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Chest pain can be alarming, especially when it's hard to pinpoint the exact location and cause. While chest pain is often associated with heart problems, it can also be caused by issues with the muscles, bones, tendons, ligaments, or tissues in the chest wall. This type of pain, known as musculoskeletal chest pain, has various causes, including injuries, rheumatic diseases, and arthritis, which can lead to inflammation and pain in the chest wall. Strained or pulled chest muscles are a common cause of chest pain and can result from overstretching, pressure, or repetitive motion, often seen in athletes and those engaging in forceful athletic activities.
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What You'll Learn
Strained or pulled chest muscle
A strained or pulled chest muscle is a common cause of chest pain and can occur due to overstretching or pressure or strain on the muscles. Nearly half of all chest muscle strains occur in the intercostal muscles, which are responsible for helping you breathe. A pulled chest muscle can be caused by a number of different situations, but is most commonly seen in athletes. Many people pull their chest muscles in contact sports and other athletics that require forceful or repetitive motion, such as tennis, golf, gymnastics and rowing. Weightlifting can also cause chest muscle strains, especially if your arm is pulled back and overhead quickly or for prolonged periods of time.
Outside of sports, manual labor is another common cause of pulled chest muscles. You can also strain your chest muscles gradually by using them too often without resting, which is called a repetitive strain injury. Certain illnesses may also cause muscle strain in the chest. For example, if you've recently had a chest cold or bronchitis, it's possible you may have pulled a muscle while coughing. Adults are more likely than children to develop chest pulls or injuries as a result of car accidents or athletic activities. Older individuals are at a higher risk of experiencing chest wall injuries from falls.
If you suspect that you have a pulled chest muscle, you should stop the activity that is causing you pain and rest. You can also apply ice or a cold pack to the affected area for 20 minutes up to three times a day to help reduce pain and inflammation. If necessary, wrap an elastic bandage around the area of inflammation to help reduce swelling, but be careful not to wrap it too tightly, as this can impair circulation. Keep your chest elevated, especially at night, using pillows or a wedge to help. You may also want to take over-the-counter pain relievers such as ibuprofen or acetaminophen to help with inflammation and pain.
Most chest muscle strains are mild and can be treated at home, but if your pain doesn't get better with rest, ice, compression, and elevation (RICE), or if it gets worse, call your doctor. Your doctor will examine you and determine if your strain is acute (due to an injury or trauma) or chronic (due to repetitive use), and will assign a grade based on the severity of the injury. Grade 1 strains are mild, while Grade 2 strains are moderate tears with a significant loss of strength and motion. Grade 3 strains are complete muscle ruptures that may require surgery to reattach the affected tendon to the bone.
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Rheumatic diseases
Musculoskeletal chest pain can be caused by rheumatic diseases, which affect the bones, muscles, and tissues enclosing the heart and lungs. Rheumatoid arthritis, an autoimmune disease that causes chronic inflammation in the cartilage cushioning joints, can lead to chest pain. Ankylosing spondylitis, a type of arthritis affecting the spine and ribs, may also cause inflammation and pain throughout the chest wall. Myofascial pain syndrome, another rheumatic condition, results in chronic muscle pain, often localized in specific areas like the chest wall.
Costochondritis, a condition causing chest pain, is often associated with rheumatic diseases due to improper joint function, leading to mechanical stress and inflammation. It is characterized by sharp, aching, or pressure-like pain that worsens with upper body movement or deep breaths. While it is not arthritis, inflammation from rheumatoid arthritis or ankylosing spondylitis can damage rib cartilage, resulting in costochondritis.
Chest pain may also be caused by noninflammatory conditions related to rheumatic diseases, such as fibromyalgia. Pleurodynia, or Bornholm disease, is another rheumatic condition causing inflammation of the chest muscles due to viral infections. It results in sharp muscle spasms and lingering aches that worsen when taking a deep breath, often accompanied by fever and sweating.
It is important to note that musculoskeletal chest pain can be challenging to differentiate from cardiac chest pain. If you are experiencing chest pain, it is always advisable to seek medical advice to determine the underlying cause and receive appropriate treatment.
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Rib fractures
The symptoms of a rib fracture include pain and difficulty breathing. In some cases, a fractured rib can damage other organs, such as the lungs, liver, or spleen. It is important to seek medical attention if a rib fracture is suspected, especially if it is accompanied by other symptoms or injuries.
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Pleuritis
The most common cause of pleuritis is viral infection, with the coxsackie B virus, HRSV, CMV, adenovirus, EBV, parainfluenza, influenza, and COVID-19 being possible causes. However, pleuritis can also be caused by bacterial infections associated with pneumonia and tuberculosis, as well as autoimmune disorders, pulmonary embolism, and other conditions. In some cases, the exact cause cannot be determined.
A doctor can diagnose pleuritis by listening to the lungs using a stethoscope to detect any unusual sounds, such as a rough, scratchy sound called a pleural friction rub. Diagnostic tests such as a chest X-ray may also be performed to detect air or fluid in the pleural space. Treatment focuses on controlling pain, often with non-steroidal anti-inflammatory drugs, and addressing the underlying cause.
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Underlying conditions
While chest pain is often musculoskeletal, stemming from bones, muscles, and tissues in the chest wall, it can sometimes be a symptom of an underlying condition. Chest pain can be alarming as it may signal a heart attack or other serious heart condition. However, chest wall pain is usually caused by other conditions, including muscle, lung, or digestive issues.
Injury
Chest muscle soreness can be caused by an injury, such as a muscle strain or rib fracture. A muscle strain, or pulled muscle, is a tear in the muscle caused by overstretching. This can happen suddenly or gradually over time through overuse without rest. Chest muscles can be pulled in contact sports and other athletics that require forceful or repetitive motion, such as tennis, golf, gymnastics, and rowing. Weightlifting can also cause chest muscle strains if the arm is pulled back and overhead quickly or for prolonged periods.
Rheumatic Diseases
Rheumatic diseases are a common cause of musculoskeletal chest pain. Arthritis and other rheumatic conditions can cause inflammation and pain in the chest wall.
Lung Infections
Lung infections, such as pneumonia, can cause chest pain. Pneumonia is an infection that causes the air sacs within the lungs to fill with fluid or pus, which can be caused by viruses, bacteria, and fungi.
Pulmonary Embolism (PE)
A pulmonary embolism (PE) refers to a blockage of the blood vessels within the lungs, usually caused by a blood clot. This is a medical emergency.
Pleuritis
Pleuritis can cause pain that feels like a pulled chest muscle. It generally causes a sharp, sudden pain that increases when taking a breath. It may be accompanied by additional symptoms such as fever, coughs, and general muscle aches.
COVID-19
COVID-19 can lead to chest pain or tightness.
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Frequently asked questions
Some common causes of sore chest muscles include injuries, rheumatic diseases, arthritis, and rib fractures.
Some symptoms of a pulled chest muscle include mild discomfort, severe symptoms, and increased severity when taking a breath.
To treat a pulled chest muscle, you can use the RICE method: rest, ice, compression, and elevation.
Chest pain could be a symptom of an underlying condition. If you are experiencing severe pain or other symptoms such as lightheadedness, you should consult a healthcare professional.
