### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My son has had pains in his shoulders, chest and back (rib area) for the last year.  His Dr said it was probably growing pains.  They are very painful and getting worse as time goes on.  He describes them as sharp, bubble like pains like they are trying to burst out of him.  He has also gotten them on his hips.  He also gets a tingly pain in his left elbow.  The chest pains are just sharp with no bubble feeling to them.  Any ideas as to what this could possibly be?  More info on him, he is 11 yrs old, asthmatic (less than 2 inhalers per month), active, otherwise healthy.  His diet is mostly veggies, fruit, wild game (deer, turkey, etc) and very little sugars and milks...he gets his calcium and other nutrients from vegetables.  I am not looking for a diagnosis, just trying to make sure that it is just growing pains and not something more serious.Thank you for your advice!

### output:

Hi, Welcome to Chat Doctor, I have read your query and understand your concern. As you have mentioned you have pain in your shoulder to chest and back rib area which is growing but does not seem to be serious. Here, I would like to know that whether you have any history of diabetes or thyroid illnesses or any injury to that joint. There could be several causes of shoulder pain such as rotator cuff injury or tear or rotator cuff tendinitis (inflammation of its tendons). The initial treatments for all these are, 1. Avoid repetitive overhead activities 2. Do not carry any heavy object or bag on affected shoulder or arm.3. Apply ice packs for about 15 minutes twice or thrice daily. 4. If you have learned how to do shoulder exercises then continue with that its could be effective. 5. Apply diclofenac based topical ointment which is more effective than paracetamol based.(available over the counter)6. Can take oral painkillers if pain is very severe. 7. Take Re-nerve Plus, as it is just a multivitamin supplement which is good for nerves (more useful in diabetic patients). If still pain is persisting then proper examination of shoulder joint is required to find the exact cause and if needed X-ray and MRI should be done. You can consult nearby doctor or orthopedic who can write X-ray and MRI of the shoulder after taking complete history and thoroughly clinical examination. Thanks and 