Fibromyalgia is a chronic condition. A person will often experience pain, tenderness, and stiffness in many muscles, connective tissues, bones, and joints. While symptoms differ among people, many report intense, sharp, or stabbing pain in the chest and ribcage.
The resulting pain may be confused with heart-related pain. As always, a correct diagnosis is essential.
In this article, we look at what kinds of chest pain are normally associated with fibromyalgia. We also describe treatment options.
People with fibromyalgia tend to have chronic pain, stiffness, and tenderness that radiates throughout the body. Although it was once considered a noninflammatory illness, research from 2017 suggests that fibromyalgia causes widespread inflammation that is not detected by routine blood tests.
If fibromyalgia-related inflammation affects the cartilage that connects the upper ribs to the breastbone, this can result in costochondritis.
Fibromyalgia can also cause inflammation, pain, stiffness, and muscle spasms anywhere in the chest.
When first experiencing costochondritis or painful or restrictive chest symptoms associated with fibromyalgia, many worry that something is wrong with their lungs or that they are having a heart attack.
People tend to describe the pain as:
- confined to one spot, usually in the very center of the chest, but it may radiate outward
The severity of symptoms will generally depend on the extent of inflammation. This is true for symptoms of costochondritis and chest-related fibromyalgia symptoms.
The pain described above may:
- worsen with movement, deep breathing, or pressure
- come and go
- improve with shallow, steady breathing and rest
- begin in one place and radiate outward, impacting a larger area
- worsen when stretching, bending, or twisting
Pain caused by costochondritis may be felt either in the center of the chest or anywhere along the cartilage that runs between the sternum, or breastbone, and the ribs.
Fibromyalgia can cause chest pain when it affects the muscles, tendons, or ligaments in the area.
When fibromyalgia impacts the cartilage that connects the ribs to the sternum, it can cause costochondritis.
Cartilage is a flexible connective tissue found in joints. The cartilage that joins the ribs to the sternum allows the ribcage to expand during inhalation. Because of this, people with severe costochondritis may have difficulty or experience pain while taking deep breaths.
Triggering events may include:
- infection or illness
Symptoms of fibromyalgia may be provoked by changing levels of some neurotransmitters, which are chemicals that help the nerves to communicate.
People with fibromyalgia tend to have increased levels of neurotransmitters that communicate pain, such as glutamate and substance P. Alterations in levels of this substance seem to change how the brain understands pain.
Also, individuals with fibromyalgia often have lower levels of neurotransmitters that inhibit the communication of pain, such as gamma-aminobutyric acid.
These differences in neurotransmitter levels may indicate that people with fibromyalgia have exaggerated responses to pain. Or, it may mean that the brain mistakenly perceives normal sensations as pain.
Doctors and researchers are still working to determine the best treatments for fibromyalgia. Each person responds to treatment differently.
When chest pain is severe, long-lasting, disabling, or frequent, comprehensive treatment may be necessary.
The American Food and Drug Administration (FDA) have yet to specify any treatment for fibromyalgia, though the organization has approved certain medications for use in managing symptoms.
Medications approved for the management of fibromyalgia include:
- pregabalin (Lyrica) and gabapentin
- some tricyclic antidepressants, specifically duloxetine (Cymbalta)
- some selective norepinephrine reuptake inhibitors, specifically milnacipran (Savella)
Some lifestyle adjustments and natural remedies have been shown to reduce symptoms of costochondritis and others associated with fibromyalgia.
Options for immediate relief include:
- applying a heating pad for 20-minute periods
- applying an ice pack wrapped in cloth for no longer than 20 minutes at a time
- taking over-the-counter pain medication that does not conflict with prescription medication
- gently stretching, focusing on the muscles, ligaments, and tendons of the chest and the sides
- taking quiet, shallow breaths
- relaxing as much as possible and remembering that the pain will eventually diminish
- reimagining the pain as a less unpleasant sensation such as numbness or tickling
Lifestyle adjustments that may help to reduce long-term symptoms include:
- getting enough sleep and staying hydrated
- eating a healthful, balanced diet rich in fruits, vegetables, fiber, lean proteins, and whole grains
- avoiding or limiting the consumption of foods and drinks that cause inflammation, such as preserved foods, red meats, rich or spicy foods, and alcohol
- doing gentle exercises, such as yoga, Pilates, walking, cycling, and swimming
- engaging in mindfulness techniques, such as meditation or guided visualization
- avoiding allergens, especially food and airborne allergens
Some traditional and alternative medical therapies are often recommended to treat long-term symptoms, though limited scientific evidence may support their use.
Popular therapies with preliminarily evidence include:
Fibromyalgia tends to cause pain throughout the body, and chest pain will often occur with other symptoms.
A person should seek immediate medical attention when chest pain occurs in isolation, or when it is accompanied by:
- severe pain, especially in areas that are not tender to the touch
- severe pain that worsens over time
- pain that becomes severe with exertion or exercise
- blood in the sputum, a mixture of mucus and saliva
- pain that extends upward, toward the arms and jaw
- difficulty breathing
- dizziness or light-headedness
- excessive sweating
- heartburn or indigestion
- lower back pain
- heart palpitations
- trouble swallowing
- a rash
Many people with fibromyalgia experience chest pain, usually where the ribs and the sternum connect, in the middle of the chest.
This pain tends to be harmless and often resolves with basic home care. However, people who experience severe, disabling, or frequent chest pain associated with fibromyalgia may require additional treatment and should speak with a doctor.
Seek emergency medical care if chest pains are not accompanied by other fibromyalgia symptoms, such as exhaustion and pain mirrored on both sides of the body.
Also, seek immediate care when chest pain occurs in areas that are not tender, or when the pain is accompanied by symptoms not related to fibromyalgia, such as coughing, fever, and heart palpitations.