<s>[INST] I have had a hoarse voice for 3 months and a pain in my mid to upper back (feels like my lung) for almost the same length of time. The pain is now unbearable in my back and the last few days have experienced pains running down the tops of my arms. I am also starting to get the same lung pain on the left. [/INST] Thanks for your question on Chat Doctor. Hoarseness of voice with chest pain can be seen in many conditions, but the common causes are1. Lung malignancy2. Endobronchial tuberculosis3. Lung abscess4. Phoenix nerve palsy with recurrent laryngeal nerve palsy (vocal cord paralysis)So better to consult pulmonologist and get done1. Chest x ray2. CT thorax3. Bronchoscopic evaluation of vocal cords and trachea to rule out above-mentioned causes. Examination of vocal cords is very important in hoarseness of voice. Its movement, nodules on surface, ulcers etc. can be very informative to reach the diagnosis. So consult pulmonologist and discuss all these. </s>