What are the common symptoms of chest wall pain. How is chest wall pain diagnosed. What are the most effective treatments for chest wall pain. When should you seek medical attention for chest wall pain. How can you differentiate between chest wall pain and a heart attack.

Understanding Chest Wall Pain: Symptoms and Characteristics

Chest wall pain is a discomfort that appears to originate from the breast, rib cage, or chest muscles. The chest wall encompasses the structures surrounding and protecting the lungs, including the ribs and sternum. This type of pain can manifest in various ways and may be triggered by specific movements or pressure on the affected area.

Common descriptors of chest wall pain include:

• Aching
• Stabbing
• Sharp
• Burning
• Tearing

The pain may worsen with certain activities, such as:

• Moving the chest
• Twisting the torso
• Raising the arms
• Deep breathing
• Sneezing
• Coughing

Additional symptoms that may accompany chest wall pain include numbness, tingling, and shooting pain that extends to the back or neck.

Identifying the Underlying Causes of Chest Wall Pain

While musculoskeletal conditions are the most frequent culprits behind chest wall pain, numerous other factors can contribute to this discomfort. The complexity of the chest’s anatomy, comprising various muscles, bones, and organs, can make pinpointing the exact cause challenging.

Musculoskeletal Causes

Musculoskeletal issues are often at the root of chest wall pain. These may include:

• Injury or trauma from accidents
• Costochondritis
• Tietze’s syndrome
• Slipping rib syndrome
• Intercostal muscle strain
• Rib stress fractures
• Nerve entrapment
• Fibromyalgia
• Rheumatic diseases (e.g., rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis)

Pulmonary Conditions

Lung-related problems can also manifest as chest wall pain, including:

• Pneumonia
• Pulmonary embolism

Cardiovascular Issues

Although less common, cardiovascular problems can cause chest wall pain:

• Heart attack
• Angina
• Pericarditis
• Myocarditis

Gastrointestinal Conditions

Sometimes, digestive issues can present as chest wall pain:

• Peptic ulcers
• Gastroesophageal reflux disease (GERD)
• Gallstones

Diagnostic Approaches for Chest Wall Pain

When evaluating chest wall pain, healthcare professionals employ a variety of diagnostic techniques to determine the underlying cause. The process typically begins with a thorough medical history and physical examination.

Medical History and Physical Examination

During the initial assessment, your doctor will inquire about your symptoms, family and personal medical history, any recent injuries, and current medications. It’s crucial to provide comprehensive information to aid in accurate diagnosis.

For suspected musculoskeletal issues, the physical examination may include:

• Checking for swelling along the ribs, chest, and sternum
• Attempting to reproduce or trigger the pain to locate its origin

Diagnostic Tests for Musculoskeletal Causes

To evaluate potential musculoskeletal sources of chest wall pain, your doctor may recommend:

• Chest X-ray
• Nerve conduction velocity tests
• Electromyography
• Musculoskeletal ultrasound
• Sympathetic skin response test

Cardiac Evaluation

If you have risk factors for heart disease, such as diabetes, obesity, hypertension, or a history of smoking, your doctor may want to assess your heart function. Tests may include:

• Exercise stress tests
• Electrocardiogram (ECG)
• Echocardiogram
• Blood tests

Pulmonary Assessment

When lung problems are suspected, diagnostic procedures may involve:

• CT scan for detailed lung imaging
• Thoracentesis
• Bronchoscopy

Effective Treatment Strategies for Chest Wall Pain

The treatment approach for chest wall pain varies depending on the underlying cause. Here are some common strategies employed for different conditions:

Managing Musculoskeletal Pain

For musculoskeletal issues, which are the most frequent cause of chest wall pain, treatment typically includes:

• Application of heat or ice
• Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen
• Muscle relaxants
• Stretching exercises
• Physical therapy
• Activity modification to avoid pain triggers

In more severe or persistent cases, corticosteroid injections may be recommended to reduce inflammation.

Addressing Rheumatic Conditions

For chest wall pain associated with rheumatic diseases, treatment is typically part of the overall management plan for the specific condition. Your doctor will help determine the most appropriate medication regimen, which may include disease-modifying antirheumatic drugs (DMARDs) or biologic agents.

Treating Lung Infections

Lung conditions such as pneumonia that cause chest wall pain are usually treated with antibiotics. The specific antibiotic and duration of treatment will depend on the type and severity of the infection.

Managing Cardiovascular Causes

If chest wall pain is caused by a heart attack or other serious cardiac condition, treatment may involve:

• Blood thinners
• Medications to open arteries
• Cardiac catheterization
• Coronary artery bypass grafting (CABG) or bypass surgery

Prognosis and Recovery from Chest Wall Pain

The outlook for chest wall pain is generally favorable, particularly when musculoskeletal conditions are the root cause. Most individuals can achieve a full recovery with appropriate rest and physical therapy over a few weeks.

For other causes of chest wall pain, the prognosis depends on the specific condition and its severity. For example:

• Rheumatoid arthritis: Treatments can help manage pain, control inflammation, and potentially lead to remission.
• Heart attacks and pulmonary embolisms: These conditions can be life-threatening if left untreated, emphasizing the importance of prompt medical attention.

When to Seek Medical Attention for Chest Wall Pain

While many cases of chest wall pain are not life-threatening, it’s crucial to recognize when medical attention is necessary. Seek immediate medical care if you experience:

• Sudden, severe chest pain
• Chest pain accompanied by shortness of breath, sweating, or nausea
• Pain that radiates to your jaw, left arm, or back
• Chest pain associated with a rapid or irregular heartbeat

These symptoms could indicate a more serious condition, such as a heart attack, and require prompt evaluation.

Differentiating Chest Wall Pain from Cardiac Issues

Distinguishing between chest wall pain and cardiac-related pain can be challenging, but there are some key differences to consider:

Characteristics of Chest Wall Pain

• Often localized and may worsen with movement or pressure
• May be sharp or stabbing in nature
• Can be reproduced by touching or pressing on the affected area
• Often changes with body position or breathing

Characteristics of Cardiac Pain

• Usually more diffuse and not localized to a specific point
• Often described as a pressure, squeezing, or heaviness
• May be accompanied by shortness of breath, nausea, or sweating
• Typically doesn’t change with body position or local pressure

Is chest pain always a sign of a heart attack? While chest pain is a common symptom of heart attacks, not all chest pain indicates a cardiac event. Many cases of chest pain, particularly those related to the chest wall, are caused by musculoskeletal issues or other non-cardiac conditions. However, it’s always better to err on the side of caution and seek medical evaluation if you’re unsure about the cause of your chest pain.

Preventing and Managing Chronic Chest Wall Pain

For individuals prone to recurrent chest wall pain, especially due to musculoskeletal issues, several strategies can help prevent and manage symptoms:

Lifestyle Modifications

• Maintain good posture to reduce strain on chest muscles and joints
• Practice proper lifting techniques to avoid chest wall injuries
• Engage in regular, low-impact exercises to strengthen chest and core muscles
• Manage stress through relaxation techniques, as stress can exacerbate muscle tension

Ergonomic Considerations

Adjusting your work and home environment can help prevent chest wall pain:

• Use ergonomic chairs and desks to maintain proper posture
• Take frequent breaks to stretch and move if you have a sedentary job
• Adjust your sleeping position and use supportive pillows to reduce nighttime discomfort

Regular Check-ups and Monitoring

For those with underlying conditions that contribute to chest wall pain, such as rheumatic diseases or cardiovascular issues, regular medical check-ups are crucial. These appointments allow for:

• Monitoring of disease progression
• Adjustment of treatment plans as needed
• Early detection of any new or worsening symptoms

How often should you have check-ups for chronic chest wall pain? The frequency of check-ups depends on the underlying cause and severity of your condition. Your healthcare provider can recommend an appropriate schedule based on your individual needs.

Alternative and Complementary Approaches to Chest Wall Pain Management

In addition to conventional medical treatments, some individuals find relief from chest wall pain through alternative and complementary therapies. While the effectiveness of these approaches may vary, they can be considered as part of a comprehensive pain management strategy:

Acupuncture

This traditional Chinese medicine technique involves inserting thin needles into specific points on the body. Some studies suggest that acupuncture may help alleviate certain types of chest wall pain, particularly those related to musculoskeletal issues.

Massage Therapy

Gentle massage of the chest, shoulders, and back can help relax tense muscles and reduce pain. It’s important to work with a qualified massage therapist who is experienced in treating chest wall pain.

Herbal Remedies

Certain herbs with anti-inflammatory properties, such as turmeric or ginger, may help reduce pain and inflammation. However, it’s crucial to consult with a healthcare provider before using any herbal supplements, as they can interact with medications or have side effects.

Mind-Body Techniques

Practices such as meditation, deep breathing exercises, and progressive muscle relaxation can help manage stress and tension, potentially reducing chest wall pain.

Can alternative therapies replace conventional medical treatment for chest wall pain? While alternative therapies can be beneficial as complementary approaches, they should not replace conventional medical treatment, especially for serious underlying conditions. Always consult with your healthcare provider before starting any new treatment regimen.

Understanding chest wall pain, its causes, and treatment options is crucial for effective management and improved quality of life. While many cases are benign and resolve with conservative treatment, it’s important to seek medical attention when symptoms are severe or persistent. By working closely with healthcare providers and adopting appropriate lifestyle modifications, individuals can effectively manage chest wall pain and minimize its impact on daily activities.

Symptoms, Treatment, and Possible Causes

Overview

Chest wall pain is the type that feels like it’s coming from your breast, rib cage, or a muscle in your chest. The chest wall usually refers to the structures surrounding and protecting your lungs, including your ribs and sternum.

You may feel pain only when you do certain movements or only if pressure is applied to your chest wall. You can feel it on one side of your chest or spread across a wide area.

If you go to the emergency room for chest wall pain, most doctors will want to make sure your pain isn’t being caused by a heart attack or another serious problem. While a heart attack can cause chest wall pain, more commonly, chest wall pain is caused by other conditions, including muscle, lung, or digestive issues. How long your chest wall pain lasts and what treatment you receive depends on what’s causing it.

Chest wall pain may be described as:

• aching
• stabbing
• sharp
• burning
• tearing
• pain that worsens when you move your chest, twist your torso, or raise your arms
• pain that increases when you breathe deeply, sneeze, or cough

Other symptoms include:

• numbness
• tingling
• shooting pain that extends to your back or neck

Musculoskeletal conditions are the most common causes of chest wall pain, but there are many other conditions that can lead to pain in the chest wall. Your chest is made up of many muscles, bones, and organs. For this reason, the exact cause of chest wall pain can sometimes be difficult to diagnose.

Some common causes of chest wall pain include:

Musculoskeletal problems

• injury or trauma to your chest, such as from a car accident
• costochondritis
• Tietze’s syndrome, which is similar to costochondritis
• slipping rib syndrome, or lower rib pain syndrome
• intercostal muscle strain or pulled chest muscle
• stress fracture in your ribs
• nerve entrapment
• fibromyalgia
• rheumatic diseases, such as rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis

Lung problems

• pneumonia
• pulmonary embolism

Cardiovascular problems

• heart attack
• angina
• pericarditis
• myocarditis

Gastrointestinal conditions

• peptic ulcer
• gastroesophageal reflux disease
• gall stones

Your doctor will ask about your symptoms and family and personal medical history. Be sure to tell your doctor about any underlying conditions you have, medications you are taking, and if you have recently suffered any injuries.

If your doctor suspects you have a musculoskeletal problem like a rib fracture or costochondritis, they may check along your ribs, chest, and sternum for areas of swelling. They may try to reproduce or trigger your pain to help them learn more about where your pain is coming from.

Other tests to help your doctor evaluate musculoskeletal sources of chest wall pain include:

• chest X-ray
• nerve conduction velocity tests
• electromyography
• musculoskeletal ultrasound
• sympathetic skin response, which is a test of your nerve’s reaction when triggered with stimuli

If you have any risk factors for heart disease, such as diabetes, obesity, high blood pressure, or a history of smoking, your doctor may want to test your heart function. Some of these tests include:

• exercise stress tests
• electrocardiogram
• echocardiogram
• blood tests

If your doctor suspects a problem with your lungs, diagnostic tests may include:

• CT scan to produce a more detailed picture of your lungs
• thoracentesis
• bronchoscopy

Treatment for chest wall pain will vary depending on the cause.

• Musculoskeletal problems. These conditions are managed with heat or ice, anti-inflammatory drugs such as ibuprofen (Advil) or naproxen (Aleve), muscle relaxers, stretching, and physical therapy. You should also try to avoid activities that aggravate your pain. For more severe or persistent cases, your doctor may suggest corticosteroid injections to help reduce inflammation.
• Rheumatic conditions. Treatment of chest wall pain is part of the overall management of each of these conditions. Your doctor will help you decide which is medication is best for you.
• Lung infections. Like other infections, lung conditions such as pneumonia are typically treated with antibiotics.

If your chest wall pain is caused by a heart attack or other serious heart condition, you may receive blood thinners or medications that open arteries. Other treatments include:

• cardiac catheterization
• coronary artery bypass grafting or bypass surgery

Since most cases of chest wall pain are caused by musculoskeletal conditions, the outlook is typically very good. Most people can make a full recovery with rest and physical therapy over the course of a few weeks.

Other causes of chest wall pain can be managed with medications and other treatments, but this depends on the severity of the condition. Treatments for rheumatoid arthritis, for example, can help to manage your pain, control the inflammatory response, and eventually lead to remission.

Heart attacks and pulmonary embolisms can be life-threatening if left untreated. You should seek emergency medical care right away if you have any of the following symptoms along with chest wall pain:

• shortness of breath
• sudden and severe pain in your lungs
• lightheadedness, weakness, dizziness, or fainting
• cough with dark-colored sputum or blood
• dark red or black stools
• nausea
• high fever

Symptoms, Treatment, and Possible Causes

Overview

Chest wall pain is the type that feels like it’s coming from your breast, rib cage, or a muscle in your chest. The chest wall usually refers to the structures surrounding and protecting your lungs, including your ribs and sternum.

You may feel pain only when you do certain movements or only if pressure is applied to your chest wall. You can feel it on one side of your chest or spread across a wide area.

If you go to the emergency room for chest wall pain, most doctors will want to make sure your pain isn’t being caused by a heart attack or another serious problem. While a heart attack can cause chest wall pain, more commonly, chest wall pain is caused by other conditions, including muscle, lung, or digestive issues. How long your chest wall pain lasts and what treatment you receive depends on what’s causing it.

Chest wall pain may be described as:

• aching
• stabbing
• sharp
• burning
• tearing
• pain that worsens when you move your chest, twist your torso, or raise your arms
• pain that increases when you breathe deeply, sneeze, or cough

Other symptoms include:

• numbness
• tingling
• shooting pain that extends to your back or neck

Musculoskeletal conditions are the most common causes of chest wall pain, but there are many other conditions that can lead to pain in the chest wall. Your chest is made up of many muscles, bones, and organs. For this reason, the exact cause of chest wall pain can sometimes be difficult to diagnose.

Some common causes of chest wall pain include:

Musculoskeletal problems

• injury or trauma to your chest, such as from a car accident
• costochondritis
• Tietze’s syndrome, which is similar to costochondritis
• slipping rib syndrome, or lower rib pain syndrome
• intercostal muscle strain or pulled chest muscle
• stress fracture in your ribs
• nerve entrapment
• fibromyalgia
• rheumatic diseases, such as rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis

Lung problems

• pneumonia
• pulmonary embolism

Cardiovascular problems

• heart attack
• angina
• pericarditis
• myocarditis

Gastrointestinal conditions

• peptic ulcer
• gastroesophageal reflux disease
• gall stones

Your doctor will ask about your symptoms and family and personal medical history. Be sure to tell your doctor about any underlying conditions you have, medications you are taking, and if you have recently suffered any injuries.

If your doctor suspects you have a musculoskeletal problem like a rib fracture or costochondritis, they may check along your ribs, chest, and sternum for areas of swelling. They may try to reproduce or trigger your pain to help them learn more about where your pain is coming from.

Other tests to help your doctor evaluate musculoskeletal sources of chest wall pain include:

• chest X-ray
• nerve conduction velocity tests
• electromyography
• musculoskeletal ultrasound
• sympathetic skin response, which is a test of your nerve’s reaction when triggered with stimuli

If you have any risk factors for heart disease, such as diabetes, obesity, high blood pressure, or a history of smoking, your doctor may want to test your heart function. Some of these tests include:

• exercise stress tests
• electrocardiogram
• echocardiogram
• blood tests

If your doctor suspects a problem with your lungs, diagnostic tests may include:

• CT scan to produce a more detailed picture of your lungs
• thoracentesis
• bronchoscopy

Treatment for chest wall pain will vary depending on the cause.

• Musculoskeletal problems. These conditions are managed with heat or ice, anti-inflammatory drugs such as ibuprofen (Advil) or naproxen (Aleve), muscle relaxers, stretching, and physical therapy. You should also try to avoid activities that aggravate your pain. For more severe or persistent cases, your doctor may suggest corticosteroid injections to help reduce inflammation.
• Rheumatic conditions. Treatment of chest wall pain is part of the overall management of each of these conditions. Your doctor will help you decide which is medication is best for you.
• Lung infections. Like other infections, lung conditions such as pneumonia are typically treated with antibiotics.

If your chest wall pain is caused by a heart attack or other serious heart condition, you may receive blood thinners or medications that open arteries. Other treatments include:

• cardiac catheterization
• coronary artery bypass grafting or bypass surgery

Since most cases of chest wall pain are caused by musculoskeletal conditions, the outlook is typically very good. Most people can make a full recovery with rest and physical therapy over the course of a few weeks.

Other causes of chest wall pain can be managed with medications and other treatments, but this depends on the severity of the condition. Treatments for rheumatoid arthritis, for example, can help to manage your pain, control the inflammatory response, and eventually lead to remission.

Heart attacks and pulmonary embolisms can be life-threatening if left untreated. You should seek emergency medical care right away if you have any of the following symptoms along with chest wall pain:

• shortness of breath
• sudden and severe pain in your lungs
• lightheadedness, weakness, dizziness, or fainting
• cough with dark-colored sputum or blood
• dark red or black stools
• nausea
• high fever

Chest pain when moving: causes, what to do, treatment

The modern way of life is high speeds, a lot of things to do, events and constant movement. During the day, a person can walk up to 15 kilometers without even noticing it, but not if he has pain in the chest in the middle when moving. In such a situation, each step will bring discomfort, and there can be no talk of comfortable well-being. If you have such a symptom, it is best to understand the causes and understand what to do to improve your condition.

Chest pain when moving: causes

The causes of pain and discomfort in the chest may be problems with the musculoskeletal system, diseases of the digestive system, heart and lung pathologies. In each case, the pain will have a different character and different accompanying symptoms.

Cardiovascular diseases

If during movement there is pain in the chest in the middle, first of all, the doctor will suspect you have a heart pathology. While walking with pathologies of the heart, the muscle may not have enough nutrition, as a result of which pain occurs. The cause may be atherosclerosis of the coronary arteries and even myocardial infarction. In this case, it starts to hurt from the back wall of the sternum, gradually the pain passes into the arm and neck, it starts to hurt in front of the chest. This creates a sensation of burning and pressure.

Diseases of the spine

Chest pain during movement is often accompanied by diseases of the spinal column. The problem may be the presence of an intervertebral hernia, calcification of the ligaments, osteochondrosis and other pathologies. Depending on the cause, a person may have difficulty raising their arms, tingling of the skin or numbness of its areas will be felt. With scoliosis, the picture is complemented by a significant or slight curvature of the spinal column.

Lung diseases

If you have chest pain when moving, you can suspect a pathological process in the lungs – pneumopleurisy, pneumothorax, or a neoplasm. Pain in the sternum can be accompanied by cough, shortness of breath, shortness of breath even at rest. Each condition does not tolerate delay, so you need to see a doctor as soon as possible.

Diseases of the gastrointestinal tract

If a person has a chest pain when moving, such pain may be a reflection of the pathological processes of the digestive system. There can be a lot of reasons, including peptic ulcer, the onset of gastritis or its exacerbation (in a chronic course), intestinal obstruction and other diseases. First, the pain occurs in the abdomen, then it goes to the chest, and in the process of movement it intensifies even more.

Chest injuries

Often, when moving, there is pain in the chest when a person is injured. You need to be concerned about your condition if you have recently:

The reason can be both that you unsuccessfully turned or lifted something heavy, while damaging a muscle or ligament, which causes pain behind the sternum when walking and even inhaling, or in a newly appeared crack or fracture. How much it hurts on the right side of the chest when moving will depend on how severe the injury is. The condition is especially dangerous if not only the structures of the musculoskeletal system were damaged, but also internal organs, which is fraught with very serious consequences. In such a situation, you should immediately visit neurologist who will probably refer you to X-ray or MRI .

Neoplasms

“The right side of the chest hurts a lot when moving” – with such a complaint, patients come to the doctor who, after diagnosis, have a neoplasm in one or both lungs, in the stomach or other organs. The nature of the neoplasm can be different, and the cause of the pain syndrome is that the tumor, growing, strongly presses on nearby tissues. Because of this pressure, discomfort, pain, a feeling of heaviness appear. Depending on the location of the neoplasm, accompanying symptoms join – cough and shortness of breath, if the lungs become the place of formation, digestive problems, if the stomach, etc.

How to relieve pain. First Aid

If during movement there is pain in the chest on the right, you need to understand how to alleviate the condition. First of all, make sure you have peace and rest. A warm bath and a light massage on the area where the pain has arisen can also be helpful. Such methods are optimal if the pathology of the spine turned out to be the cause of the pain syndrome on the left side. Medical assistance may consist of taking non-steroidal anti-inflammatory and analgesic drugs. The most important thing is to use methods of getting rid of pain only to relieve the condition before visiting the doctor, but in no case do not use them constantly, ignoring the need to visit a doctor.

Diagnostics

When a patient goes to the doctor with a complaint that there is pain in the middle of the chest during movement, the first thing to do is a questioning and examination. To confirm or refute the diagnosis, you will need to undergo a series of studies – from those whose task is to visualize the organs and structures of the chest (CT, MRI, X-ray, gastroscopy, etc. ), to those that will help determine the state of health by the composition of blood, urine or feces.

Treatment

If there is pain in the chest when moving the hands, the doctor will prescribe you a treatment depending on the pathologies that caused the pain. For problems with diseases of the digestive tract, to alleviate the condition, you need to cure an ulcer or gastritis before the pain subsides. In the case of lung pathologies, antibiotics or even surgery will be required. Treatment of the spine in a condition where movement causes pain in the chest on the left side may include taking anti-inflammatory drugs, applying ointments, massage and exercise, which prescribes neurologist for each case individually.

You can make an appointment with specialists online , as well as by phone 8 (812) 901-03-03.

Chest pain

Chest pain can be caused by a number of reasons. To begin with, it should be noted that we will analyze only the pain that is not related to the pathology of internal organs, primarily the heart (angina pectoris, heart attack) or acute diseases of the pleura and lungs (pleurisy, pneumonia), as well as large vessels (aortic aneurysm, thromboembolism pulmonary artery). These diseases are acute life-threatening conditions and they are dealt with by specialists of the appropriate profile. We are approached by patients with chest pain of a long-term chronic nature, and they have already been examined by most specialists (cardiologists, internists, neurologists, vascular surgeons), but no pathology has been identified.

Divide chest pain into:

1. Pain along the anterior surface of the chest wall

2. Lateral pain

3. Pain on the posterior surface, usually between the shoulder blades

4. Girdle pain

5. Cancer pain (lung cancer, rib metastases)

I. Pain along the anterior surface of the chest along the sternum, especially on the left side, can mimic acute cardiac pathology or dissecting aortic aneurysm, while there are no changes on the ECG and analyzes also do not show acute coronary circulation disorder. If the patient has had previous heart surgery, then as a rule, pain in the sternum is due to damage to the costosternal joints or the sternum itself after sternotomy.

In addition, pain in the costosternal joints can be caused by arthrosis, intercostal neuralgia with irradiation of pain in the sternum also causes similar pain.

Costochondritis is a condition defined as a painful chronic inflammation of the costochondral junctions of the ribs or chondrogrenal joints of the anterior chest wall. This is a clinical diagnosis that does not require special diagnostic studies in the absence of concomitant cardiopulmonary symptoms or risk factors. Costochondritis is often confused with Tietze’s syndrome. The difference is that the affected joints show swelling, swelling under the breastbone, and/or redness of the skin over the painful area.

On palpation, pain is reproduced in the affected areas of the cartilage, which can spread into the chest wall.

Tietze’s syndrome is an inflammatory process that causes visible enlargement of the costochondral junction. This condition causes severe pain when coughing and breathing deeply. Tietze’s syndrome is not life-threatening or contagious, but it is persistent and painful. Costochondritis and Tietze’s syndrome are often mistaken for each other, but are two completely different conditions.

The chest wall consists of the sternum in front, the spine (12 thoracic vertebrae) behind, limited by 12 paired ribs and costal cartilages. The ribs are made up of bone and cartilage, with the cartilage serving as an elastic bridge between the bony part of the rib and the sternum. There are three types of ribs: The first seven pairs of ribs are called “true ribs” because they are directly attached to the sternum. The eight to tenth pair of ribs are called “false ribs” because they are not attached to the sternum, but are attached to each other. Finally, the eleventh and twelfth are called “floating ribs” because they are only attached to the back of the vertebrae. Each rib is attached to the back of the spine: rib 1 is attached to vertebrae 1, rib 2 is attached to vertebrae 2, and so on.

Anteriorly, the costal cartilage of the first rib is connected to the manubrium (handle of the sternum) by a rigid fusion of bone and cartilage. The next seven pairs of ribs articulate with the sternum through cartilage at the synovial joints. Ribs eight through ten are attached anteriorly to the cartilaginous portion of the rib below them. The bottom two ribs do not connect to any structure in front.

Ribs move with breathing or movement of the upper limbs. The intercostal nerves provide innervation to the chest wall.

In the clinic “ANESTA” blockades of the rib-sternal joints with the introduction of steroids are performed. With insufficient efficiency, ablation of the anterior branches of the intercostal nerves innervating this zone is performed.

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II. Pain on the side of the chest

The most common cause of pain on the lateral surface of the chest is intercostal neuralgia associated with nerve damage to the herpes virus (shingles). Such pain can also have a girdle character in the form of periodic lumbago along the intercostal nerves. At the same time, in the affected area and scars after a herpes infection, the patient feels a constant burning sensation and bursting pain.

Postherpetic neuralgia of the intercostal nerves is very difficult to treat, especially if the case is advanced and the patient applied 6 months after the illness. In such cases, the ANESTA clinic, in addition to systemic therapy, performs ablation of the intercostal nerves, in case of ineffectiveness, ablation of the dorsal (sensitive) ganglia of the spinal roots, which form the corresponding nerve.

III. Pain in the back of the chest

Pain on the back surface (interscapular region). The most likely cause of the pain is damage to the facet joints of the thoracic spine, costotransverse joints, or neuralgia of the dorsal nerve of the scapula.

Spondylarthrosis – arthrosis of the facet joints (popular name – osteochondrosis)

Spondylarthrosis refers to the wear of the vertebral or facet joints, the function of which is to stabilize the posterior column of the spine. In more than 90% of cases, facet arthrosis manifests itself secondarily and occurs as a result of degeneration and shrinkage of the intervertebral discs, which leads to a loss of the natural height of the disc. Thus, the facets are squeezed towards each other and gradually wear out. In about 10% of cases, facet arthrosis manifests itself primarily in adolescence (idiopathically) in the form of scoliosis or congenital lordosis of the sacral spine (hyperlordosis). Osteoarthritis of the facet joints can be accompanied by acute pain.

Regular physical therapy or injection of a steroid mixed with a local anesthetic into the joints often helps relieve pain symptoms. If these methods of treatment did not lead to an improvement in your health, the ANESTA clinic also applies denervation (thermal ablation) of these joints, i.e. the nerve endings that innervate the facet joints are eliminated, which can significantly reduce pain symptoms.

Pain along the edge of the scapula, interscapular region, radiating to the shoulder girdle may be associated with neuralgia of the dorsal nerve of the scapula.