I teach ESL in China, so I cannot easily get to a doctor. I have always been in good health, just turned 40, no problems in the past, no history of diseases in my family, and in good shape.

My hair was thinning so I started using minoxidil 5%. After four months I began to feel a slight tightness in my chest. I was aware that this could be a side effect from the minoxidil. But I was breathing fine and had no dizziness and had recently begun lifting weights.

But the pain started to grow and it started to move into my left shoulder and arm. I have a doctor friend here that I can talk to once in a while but he is often busy. He looked at an EKG from the hospital and it was fine. He thought I might have a rotator cuff tear and told me to take ibuprofen. I didn’t tell him about the minoxidil. From what I saw on the internet, I didn’t think I had a rotator cuff tear because it wasn’t that much pain. But I was worried that maybe the minoxidil was effecting me somehow, so I stopped using it.

I took Ibuprofen like he said but it didn’t seem to help, yet after much protection of my left side, it seemed to be qetting better, except when I lifted something.
So I thought I could use the minoxidil again and when I did, it seemed to re-awaken the pain. So I stopped it.

With careful rest and protection of my left shoulder/arm, the pain seemed to go away again. I thought surely it had nothing to do with minoxidil, so I started again, and it came back again!

So I quit minoxidil again. After about a month, the pain seemed to go away (but not completely. But after lifting heavy luggage it came back on again. Another doctor came passing through and suggested it could be acromioclavicular bursitis. But now here is the worst part…

I had to carry luggage up a flight of stairs, and the old pain came back again, and this time it came also to my right side a little, as if in the way that it all started months ago on the left side. And I do not know if this is connected, but I just started to feel some arthritis-like pain in my feet (very mild).

Do you have any ideas? When I say pain in all of this, I mean troubling pain, but not unbearable or debilitating pain. I can raise my arms fine and etc.

Dr. Joshua’s Answer:

It’s important to determine the source of the pain: is it heart, or muscle related? That makes all the difference. Anyone complaining of tightness in the chest should have their heart checked for coronary disease. Factors that would increase the possibility of a 40-year old male having coronary artery disease:
-positive family history (parents, siblings) for heart disease
-smoking
-obesity
-high blood pressure
-high blood lipids, especially LDL cholesterol

If you have none of these, it is unlikely although not impossible that you have coronary artery disease. However, if the pain is squeezing or tightness in nature, and radiates to the left arm, jaw, or neck/throat region, coronary artery disease is suspected and the heart should be examined. A single EKG does not rule out coronary artery disease. Further examinations are needed.

On the other hand, your description has several points that suggest we are dealing with a musculoskeletal pain and not coronary pain. It started to appear after you started lifting weights; resting your arm/shoulder area provides relief, etc…

I cannot make a diagnosis without interviewing you and physically examining you. You need to be properly examined by a physician, not just by a physician friend nor a chinese traditional physician. Try and schedule an appointment with a doctor if at all possible.

I doubt that minoxidil has anything to do with this, but I can’t say it’s impossible. Make sure you use it according to the instructions and not apply too much; side-effects are more likely if too much is used. However, if you feel that the pain is connected to minoxidil use - consider stopping minoxidil. Accept that thinning hair is a sign of mature masculinity, keep a short haircut, or shave your head - take it from me, the latter is not a bad option..

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