying cause for stress and mental make up of a person. Any muscle rupture or pull can be detected by scans like C.T. and MRI. Treatment rests in giving rest to the part by splinting it and pain killer drugs.

One may have a burning type of chest pain due to dyspepsia or ulcers which may be coincidental with lifting heavy objects.

It is a good idea to avoid muscle building exercises in the gym. These kind of exercises tend to cause muscle contraction and stimulate release of adrenalin in the body which in turn can raise the blood pressure and precipitate angina and even heart attack.

As such, lifting very heavy objects puts a strain on the back as well and can cause chronic backache and shoulder pain. In a young person, it can cause early spondylosis, i.e. stiffening of back. If lifting a weight is necessary, if possible the weight can be divided (as with a heavy suit case). It is also important to hold the heavy object with both hands in front to minimize straining the back.

Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital