What are the common causes of intercostal muscle strain. How can you identify the symptoms of this condition. What are the most effective treatment options for managing intercostal muscle pain. How long does it typically take to recover from an intercostal strain.

Understanding Intercostal Muscle Strain: An Overview

Intercostal muscle strain is a common condition that affects the muscles between your ribs. These muscles, known as intercostal muscles, play a crucial role in stabilizing your upper body and facilitating breathing. There are three layers of intercostal muscles: external, internal, and innermost. When any of these layers are stretched, pulled, or partially torn, it results in an intercostal strain, causing pain and difficulty breathing.

Interestingly, intercostal muscle strains account for a significant portion of musculoskeletal chest pain, with studies suggesting that 21 to 49 percent of such cases are attributed to these muscles. This prevalence underscores the importance of understanding the condition and its management.

Common Causes and Risk Factors for Intercostal Muscle Strain

Intercostal muscle strains can occur due to various activities and circumstances. Some common causes include:

• Reaching overhead, such as when painting a ceiling
• Lifting while twisting
• Chopping wood
• Coughing or sneezing forcefully
• Participating in sports like rowing, golf, tennis, or baseball
• Falling or experiencing direct impact to the ribcage
• Being involved in a car accident or contact sports

These activities often involve sudden twisting motions or repetitive movements that can strain the intercostal muscles. Understanding these risk factors can help individuals take preventive measures to avoid injury.

Recognizing the Symptoms of Intercostal Muscle Strain

Identifying the symptoms of intercostal muscle strain is crucial for prompt diagnosis and treatment. The most common symptoms include:

1. Pain: This can be sharp and immediate or develop gradually over time. The pain typically worsens with twisting, stretching, deep breathing, coughing, or sneezing.
2. Tenderness: The affected area between the ribs becomes sore to the touch.
3. Difficulty breathing: Due to pain, individuals may resort to shallow breathing, leading to shortness of breath.
4. Swelling: Inflammation of the strained muscle can cause visible swelling between and around the affected ribs.
5. Muscle tightness: The injured muscles may feel tight during breathing, reaching, or twisting movements.

Are these symptoms unique to intercostal muscle strain? While these symptoms are characteristic of intercostal muscle strain, they can also mimic those of more serious conditions. Therefore, it’s essential to consult a healthcare professional for an accurate diagnosis.

Diagnosing Intercostal Muscle Strain: What to Expect

When you suspect an intercostal muscle strain, seeking medical attention is crucial. Your doctor will perform a thorough assessment to determine the extent of the injury and rule out other potential causes of your symptoms. The diagnostic process typically involves:

• A detailed medical history
• Physical examination
• Imaging tests (if necessary), such as X-rays or MRI scans

During the examination, your doctor may ask you to perform specific movements to assess pain levels and muscle function. They will also check for any signs of bruising or swelling in the affected area.

Effective Treatment Options for Intercostal Muscle Strain

Once diagnosed, there are several treatment options available to manage intercostal muscle strain and promote healing. These include:

1. Over-the-counter Pain Medications

Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) or naproxen (Aleve) can help reduce pain and inflammation. Acetaminophen (Tylenol) is another option for pain relief. It’s important to follow the recommended dosage and consult with your doctor, especially if you’re taking other medications.

2. Hot and Cold Therapy

Applying cold packs to the injured area for the first 48 hours can help reduce inflammation and pain. After this initial period, heat therapy can be beneficial in relaxing the muscles and promoting blood flow. Apply cold or heat for 20 minutes at a time, several times a day.

3. Epsom Salt Soaks

Warm baths with Epsom salts (magnesium sulfate) can provide relief and help relax the muscles. Add about 2 cups of Epsom salts to your bath and soak for at least 15 minutes.

4. Rest and Modified Activity

Allowing the injured muscles to rest is crucial for recovery. Avoid activities that exacerbate the pain, such as twisting or reaching movements. Gradually reintroduce activities as your symptoms improve.

5. Physical Therapy

A physical therapist can guide you through exercises to strengthen the intercostal muscles and improve flexibility. They may also use techniques like massage or ultrasound therapy to promote healing.

6. Breathing Exercises

Gentle breathing exercises can help maintain lung function and prevent complications like pneumonia. Your healthcare provider can recommend appropriate exercises based on your condition.

How long does recovery from intercostal muscle strain typically take? The recovery time can vary depending on the severity of the strain, but most cases improve within 3 to 8 weeks with proper treatment and rest.

Preventing Intercostal Muscle Strain: Tips and Strategies

While it’s not always possible to prevent intercostal muscle strain, there are several strategies you can employ to reduce your risk:

• Warm up properly before physical activities, especially those involving twisting motions
• Practice good posture and body mechanics when lifting or reaching
• Strengthen your core muscles through regular exercise
• Use proper technique when participating in sports or physical activities
• Take regular breaks during repetitive tasks to avoid overuse injuries
• Stay hydrated and maintain a balanced diet to support overall muscle health

Can specific exercises help prevent intercostal muscle strain? Yes, exercises that focus on strengthening the core and improving flexibility can help reduce the risk of intercostal muscle strain. Some beneficial exercises include:

1. Gentle twisting stretches
2. Shoulder blade squeezes
3. Diaphragmatic breathing exercises
4. Plank holds
5. Cat-cow stretches

Always consult with a healthcare professional or certified fitness instructor before starting a new exercise regimen, especially if you have a history of muscle strains or other injuries.

When to Seek Medical Attention for Intercostal Muscle Pain

While many cases of intercostal muscle strain can be managed at home, there are situations where medical attention is necessary. Seek immediate medical care if you experience:

• Severe, persistent pain that doesn’t improve with rest and home remedies
• Difficulty breathing or shortness of breath that worsens over time
• Chest pain accompanied by fever, chills, or other signs of infection
• Pain that radiates to your arms, jaw, or back
• Sudden, intense chest pain that may be accompanied by sweating or nausea

These symptoms could indicate a more serious condition, such as a heart attack or pneumonia, which require immediate medical intervention.

Long-term Management and Recovery from Intercostal Muscle Strain

Recovering from an intercostal muscle strain is a process that requires patience and consistent care. Here are some tips for long-term management and successful recovery:

1. Follow your healthcare provider’s instructions carefully
2. Gradually increase your activity level as pain subsides
3. Continue with prescribed exercises or physical therapy even after pain improves
4. Pay attention to your body and avoid activities that cause pain
5. Maintain good posture and body mechanics in daily activities
6. Consider complementary therapies like acupuncture or massage, under professional guidance
7. Manage stress, as tension can exacerbate muscle strains

Is it possible for intercostal muscle strain to recur? Yes, like many muscle injuries, intercostal strains can recur, especially if the underlying causes are not addressed. This is why proper rehabilitation and adopting preventive measures are crucial for long-term health and prevention of future injuries.

Understanding the Impact of Intercostal Muscle Strain on Daily Life

Intercostal muscle strain can significantly impact various aspects of daily life. Some common challenges individuals may face include:

• Difficulty with deep breathing, which can affect exercise tolerance and overall energy levels
• Challenges in performing household chores or work-related tasks that involve reaching or twisting
• Disrupted sleep due to pain, especially when changing positions
• Emotional stress or anxiety related to pain and limited mobility
• Temporary limitations in sports or recreational activities

How can you adapt your lifestyle to manage these challenges? Consider the following strategies:

1. Use assistive devices like reaching tools to avoid straining the injured muscles
2. Modify your sleeping position and use extra pillows for support
3. Practice stress-reduction techniques such as meditation or gentle yoga
4. Communicate with your employer about temporary work modifications if necessary
5. Seek support from family, friends, or support groups to manage emotional challenges

By understanding these potential impacts and adopting appropriate coping strategies, individuals can navigate the recovery process more effectively and maintain a good quality of life while healing.

Intercostal Muscle Strain: Symptoms, Treatment, and More

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An intercostal muscle injury can cause symptoms that include rib pain and tightness that gets worse with certain motions.

What is an intercostal strain?

Your intercostal muscles lie between your ribs, attaching them to one another. They help stabilize your upper body and help you breathe. There are three layers of intercostal muscles: the external intercostals, the internal intercostals, and the innermost intercostals.

A strain is when a muscle stretches, pulls, or is partially torn. A strain of any of the layers of the intercostal muscles can cause pain and difficulty breathing.

Muscle strains are a common cause of chest pain. From 21 to 49 percent of all musculoskeletal chest pain comes from the intercostal muscles.

You can strain or pull your intercostal muscles in many different ways. These muscles are usually hurt during some twisting motion. Pain can start either from a sudden injury, or it can begin gradually from repetitive motions.

Activities that may cause you to strain these rib muscles include:

• reaching, like when painting a ceiling
• lifting while twisting
• chopping wood
• coughing or sneezing
• participating in sports like rowing, golf, tennis, or baseball
• falling
• being hit in the ribcage, like in a car accident or during contact sports

Symptoms of intercostal muscle strain include:

• Pain: You may feel a sharp pain at the time of injury, or it may come on more gradually. The pain will get worse when you twist, stretch, breathe in deeply, cough, or sneeze.
• Tenderness: The area of the strain between your ribs will be sore to the touch.
• Difficulty breathing: Because it’s so painful to breathe, you may find yourself taking small, shallow sips of air. This can leave you short of breath.
• Swelling: A partially torn or strained muscle will become inflamed. You may see some swelling between and around the affected ribs.
• Muscle tightness: The injured muscles may feel tight when you breathe, reach, or twist.

These symptoms can be similar to those of more serious problems, so schedule an appointment with your doctor. They can assess your symptoms and determine the underlying cause.

If you think you’ve injured the muscles between your ribs, make an appointment with your doctor. They can identify which muscle has been strained, and make sure you haven’t injured some other structure in your chest.

Your doctor will give you a complete treatment plan, but in the meantime, avoid twisting and reaching activities that make the pain worse. You can also try these methods for relief:

Over-the-counter pain killers

While you wait to see your doctor, you can take over-the-counter anti-inflammatories like ibuprofen (Advil) or naproxen (Aleve), or simple pain relievers like acetaminophen (Tylenol). Follow the package directions for how much and how often to take these medicines.

You should also be sure that you’re not overmedicating by taking several products that contain pain relievers, including medicines for colds or menstrual cramps. Consult with your doctor before taking over-the-counter medication together with your normal medication.

Hot and cold therapy

Cold therapy can help ease your pain and reduce inflammation of the muscle. Apply a cold pack to the injured area for 20 minutes at a time, several times a day for the first two days. You can use an ice bag, a gel cold pack, a plastic bag filled with ice and wrapped in a towel, or even a bag of frozen veggies.

After the first 48 hours, you may want to start using heat on the injured ribs. Heat can help loosen and relax the muscles so you can do your physical therapy. You can apply heat for 20 minutes at a time with a heating pad or a warm damp towel.

Epsom salt soaks

As part of your heat therapy, you may want to take a warm bath with magnesium sulfate (Epsom salts) added. You can find Epsom salts at your local drug store or online at Amazon.com. Simply add about 2 cups to your bath, and soak for 15 or more minutes.

The dissolved minerals absorb through your skin and may slightly increase your blood levels of magnesium. Magnesium is an important mineral for muscle function. Although the small amount of magnesium absorbed from your bath is unlikely to actually do anything to help your strained muscles, the hot bath can help you relax.

Breathing exercises

Breathing with an intercostal muscle strain is painful. But taking only shallow breaths —instead of full, deep breaths — can lead to infection and pneumonia. Deep breathing exercises can also be a form of meditation to reduce stress.

Try to do a few minutes of breathing exercises every hour. For example:

1. Hold a pillow against your injured muscles.
2. Breathe in slowly and as deeply as you can.
3. Hold the breath for a few seconds.
4. Breathe out slowly.
5. Repeat 10 times.

Once you see your doctor, they may send you home with a spirometer, a plastic tool that gives you a visual clue to how deeply you should breathe.

Your doctor will diagnose your intercostal muscle strain by asking you some questions and doing a physical exam. They’ll want to know if you remember falling or twisting when the pain began. They’ll ask about any sports you play. They’ll touch the tender area and test your range of motion and pain level during motion.

Your doctor may order a chest X-ray to make sure your lungs weren’t bruised or punctured when you were injured.

Grading

Muscle strains are graded according to their severity.

• Grade 1: Mild strain with less than 5 percent of muscle fibers damaged, causing minimal loss of motion. These injuries take two to three weeks to improve.
• Grade 2: More extensive damage of muscle fibers, but the muscle isn’t completely ruptured. You’ll have significant loss of motion and may need two to three months to heal.
• Grade 3: Complete rupture of the muscle. These injuries may require surgery.

Along with rest, ice, heat, and breathing therapy, physical therapy may ease your discomfort and speed your healing. Your doctor may refer you to a physical therapist after making a diagnosis.

A physical therapist can give you tips for sleeping — like trying a recliner so your chest is elevated — and for loosening up in the morning. Following a physical therapy program can help you get back to your usual activities sooner.

Intercostal muscle strains can take a long time to heal, which may be frustrating. If your strain is especially stubborn, your doctor may inject the area with lidocaine and corticosteroids to reduce pain and swelling.

Intercostal muscle strains are sometimes accompanied by a rib stress fracture. But even if you do have a stress fracture, your treatment probably won’t change. Follow your therapy regimen, do your breathing exercises, and you’ll be feeling like yourself again and back on the playing field soon.

To prevent future muscle strains, be sure to warm up well before sports or exercise, and don’t overdo activities that your body isn’t used to doing.

Treatment Options, Risks, and Prevention

Overexerting your body can lead to numerous injuries. A muscle strain, or pulled muscle, occurs when your muscle is overstretched or torn. This can be minor and like soreness after an intense workout, or it can be so severe that it needs medical attention.

Muscle strains are a very common injury. Most people who participate in sports have experienced it at some point in their lives. Poor conditioning, fatigue, and an improper warmup can lead to a muscle strain.

When muscle strain occurs, people often report a popping or snapping sensation. This is the feeling of the muscle tissue being stretched until it snaps. This is often a very painful experience. Strains most commonly occur in the:

• lower back
• neck
• shoulder
• hamstring muscle, which is located in the back of the thigh

There are several different ways to treat muscle strains. The extent of the treatment depends on the extent of the strain.

Diagnosing and treating a muscle strain:

• alleviates pain and inflammation
• reduces the risk of further injury
• helps you regain full use of your body
• gives your body a chance to rest and heal properly

Without proper treatment, you may experience recurring injuries or pain and weakness in the muscle during everyday use. It can be especially painful during exercise and athletic activities.

In some cases, surgery may be necessary to repair a muscle that’s torn as opposed to one that’s strained. A doctor will consider your age, type of injury, symptoms, and other factors to decide if surgery is an option. Surgery is typically only considered for severe muscle injuries.

Approaches to treatment depend on the type and severity of your injury.

If needed, anti-inflammatory pain relievers such as ibuprofen (Advil) or aspirin can help reduce swelling and pain.

Physical therapy may also be needed.

Surgery is sometimes considered for torn or ruptured muscles. You and your doctor will discuss all surgical or nonsurgical options available to repair your muscle.

Supplies

Most muscle strains are minor and don’t require professional medical treatment. Properly treating muscle strain requires the right supplies and a comfortable place to rest. You may need the following supplies:

• ice
• plastic bag
• towel
• compression bandage, such as an ACE bandage
• pillows
• painkillers

Depending on the muscle affected, you may need assistive devices to help stabilize the muscle, especially if it affects one of the limbs. These can include:

• crutches
• a sling
• a brace
• a wheelchair

With proper treatment, all of these devices are temporary.

RICE Method

According to the American Academy of Orthopaedic Surgeons (AAOS), the most common and effective treatment for muscle strains is the RICE method. The individual letters of RICE stand for rest, ice, compression, and elevation. In particular, RICE involves the following:

• Rest by taking an adequate amount of time to heal and avoiding physical activity. This can help strained muscles and other injuries.
• Ice your muscle by using cold packs with a barrier between them and your skin four to eight times per day for 20 minutes at a time.
• Compress your muscle by applying a steady, gentle pressure on it. This prevents swelling and inflammation, which are thought to delay healing. Wrapping an elastic bandage around the affected muscle is best.
• Elevate the injury above your heart to reduce swelling. Use pillows or other devices to raise an affected limb while you rest.

Although the RICE approach remains popular, newer approaches also exist. Some health care professionals recommend using the PEACE and LOVE method for muscle strains.

The PEACE approach is meant to be used right after your injury and during early healing. The letters in PEACE instruct you to:

• Protect the injury from irritation by reducing your use of the strained limb or area. As your pain lowers, try to get back to using the strained area as soon as possible.
• Elevate the injury above your heart to help reduce swelling, using pillows or other supports.
• Avoid anti-inflammatory treatments like NSAIDs and ice. Some believe that inflammation is important for healing a strain.
• Compress the muscle with tape or an elastic bandage.
• Educate yourself to know how long recovery can take and what to expect along the way. Talk with your doctor or health care professional.

After the first few days of rest, the LOVE method applies a more active approach to healing. The letters in LOVE stand for:

• Load: Get back to using your strained muscle as much as you can, as long as you aren’t causing pain.
• Optimism: Do your best to remain positive about your healing process.
• Vascularization: Try to find ways to get active. Working on your cardiovascular health might help you heal.
• Exercise: Do the exercises that are recommended by your doctor or health care professional, if they recommend any.

If you’re choosing between the RICE method and the PEACE and LOVE method, it’s best to discuss your options with your doctor.

There are very few risks of treating a muscle strain. However, there’s a small chance of taking too many painkillers or leaving an ice pack on the skin for too long.

If you try to use the injured area, watch out for pain or any other signs that the injury is getting worse.

Always follow dosage instructions on all prescription or over-the-counter medications. Use a barrier such as a towel between an ice pack and your skin. Allow your skin to warm up in between icing intervals.

Surgery to repair a torn muscle carries certain risks. These can include:

• bleeding
• blood clots
• infection
• pain
• stiffness
• slowed healing time

The last thing you want to do is reinjure a strained muscle. There are several ways you can prevent a muscle strain from recurring, including:

• allowing for proper time to heal from an injury
• stretching your muscles daily
• cross-training for sports by weightlifting or choosing another activity to strengthen your muscles
• warming up before exercise or intense activity
• eating foods high in potassium, like bananas and avocados, before exercise to prevent muscle fatigue
• properly hydrating during exercise

Talk to your doctor about what steps you can take to avoid muscle strains if you experience them regularly.

If you have a muscle tear that requires surgery, medication or physical therapy may be necessary after your procedure. Your doctor will provide specific follow-up instructions based on the type and severity of your injury.

Pain in chest muscles

Sore chest muscles

Pain in the back, chest in medicine is defined by the general concept – dorsalgia. Dorsalgia is considered one of the most common syndromes that doctors of various specializations work with – from a surgeon, a neuropathologist to a gastroenterologist, vertebrologist and other areas. A pain symptom in the chest area, including pain in the muscles of the chest, is called thoracalgia and is observed in 85-90% of people, regardless of age or social status. This syndrome has different causes and is not an independent nosological unit. In order to classify pain in the muscles of the chest, a complex, complex diagnosis is required, including specific anatomical, topographic designations of pain localization. Thoracalgia, in turn, is as common as abdominalgia – abdominal pain, in contrast to acute painful abdominal symptoms, chest pain in 25-30% of cases is not caused by pathology of internal organs, but by damage to skeletal muscles, therefore, with myalgia.

Causes of chest muscle pain

The causes of thoracalgia, as well as the causes of pain in the muscles of the chest, can be associated with both vertebrogenic pathologies, caused specifically by muscle lesions, and neurogenic factors, as well as diseases of the heart and gastrointestinal tract. Actually thoracic syndromes are infringement, irritation or compression of the intercostal nerves, which results in muscle spasm and pain of a different nature, localization and duration. Thus, any cause of thoracalgia to one degree or another can be a factor that provokes pain in the muscles of the chest.

There are several well-studied clinical forms of vertebrogenic thoracalgia, which are diagnosed in 65-70% of cases:

1. Functional thoracalgia due to degenerative changes in the spine in the lower cervical region. Pain in the chest, in nerve endings and muscles is localized in the upper zone and radiates to the neck, shoulder, often to the arm. The symptom is directly related to the condition of the spine and can be aggravated by various movements, physical activity.
2. Thoracalgia caused by degenerative processes in the upper thoracic spine. The syndrome is characterized by diffuse pain in the retrosternal space, between the shoulder blades, depends on the depth of breathing, but does not change at all during movements due to inactivity.
3. Pain in the chest, in the back, associated with the defeat of the scapular zone. The pain is characterized by stabbing, sharp, cutting sensations, depends on the depth of breathing, partly on movements and radiates towards the direction of the intercostal nerve endings.
4. Thoracalgia due to lesion, compression of the anterior part of the chest. The pain is aching, prolonged, localized in the middle or lower part of the chest, depends on motor activity

It should be noted that the causes of pain in the muscles of the chest can be both vertebrogenic and non-vertebrogenic in nature:

• Osteochondrosis.
• Kyphoscoliosis.
• Xifoidalgia.
• Injuries of the spine (thoracic region).
• Tietze syndrome.
• Infectious diseases (herpes).
• Hernias, infringements, protrusions of discs.
• Vertebromuscular coronary syndrome.
• Myalgia associated with overexertion, lifting or moving heavy objects.
• Myofascial pain syndrome – musculoskeletal thoracalgia.

Why chest muscles hurt

What is the pathogenetic mechanism of the syndrome, why does the chest muscle hurt?

Any of the etiological factors that provoke thoracalgia leads to irritation, infringement, compression of the nerve endings, which are surrounded by ligaments, fascia and muscles. Irritation can cause inflammation and swelling of the nerve, it can damage it – the nerve is torn, compression can also occur, compression of the nerve ending. The damaged nerve no longer performs its function, it can only transmit a pain signal to the nearby soft tissues, most often to the muscles.

The reasons explaining why the chest muscles hurt can be myofascial manifestations – musculoskeletal thoracalgia. Myofascial pain syndrome in the chest is directly related to prolonged physical tension of a certain muscle group, the symptom intensifies and is activated by awkward turns and movements. But the pain is most fully manifested during palpation of the so-called trigger zones, which are diagnostically important and determine the actual MFPS. Muscle irritation in trigger zones is accompanied by either clearly localized or referred pain, which can spread beyond the trigger point. Among the causes of MFPS can be not only purely physical factors, myofascial chest pains are often caused by latent rheumatic diseases, osteochondritis, radiculopathy, neurogenic pathologies, metabolic disorders.

In any case, no matter what provokes a pain symptom in the muscles of the chest, there is one pathogenetic reason – this is nerve damage, which can lead to swelling, tearing or compression. The nature, localization and duration of pain, that is, the actual symptoms, depend on the type of damage to the nerve ending.

Why does the muscle under the breast hurt

If the muscle under the breast hurts, this can mean a lot of problems not related to a purely muscular syndrome.

• Tietze’s syndrome or perichondritis, costal chondritis, anterior chest wall syndrome and other variations of names. Judging by the variety of definitions of the syndrome, its etiology is still unclear, but the clinical manifestations have been studied quite well. According to the version of the author, who first described the syndrome in detail at the beginning of the last century, the disease is associated with an alimentary-dystrophic, nutritional factor, that is, with a metabolic disorder and degeneration of the cartilaginous structure. There are also theories that explain chondritis by constant trauma, infectious and allergic diseases. Tietze’s syndrome is characterized by acute, shooting pain in the area of ​​​​attachment of the sternum to the costal cartilage, more often in the zone of the II-IV rib. Inflamed cartilage provokes a pain symptom similar to an angina attack, that is, left-sided pain. However, complaints are often noted that the muscle under the breast on the right hurts, and symptoms resembling signs of cholecystitis, gastritis, and pancreatitis are also common.
• The chronic form of Tietze’s syndrome is called xifoiditis or xifoid syndrome, when the pain is localized in the zone of the xiphoid process, less often in the lower part of the chest (under the breast). The pain radiates to the epigastrium, to the area between the shoulder blades, increases in motion, especially when bending forward. A characteristic symptom of xyphoiditis is an increase in pain when overeating, overfilling the stomach. Unlike gastrointestinal pain, xifoiditis manifests itself clinically in a sitting position, half-sitting.
• Hernia of the esophagus (diaphragm) often provokes pain similar to muscle spasms in the lower chest. The pain is felt like colic, localized in the retrosternal space, but can move to the area under the chest or to the side, sometimes resembling an angina attack. The symptom depends on the position of the body, increases in a horizontal position and subsides in a vertical position, which helps to distinguish it from angina signs.
• Abdominal form of musculoskeletal pain in the chest may indicate an atypical development of myocardial infarction. The pain is localized in the upper abdomen, under the breasts, accompanied by a feeling of nausea, bloating. The clinic of this syndrome is very similar to the signs of intestinal obstruction, which greatly complicates both the diagnosis and the timeliness of assistance.

In general, if a muscle hurts under the breast, in the lower chest, the patient should immediately consult a doctor, since most often such signs indicate serious, sometimes life-threatening conditions. It is extremely rare that the localization of muscle pain under the breast concerns myofascial syndrome.

Symptoms of chest muscle pain

The main signs of thoracalgia, including symptoms of pain in the muscles of the chest:

• Pain localized to the right or left in the chest. The pain is constant, feels like girdle, shooting, paroxysmal. The pain can spread along the direction of the intercostal nerve endings, depends on many types of movement – turns, bends, coughs, sneezes, breathing.
• Pain of a burning nature, accompanied by numbness, radiating to the region of the scapula, to the heart, less often to the lower back. A burning sensation can spread along the direction of the nerve branches. Often this symptom is characteristic of intercostal neuralgia.
• Pain associated with the muscles of the shoulder girdle, extensor muscles of the back, muscles of the scapula. Such a symptom is not associated with compression or compression of the nerve; rather, it is due to hypertonicity of the muscle tissue, provoked by overstrain, both dynamic and static. The pain is felt as growing, aching, aggravated by a load on the muscle damaged by stretching (turns, tilts, lifting weights).
• True thoracalgia must be differentiated from intercostal neuralgia, which is a common diagnostic problem. In addition, the symptoms of chest pain are very similar to the pain symptoms of other syndromes – cervicalgia (pain in the neck) and thoracobrachialgia (pain in the shoulder, arm).
• Intercostal neuralgia is characterized by acute, piercing pain, most often localized in the anterior chest area.
• Thoracobrachialgia is characterized by pain radiating to the arm.
• Cervicalgia is specific with the onset of a pain symptom directly in the neck, if the pain spreads to the chest area, it is characterized as cervicothoracalgia.

To determine the exact syndrome for musculoskeletal chest pain, use the following scheme:

Syndrome Definition

The zone of localization of trigger points, determined by palpation

Feeling and nature of pain

sternal syndrome

chest area, synchondrosis

The pain is felt in the depths, in the retrosternal space

Rib-sternal syndrome

Intercostal muscles (zone II of the IIIrd rib), as well as costal-sternal joints, more often on the left

Pain of a constant, aching nature, the symptom depends on many movements – turns, bends, coughing, sneezing

Xyphoidalgia

Zone of the xiphoid process

Pain that depends on the position of the body. Increases in flexion and extension of the body, in squats, body position – half-sitting, depends on abundant food (large volume)

Anterior costal syndrome

Zone VIII-X-th rib, region of the edge of the cartilage

Severe, sharp pain in the lower chest, in the precordial zone, aggravated by movement, when turning

Tietze syndrome

Zone II-III costal articulation, hypertrophied cartilage is palpable

The pain is long-lasting, aching, does not subside at rest, in the area of ​​compacted cartilage

Myofascial syndrome is the most common cause of a pain symptom in the chest area that is not associated with vertebrogenic pathology.

Myofascial dysfunctions are characterized by a chronic course, can be localized in various zones, but rarely migrate beyond certain diagnostic trigger points. It is these points that are pathognomonic criteria that determine MFPS – myofascial pain syndrome. Palpation in the trigger zones reveals a painful induration, a muscle cord ranging in size from 2 to 5-6 millimeters. If mechanical pressure is applied to the painful point both from the outside and due to body movements, the pain intensifies and can be reflected in nearby soft tissues. The characteristic signs of MFBS that determine the symptom are chest muscles that hurt:

• Symptom of reflection – “jump”, when the pain intensifies and grows when pressing on the compacted muscle.
• Pain may increase spontaneously when the affected muscle is loaded (active trigger point) with load, pressure.
• A feeling of stiffness, aching pain is characteristic of latent trigger points. The pain symptom limits the range of motion of the chest muscle.
• Pain in MFPS often depresses muscle function and provokes muscle weakness.
• Myofascial pain may be accompanied by neurovascular symptoms characteristic of compression syndromes, if a nerve, neurovascular bundle is located between the trigger points.

The reasons why MFBS develops and chest muscles hurt can be as follows:

• Acute muscle overload, strain due to exercise.
• Static posture, long-term preservation of the anti-physiological position of the body.
• Hypothermia.
• Congenital anatomical skeletal anomaly (asymmetry of the pelvis, different leg lengths, asymmetry in the structure of the ribs, and so on).
• Metabolic disorders.
• Viral, infectious diseases in which MFPS is a secondary syndrome.
• Rarely – psychogenic factors (depression, phobias).

It should be noted that the most common complaint is “chest muscles hurt” among those who begin to play sports, training, especially for power sports – bodybuilding, that is, physical overload of the spinal column and the muscles surrounding it. Unfortunately, other causes of a pain symptom in the chest often remain undiagnosed in a timely manner, the pain becomes chronic, non-specific, which makes it difficult to identify the true cause and prescribe adequate treatment.

Diagnosis of chest muscle pain

Pain in the muscle tissue of the chest can indicate various diseases, including life-threatening conditions. Therefore, the diagnosis of pain in the muscles of the chest should be not only timely, but also the most differential, accurate, which is quite difficult, given the polysymptomatic and variability of sensations of this nature. According to statistics, musculoskeletal chest pain is the result of such pathologies:

• Cardialgia – 18-22%.
• Osteochondrosis and other vertebrogenic pathologies – 20-25%.
• Diseases of the digestive system – 22%.
• True benign muscle diseases, more often MFPS (myofascial pain syndrome) – 28-30%.
• Injuries – 2-3%.
• Psychogenic factors, depression – 3-8%.

In order to quickly differentiate purely muscular pathologies from coronary cardialgia and other serious diseases, the doctor conducts and prescribes the following types of examination:

• Taking an anamnesis, including hereditary, determining the objective cause of pain, its relationship with food intake, neurogenic factors, body position, and so on.
• Exclusion or confirmation of typical signs of angina pectoris.
• Electrocardiogram.
• Testing with anti-angial drugs is possible.
• Identification of symptoms of possible vertebral diseases. Visually, the deformation of the spine, its biomechanical disorders are determined, with the help of palpation, muscle clamps at trigger points are detected. In addition, the limitation of movements, the presence of areas of hyperesthesia are determined.
• Exclusion or confirmation of degenerative changes in the spine using X-ray.
• Manual examination of muscle tissue.

If MFPS (myofascial pain syndrome) is preliminarily determined, the affected muscle can be determined by the localization of pain and a more accurate therapeutic strategy can be drawn up.

Pain symptom area

muscles

Anterior chest

Large, small, scalene, sternoclavicular, sternoclavicular (mastoid) muscles

Posterior sternum, upper part

Trapezius and levator scapula muscles

Mid chest, middle

Rhomboid and latissimus dorsi, serratus posterior superior, and serratus anterior and trapezius muscles

Posterior surface of the chest, lower zone

iliocostal and serratus posterior inferior muscles

In addition, the diagnosis of pain in the muscles of the chest takes into account such conditions and signs:

• Connection of pain with the position and posture of the patient’s body, as well as with hand movements.
• Absence or presence of radiological signs of vertebrogenic syndrome, or muscular-tonic manifestations.
• The presence of concomitant symptoms, including feelings of anxiety, fear.
• Absence or presence of osteofibrotic areas in the upper chest.
• Absence or presence of pronounced abnormalities on the ECG.
• Reaction to the use of anticoagulants and nitroglycerin.
• Dependence of pain on massage, biomechanical correction.

Summarizing, it can be noted that an experienced doctor always remembers the so-called “red flags” in the process of diagnosing dorsalgia in general and thoracalgia in particular. This allows you to quickly exclude or confirm serious pathologies and start adequate therapeutic measures.

Treatment of chest muscle pain

If the vertebrogenic nature of pain in the muscles of the chest is revealed, the treatment is aimed at the main provoking factor. The pain is relieved either by injectable blockades using corticosteroids or by prescribing anti-inflammatory drugs in tablet form, it all depends on the nature of the pain. The remission stage involves acupuncture, traction therapy, massage, physiotherapy exercises.

Tietze’s syndrome is treated with warming treatments and ointments containing NSAIDs. If the pain is intense, infiltration with local analgesics is prescribed, more often with novocaine, less often with corticosteroids.

Rib-sternal syndrome is treated with blockade of intercostal nerve endings, then, according to the patient’s condition, massage, exercise therapy.

Treatment of pain in the muscles of the chest with sternoclavicular syndrome (hyperostosis) consists in the use of anti-inflammatory nonsteroidal drugs, both in tablet form and in the form of ointments. Warm compresses, physiotherapy, and muscle strengthening exercises are also shown.

Myofascial syndrome is treated in a complex way, since it is necessary to influence all the numerous links of the process. Painkillers, NSAIDs, antidepressants, myelorelaxants, massage and stretching of the affected muscles, thermal procedures, electrical stimulation, and even botulinum toxin injections are prescribed. Local applications with dimexide and lidocaine, post-isometric relaxation, gentle manual therapy are effective.

In general, the treatment of pain in the muscles of the chest is a competent combination of drug therapy and non-drug methods, which allows not only to stop the pain symptom, but also significantly reduce the risk of recurrence of the syndrome.

Prevention of chest muscle pain

To date, unfortunately, there are no special, generally accepted recommendations for the prevention of pain in the muscles of the chest. This is due to polysymptomatics and a variety of causes that provoke pain.

It is obvious that the rules to avoid traumatization, diseases during life, relate to the observance of the norms of a healthy lifestyle. However, even those who constantly care about their health are not immune from certain pain sensations in the muscles of the body, including in the chest area. However, given that most of the factors that provoke myalgia are associated with spinal degeneration and overstrain, muscle strain, the following tips can be offered:

• It is necessary to lead an active lifestyle, taking into account the total hypodynamia, characteristic of our age of high technology. A sedentary, sedentary lifestyle is the right way to develop all types of osteochondrosis, and, accordingly, to muscle pain.
• If pain in the muscles of the chest is diagnosed, the cause is established and the treatment is completed, it is necessary to follow all medical recommendations in the future to exclude the possibility of relapse.
• Given the close relationship between myalgia and the state of the respiratory, digestive system, one should adhere to the rules of a healthy diet, give up bad habits – alcohol abuse, smoking.
• In sports, one should observe the rule of reasonable load distribution and the ratio of one’s own capabilities with the set sports task.
• Given the close relationship of all types of myalgia with the state of the nervous system and the fact that about 15% of its causes are due to psychogenic factors, it is necessary not only to protect the nerves, but to regularly engage in autogenic training, to know and perform anti-stress, relaxation exercises.
• At the first alarming pain sensations, you should consult a doctor, be examined, because sometimes it is timely diagnosis and treatment that helps to avoid not only the development of a pain symptom, but also serious, life-threatening conditions.

Pain in the muscles of the chest is not a specific symptom indicating a specific problem, disease, so self-medication can only turn the acute nature of the pain into a chronic one. Constant discomfort in the chest area interferes with full-fledged work, reduces the quality of life, while a timely cured disease helps to fully experience all the benefits of recovery, that is, returned health.

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.