What to know about chest wall pain

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Chest wall pain refers to pain inside of the chest. It may affect the muscles, bones, or soft tissue in the chest. In some cases, the pain might involve organs, such as the heart and lungs.

Chest wall pain can cause different sensations, ranging from tightness to sharp, stabbing pains. It may also come and go and vary in duration from hours to days.

In some cases, chest wall pain may only occur with movement or in response to touching the area.

Chest pain can occur with heart disease or a heart attack. However, many instances of chest wall pain are not due to a heart problem. In fact, some estimates suggest that nearly a quarter of the population will experience chest wall pain from something other than a heart problem.

For example, a common cause of chest wall pain is an injury to the muscles, joints, or cartilage.

Chest wall pain warrants emergency care if person experiences:

• intense pain in the center of the chest that lasts for longer than a few minutes
• pain that spreads to the back, neck, or shoulders
• other symptoms, such as shortness of breath, dizziness, or confusion
• loss of consciousness or fainting

These symptoms could indicate a heart attack and, therefore, require immediate medical care.

A heart attack is not the only reason to seek emergency care. Some other signs that chest wall pain requires emergency care include:

• chest pain with a fever
• difficulty breathing
• intense chest pain following a fall or blow to the chest

Several medical conditions can cause chest wall pain. The sections below will look at some of these in more detail.

Musculoskeletal injuries

Injuries to the muscles or bones of the chest can cause pain in the area. These injuries can be sudden, such as from a fall or blow to the chest, or occur over time, such as from bad posture or a sedentary lifestyle.

Signs that the cause may be an injury include feeling pain in a specific location or having pain that spreads to different areas. Another sign is if the area is painful to touch.

With mild muscle injuries, the pain can be a mild, intermittent ache. In more severe cases, such as from a bone fracture, the pain can be intense and persistent.

Angina

Angina is a type of chest pain that occurs as a symptom of an underlying heart condition. It occurs when there is a disruption of blood flowing to the heart.

Some factors that increase the risk of angina include:

• being older
• having excess weight or obesity
• being physically inactive
• eating an unhealthy diet
• having diabetes

Angina causes a feeling of tightness in the middle of the chest and shortness of breath. It lasts for several minutes and does not get better with massages or deep breathing.

Angina can indicate a heart attack, which requires emergency medical care.

Costochondritis

Costochondritis refers to inflammation of the cartilage between the ribs, where they connect to the breastbone. It can cause an intense burning sensation, a dull ache, or sudden chest pain. The pain may worsen with movement.

Costochondritis usually goes away on its own. A doctor can prescribe anti-inflammatory pain medications to reduce the pain. Some people might also benefit from stretches or massages.

Breast pain

Breast pain can cause pain in one or both breasts. Pregnant and lactating people are more likely to experience breast pain. Some people also experience breast pain during menopause or periods.

Several factors can cause breast pain, such as hormonal changes or infections. Blocked ducts and inflamed breasts are specific problems in people who are breastfeeding.

The pain tends to get worse when a person presses on the affected area. It can sometimes resolve on its own, but it may require treatment. Some people find relief from massaging the area or using a warm compress.

Asthma

An asthma attack can cause chest pain or tightness. Some other symptoms include breathlessness, feeling dizzy, and throat tightness.

Asthma is more common in childhood, but it can develop at any age.

A severe asthma attack usually requires medical treatment or an inhaler.

Other chronic conditions

Several other chronic conditions can cause chest pain. The pain may appear suddenly or develop slowly over time. It might come and go and may last for weeks or months.

Some other conditions that may cause chest pain include:

• arthritis
• fibromyalgia
• Tietze syndrome, which is a rare inflammatory disease
• sickle cell disease
• liver or gallbladder disease

Treatment depends on the condition a person has, but taking medication to treat the underlying cause usually helps.

Infections

Some infections may also cause chest pain. For example, pneumonia can cause chest pain with a fever and breathing difficulties.

Infections in the bones or muscles may also cause pain. Chest pain following a recent illness could indicate that an infection is the cause.

Infections usually require medical treatment, and the treatment will depend on the cause. For example, a person may need to take antibiotics for a bacterial infection. Resting may help ease the pain, but serious infections may require hospitalization.

Lung injuries

An injury to the lung might include a collapsed or punctured lung. Another potential lung-related cause of chest pain is pulmonary embolism, wherein a blood clot from elsewhere in the body travels to the lungs, causing chest discomfort.

Lung injuries might cause breathing problems. The pain might follow a blow to the chest, such as from a fall or vehicle accident.

Lung injuries can be life threatening, so they require immediate medical treatment.

Mild pain may go away on its own without medical care if there are no other symptoms.

More severe pain, however, usually requires treatment. A person needs medical care if chest pain occurs after a blow to the chest or alongside any other symptoms of a heart attack.

To diagnose the cause, a doctor may:

• ask about the person’s symptoms and medical history
• examine their chest
• take a blood sample
• administer X-rays or other imaging tests

Home treatments can be helpful if emergency care is not necessary. These include:

• applying an ice pack to the chest
• using heat packs
• massaging the area
• doing gentle stretches
• taking nonsteroidal anti-inflammatory drugs, such as ibuprofen

Many causes of chest wall pain are not a cause for concern.

However, when chest pain does not go away on its own or gets worse, a person needs medical care.

Look out for symptoms of a heart attack or other conditions that require emergency care.