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

### input:
Hi I am a female midwifery student 20 years old. Over the last week I have had a really bad pain on my back. The pain originates on my left hand side between my shoulder blade and spine and spreads round my ribs leaving me feeling breathless. The only way I can describe it is like I have been winded - it feels like i have been kicked by a horse. I haven t done anything that may have caused it (that I am aware of). It was a gradual onset and does not appear to be getting better. I have taken paracetamol and Ibuprofen for it and have rubbed some muscular anti inflammatory cream into it but doesn t seem to work. I cannot get into a comfy position whilst sitting or standing and the best position i can be in is lying on my right hand side. Any suggestions as to what it is or what i can do or take to numb the pain would be great.

### output:

Hello Thanks for writing to us, I have studied your case with diligence. As per your history of trauma there is possibility of rib contusion. Rib contusion is not always visible on X-ray. You may need to do MRI or HRCT. I will advise consulting to orthopedic surgeon. Medication like muscle relaxant and analgesic will reduce pain along with it use rib support belt. You may consult physiotherapist for pain management. He may start TENS, or ultrasound which is helpful in your case. You may need to take rest for early healing. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not forget to give rating at end of discussion. Wishing you good health. Take disregards Chat Doctor. 