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Chest and sternum pain: Sternal pain – different causes

Chest or Back Pain – Digestive Disorders


Jonathan Gotfried

, MD, Lewis Katz School of Medicine at Temple University

Reviewed/Revised Jan 2022 | Modified Sep 2022


Pain in the middle of the chest or upper back can result from disorders of the esophagus Overview of the Esophagus The esophagus is the hollow tube that leads from the throat (pharynx) to the stomach. Food does not just fall through the esophagus into the stomach. The walls of the esophagus propel food to… read more or from disorders of the heart or aorta ( see Chest Pain Chest Pain Chest pain is a very common complaint. Pain may be sharp or dull, although some people with a chest disorder describe their sensation as discomfort, tightness, pressure, gas, burning, or aching… read more ). Symptoms may be similar. Gastroesophageal reflux disease Gastroesophageal Reflux Disease (GERD) In gastroesophageal reflux disease, stomach contents, including acid and bile, flow backward from the stomach into the esophagus, causing inflammation in the esophagus and pain in the bottom… read more (GERD), caused by stomach acid splashing up into the esophagus, can cause a burning sensation or a tightness under the breastbone (sternum), which may resemble the pain of heart disease. Spasms of the esophagus Esophageal Spasm Esophageal spasm is a disorder of the rhythmic waves of muscular contractions (peristalsis) of the esophagus. The cause of this disorder is not known. Symptoms include chest pain and difficulty… read more and other esophageal muscle disorders can cause a severe squeezing sensation also resembling the pain of heart disease.

Some symptoms are more suggestive of esophageal disorders. Severe pain that occurs suddenly after vomiting or after a procedure involving the esophagus suggests a rupture of the esophagus, although this is rare. Heartburn is a burning pain caused by GERD that rises into the chest and sometimes the neck and throat, usually after meals or when lying down. Heartburn is among the most common digestive symptoms in the United States. Difficulty swallowing Difficulty Swallowing Some people have difficulty swallowing (dysphagia). In dysphagia, foods and/or liquids do not move normally from the throat (pharynx) to the stomach. People feel as though food or liquids become… read more and discomfort that occurs only with swallowing also suggest an esophageal disorder. Chest discomfort that occurs routinely with exertion and goes away after a brief rest suggests a heart problem. However, because symptoms frequently overlap, and because heart disease is particularly dangerous, doctors often do a chest x-ray X-Rays of the Chest Anyone thought to have a heart disorder has chest x-rays taken from the front and the side. Typically, the person is standing upright, but chest x-rays can be done with people lying in bed if. .. read more , an electrocardiogram Electrocardiography Electrocardiography (ECG) is a quick, simple, painless procedure in which the heart’s electrical impulses are amplified and recorded. This record, the electrocardiogram (also known as an ECG)… read more (ECG), and sometimes a cardiac stress test Stress Testing Stressing the heart (by exercise or by use of stimulant drugs to make the heart beat faster and more forcibly) can help identify coronary artery disease. In coronary artery disease, blood flow… read more before doing tests to look for esophageal disease.

  • Depends on cause

Treatment of chest or back pain is usually given only when the cause is known, but people with very typical symptoms of GERD may be given a trial of acid-blocking drugs.


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Top 5 Exercises for Costochondritis

Costochondritis is a condition that affects the chest wall and is pathologically not-serious, despite being reasonably common. It results from inflammation of the cartilage connecting the ribs to the breastbone (sternum). Typically, it causes a sharp, localised chest pain, typically at the costosternal joint (where the ribs attach to the breastbone).

The condition is frequently misdiagnosed as a heart attack or heart problem, because the pain can be intense and spread to the neck and shoulder. However, it is not life-threatening, and the pain subsides in a few days or weeks on average. However, caution should always be first, and if you get pain that you think may be costochondritis, you must go to see your GP to rule out any heart-related issue.

Costochondritis is commonly caused by repetitive activities such as heavy lifting, sports participation, and overstretching. There are a lot of people who also believe that stress is a key factor.

The most common symptom of costochondritis is sharp, localised chest pain. It is sometimes worsened by deep breathing or coughing, and is sometimes felt in the back or abdomen. Other possible symptoms include chest tenderness, difficulty breathing, and fatigue.

Costochondritis is typically diagnosed through a physical examination, without the need for additional testing. However, if the chest pain is severe or persistent, the doctor may order an X-ray to rule out other potential causes.

Typically, costochondritis is treated with rest, anti-inflammatory drugs, and heat or cold therapy. It is essential to avoid painful activities and avoid lifting heavy objects. In some cases, physiotherapy may also be beneficial to reduce pain, stretch the chest, and mobilise the ribs. At Surrey Physio, we perform manual therapy and electrotherapy to help reduce the pain, and it does seem to work well.

If the pain persists or is severe, the doctor may prescribe stronger painkillers, but again it must be mentioned that if symptoms become more severe with symptoms of strong chest pains, palpitations, sweating or fever, or severe shortness of breath, you should go to A&E and seek investigation.

In the majority of cases, costochondritis is a temporary condition, and the pain subsides within a few days or weeks. However, if the pain is severe or persists, it is crucial to see a doctor immediately.

Let’s look at our top five exercises for costochondritis:

1. Pec Stretch: Place your arms at 90 degrees, with your palms flat on the wall, and face towards a corner. Push your body into the corner keeping your hands in the same position. You will feel a stretch across your upper arms, front shoulders and chest.

2. Straight Arm Pec Stretch: Hook your fingers around a door frame or corner of a wall, and lean forwards creating a stretch across your upper arm, front shoulder and slightly into your chest. This exercise stretches the pectoral muscle.

3. Ice the Chest: Place an ice pack or frozen peas over your chest. Wrap it in a thin towel so its not too cold. Hold it here for the required time as recommended by your therapist.

4. Diaphragmatic Deep Breathing: Place one hand on your stomach, and the other on your chest. Take a deep breath in, and push your belly (and your hand) outwards. Try and keep the movement of your chest to a minimum, so you concentrate on the deep breathing. Relax your neck and shoulders as you breathe. This will help you to use your diaphragm, the main inspiratory muscle.

5. Mid-Scalene Sternocleidomastoid Stretch: Hook your fingers above your collar bone, and gently side-bend your neck to the opposite side. Hold the stretch. You should feel the stretch at the front/side of your neck. This exercise will help improve mobility to your neck.

If you are a therapist and like the exercises and information in this document, please go to www.rehabmypatient.com and sign up to this amazing exercise prescription software. If you are a patient and need some advice, treatment or a consultation, please go to www. surreyphysio.co.uk/bookonline. We provide virtual and face-to-face appointments with our expert team.

If you want to buy any equipment seen on these articles, please go to www.rehabme.com/shop.

For more advice on carpal tunnel syndrome, check out this page: https://www.rehabmypatient.com/thoracic-spine/costochondritis

Chronic chest pain

Chronic chest pain | Center Dikul

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Chronic chest pain

Chronic chest pain develops gradually after one or more acute periods. The disease is often associated with incorrect posture (stooped back and head tilted forward) and manifests itself in the form of pain between the shoulder blades, sometimes along with pain in the back of the head and shoulder girdle. Pain is aggravated by deep breathing and bending forward and to the side. In persons suffering from asthma or other lung diseases, the very shape of the chest predisposes to chronic chest pain.


In stooped thoracic vertebrae, ribs, ligaments, muscles and nerve fibers for a long time are subjected to additional stress, and it is the cause of the disease. Professional drivers and office workers are more likely than others to experience chronic chest pain. The disease is characterized by a long development with asymptomatic periods and increasing stoop.