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:
- 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:
- 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:
- injury or trauma to your chest, such as from a car accident
- 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
- rheumatic diseases, such as rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis
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
- 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
- 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
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
- high fever