<s>[INST] I have had a cough for a number of years, but it has changed so that I now have new symptoms with less coughing, but chest pain (which sometimes extends to my back) when I do cough, sneeze hick up and general chest discomfort; however the cough dose most times does not clear anything. I am a woman just under 75 & have RA, a right shoulder replacement (which is somewhat restricting but I am used to it). [/INST] Thanks for your question on Chat Doctor. In my opinion you should consult pulmonologist and get done following tests.1. Chest x-ray.2. PUT (Pulmonary Function Test).3. Since you are having long-standing RA, RA associated pulmonary complications like pulmonary fibrosis, bronchitis, bronchiectasis etc. needs to be rule out first. So consult pulmonologist and discuss all these. ECG is needed to rule out cardiac cause for chest pain. </s>