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Chest pain is a common symptom with a variety of possible causes, ranging from muscle strain to cardiac conditions. While chest pain is often associated with heart attacks, it can also be caused by muscle strain, which can feel scary due to the chest's proximity to the heart and lungs. Muscle strain in the chest can cause sharp pains when breathing, moving, or coughing, and usually occurs due to impact injuries, overuse, or repetitive strain. It is important to seek medical attention for any chest pain to rule out more serious conditions and receive proper treatment.
| Characteristics | Values |
|---|---|
| Common Causes | Injuries, like muscle strains and rib fractures |
| Rheumatic diseases, arthritis, and other rheumatic conditions | |
| Sports, weightlifting, manual labor, and repetitive strain injuries | |
| Symptoms | Sharp pains when moving or breathing |
| Swelling, muscle spasms, bruising, soreness, tenderness | |
| Pain that increases with movement of the chest or upper spine | |
| Pain that worsens when breathing deeply, sneezing, coughing, or twisting | |
| Treatment | Rest, ice, compression, and elevation (RICE) |
| Pain relievers, physical therapy, and changing the exercise routine |
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What You'll Learn
Intercostal muscle strains
The symptoms of intercostal muscle strains include sharp, direct pain, stiffness, and mobility difficulties. Pain may increase with movement, deep breathing, coughing, or sneezing. Swelling, tenderness, and bruising may also occur, especially in more severe cases.
Diagnosis of intercostal muscle strain involves a physical examination to check for limitations of movement and assess areas of tenderness. Imaging tests, such as X-rays or MRIs, may be ordered to rule out other possible causes of the pain, such as rib fractures or internal organ injuries.
Treatment for intercostal muscle strains depends on the severity of the injury. Mild to moderate strains can usually be treated with rest, ice, compression, and elevation (RICE). Over-the-counter pain medications, such as acetaminophen or ibuprofen, can also help with pain and inflammation. For more severe strains, physical therapy may be recommended to strengthen the intercostal muscles. In the most severe cases, surgery and an extended period of physical rehabilitation may be necessary.
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Sports injuries
Chest pain is a common symptom of many conditions, and it can be challenging to determine its exact cause. Musculoskeletal chest pain, originating from muscles, bones, or joints in the chest wall, is one potential cause. Sports injuries, such as muscle strains, are a common trigger of musculoskeletal chest pain.
Muscle strains in the chest can lead to sharp pains when moving or breathing and are often caused by impact injuries or overuse. Strains occur when a muscle is overstretched, twisted, or subjected to impact force, resulting in a tear. Sports that involve forceful or repetitive motions, like tennis, golf, gymnastics, and rowing, are particularly prone to causing chest muscle strains. Weightlifting and manual labor are also common causes of chest muscle strains.
Sports enthusiasts who participate in activities requiring explosive actions, such as sprinting, or those that involve twisting at the torso, are at risk of intercostal muscle strains. These muscles, located between the ribs, assist in breathing and stabilize the rib cage. Straining these muscles can cause pain when breathing, coughing, or moving the upper spine or chest.
If you suspect a pulled chest muscle, the recommended treatment is RICE (Rest, Ice, Compression, and Elevation). Rest involves stopping activities that aggravate the muscle strain, while ice helps reduce pain and inflammation. Compression with an elastic bandage can minimize swelling, and elevation, especially at night, can aid in the healing process. Over-the-counter pain relievers can also be taken to manage discomfort.
While chest muscle strains are typically minor, it is crucial to seek medical attention to rule out more serious conditions, such as heart-related issues or broken bones. A healthcare provider will conduct a physical examination, evaluating your range of motion and checking for tenderness in specific areas of the chest wall. They can then determine the severity of the strain and provide appropriate treatment recommendations.
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Repetitive strain injuries
Occupational RSIs are of particular concern as they affect the patient's livelihood. These injuries result from repetitive and forceful motions, awkward postures, and other work-related conditions and ergonomic hazards. Certain jobs that involve repeated motion patterns or prolonged postures within a work cycle are associated with a higher risk of RSI. For example, miners and poultry workers must make repeated motions, which can lead to tendon, muscular, and skeletal injuries. Young athletes are also predisposed to RSI due to their underdeveloped musculoskeletal systems.
The symptoms of RSI include aching, pulsing pain, tingling, and extremity weakness. These symptoms initially present with intermittent discomfort, but as the condition progresses, they become more frequent. Early diagnosis of RSI is critical to limit damage and prevent long-term adverse effects. Various tests and imaging techniques, such as X-rays and MRIs, can aid in the diagnosis of RSI.
Treatment options for RSI depend on the severity of the condition. Commonly prescribed treatments for early-stage RSI include analgesics, myofeedback, biofeedback, physical therapy, relaxation techniques, intermittent vacuum therapy, and ultrasound therapy. The RICE (Rest, Ice, Compression, Elevation) protocol is often recommended as the first line of treatment for muscle strains and other soft tissue injuries. Low-grade RSIs may resolve with early intervention, but more severe cases may require aggressive intervention, including surgery. Ergonomic interventions, such as changing workplace equipment, can also help minimize repetitive strain and prevent future injuries.
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Pleurodynia (Bornholm disease)
Pleurodynia, also known as Bornholm disease, is characterised by the sudden onset of chest pain due to inflammation of the diaphragm, accompanied by general malaise, headache, fever, and sore throat. It is caused by a viral infection, specifically the Coxsackie B virus, which is spread through the faecal-oral route, respiratory secretions, and oral-oral methods. The illness typically lasts 3 to 5 days and is most common in children and adolescents. It is considered a benign condition with a complete regression and a good prognosis.
Bornholm disease is characterised by spasmodic pain, fever, and relapses, which help distinguish it from other causes of pain such as appendicitis or myocardial infarction. It is primarily associated with coxackie B viruses, particularly CVB3 and CVB5, although other enteroviruses can also be responsible. The illness gets its name from an epidemic of pleurodynia that occurred in Bamble, Norway, in 1872.
The symptoms of Bornholm disease include episodes of sharp or stabbing muscle spasms, followed by a lingering dull ache that worsens when taking a deep breath. Fever, sweating, tachycardia, arrhythmias, and maculopapular rashes are also common. While rare, myocarditis, respiratory failure, hepatic necrosis with coagulopathy, disseminated intravascular coagulopathy (DIC), aseptic meningitis, pericarditis, and pleurisy have been reported as potential complications of Bornholm disease.
It is important to note that chest pain may also be caused by muscle strains, injuries, or rib fractures. Muscle strains can occur due to overstretching, twisting, or impact force and are common in sports injuries. They can cause swelling, pain when using the affected muscle, muscle spasms, and bruising. Treatment for muscle strains typically involves rest, ice, compression, and elevation (RICE), along with pain relievers and physical therapy if needed.
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Chest wall pain syndromes
Chest pain is a common symptom with a wide range of potential causes. It can be challenging to determine the exact origin of chest pain, as it may be related to the muscles, bones, joints, tendons, or ligaments in the chest wall, or it could be cardiac (heart-related). Musculoskeletal chest pain has distinct characteristics that set it apart from typical cardiac chest pain.
Costochondritis
Costochondritis is an inflammatory condition affecting the cartilage that connects the ribs to the sternum (costochondral joints). It is also known as anterior chest wall syndrome when it affects the front of the chest. Costochondritis typically causes chest wall pain that improves over time without intervention. Tietze syndrome is a similar condition that involves inflammation of the upper rib costochondral joints and results in visible swelling.
Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation in the cartilage cushioning the joints. It can affect the sternoclavicular joint and the thoracic spine, leading to pain throughout the chest wall.
Myofascial Pain Syndrome
Myofascial pain syndrome causes chronic pain in specific areas, such as the chest wall. The pain originates from trigger points within the muscles, which can be identified by a healthcare provider. Serratus anterior myofascial pain syndrome is a subtype associated with pain in the chest, back, or arm and can affect the range of motion in the affected areas.
Fibromyalgia
Fibromyalgia is a chronic condition characterised by musculoskeletal pain and fatigue throughout the body. It tends to flare up in episodes triggered by factors such as stress, hormone fluctuations, and nutritional changes.
Thoracic Spine Conditions
Issues affecting the thoracic spine may result in referred pain felt in the chest, even in the front. Herniated disks or stress injuries to the costovertebral joints are potential causes of thoracic spine-related chest wall pain.
Psoriatic Arthritis
Psoriatic arthritis is a type of arthritis that affects some individuals with psoriasis. It can impact the thoracic joints and the posterior chest wall, leading to chest wall pain.
Sternalis Syndrome
Sternalis syndrome is an unusual cause of anterior chest wall pain. It is associated with the presence of an accessory muscle, the sternalis muscle, which is found in only 5-10% of people. This syndrome presents with anterior chest pain and localised tenderness over the sternum or sternalis muscle.
Slipping Rib Syndrome
Slipping rib syndrome affects the joints between the lower ribs, which are technically ligaments with cartilage tips. It can cause chest wall pain and discomfort.
Pleurodynia (Bornholm Disease)
Pleurodynia is an inflammatory condition of the chest muscles caused by a viral infection. It leads to episodes of sharp or stabbing muscle spasms followed by a lingering dull ache that worsens with deep breathing.
Anxiety and Depression
Mental health conditions such as anxiety and depression can also contribute to non-cardiac chest pain.
It is important to note that this list is not exhaustive, and there may be other rare or less common chest wall pain syndromes. Additionally, chest pain can be a symptom of serious conditions, so seeking medical advice is crucial for an accurate diagnosis and appropriate treatment.
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Frequently asked questions
Yes, a muscle strain can cause chest pain when breathing. This is often a minor condition that can be treated with rest and proper care. Strains occur when a muscle sustains damage from overstretching, twisting, or impact force.
A strained chest muscle can cause pain that increases with movement or deep breathing. It can also cause muscle spasms, swelling, bruising, and soreness or tenderness within the chest wall.
For mild to moderate chest muscle strains, the best first line of treatment is RICE (rest, ice, compression, and elevation). Over-the-counter pain relievers such as ibuprofen or acetaminophen can also help with inflammation and pain.
