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.

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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.