<s>[INST] I m a 28 year old male. I am 5 8 and 260 pounds. I have sever anxiety and am on paradise time for that and it does help. As of late I have been having major upper back and neck pain accompanied with these odd episodes with my heart. I will be sitting and within a second my heart rate jumps from a resting 60 bpm to over 200. There is no pain anywhere it s just very uncomfortable and scary. The heart rate slow during if I lay on the floor and push in hard on my stomach. It usually take anywhere from 5 to 20 minutes for my heart to return to normal. Is this related to my back, my stomach, my esophagus or my heart? [/INST] HelloThis sudden increase in your heart rate is most probably the part of your anxiety. Its not related to your back or oesophagus.I think you should visit your doctor again.The back and neck pain would require a treament in the form of physiotherapy.You can take tablet combiflam when needed for pain. Do hot compresses for muscle relaxation. Can wear a cervical collar for neck pain.Thanks </s>