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

### input:
My partner has been suffering acute pain in the left side of the upper back near his shoulder blade and in his left side of chest for week and half, he is excusted all the time, no energy,  he has been to his doctor and has been diagnosied with shingles and has had a course of antibiotics and pain killers for a week, he has no rash and doesnt seem to be getting any better in fact he is getting worst.

### output:

Here the pain for left shoulder blade and under the chest can be related to 2 things first it can be due too heart problem, or it can be due to cervical spine problem check if patient have pain under the chest while walking upstairs or going up hill along with breathing difficulty then it might be related to heart, and you need to see cardiologist and should go ahead with electrocardiogram as well treadmill test if both this test comes normal then he can check weather he has pain radiating from check to hand along with numbness in hand in that case it can be related to lower cervical spine and I suggest visiting orthopedic and go ahead with x-ray or MRI of cervical spine. As per the report here orthopedic will suggest for conservative management with medication and physiotherapy or else surgical management for sever spinal or disc related problem. Suppose if there is no much issue then he can also check with physio after doing all testing. Here physio will guide him with few stretching and strengthening exercise to improve further. Along with this also take physiotherapy treatment to relax soft tissues and increase healing effect in soft tissue. You can also use hot pack frequently at home to have some more relaxing effect on your soft tissues this should be used mainly on painful area near to spine. Take care.