Musculoskeletal chest pain: Overview
Chest pain is not always a sign that something is wrong with your heart or that you have another serious problem. The doctor thinks your chest pain is caused by strained muscles or ligaments, inflamed chest cartilage, or another problem in your chest, rather than by your heart. You may need more tests to find the cause of your chest pain.
Chest wall pain
Chest wall pain is pain in the bones, cartilage, or muscles that make up the chest wall. Chest wall pain occurs in a specific area of the chest and may feel worse when pressure is applied to the area.
Chest wall pain can be caused by many problems, including:
- An injury, such as a blow to the chest.
- Prolonged or violent coughing, which can strain the muscles or ligaments in the chest.
- Inflammation of the cartilage of the rib cage (costochondritis).
Chest wall pain usually feels different than the chest pain of a heart attack. Breathing deeply, lying on the affected area, or moving, such as twisting to the side or raising the arms, also can make chest wall pain feel worse.
Treatment for chest wall pain depends on the cause of the pain. Minor chest wall pain is treated with rest, ice or heat applied to the area, and nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen. If the chest wall pain is the result of coughing, the pain should improve as the cough improves.
How can you care for yourself when you have musculoskeletal chest pain?
- Take pain medicines exactly as directed.
- If the doctor gave you a prescription medicine for pain, take it as prescribed.
- If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
- Rest and protect the sore area.
- Stop, change, or take a break from any activity that may be causing your pain or soreness.
- Put ice or a cold pack on the sore area for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when you are awake) or until the swelling goes down. Put a thin cloth between the ice and your skin.
- After 2 or 3 days, apply a heating pad set on low or a warm cloth to the area that hurts. Some doctors suggest that you go back and forth between hot and cold.
- Do not wrap or tape your ribs for support. This may cause you to take smaller breaths, which could increase your risk of lung problems.
- Mentholated creams such as Bengay or Icy Hot may soothe sore muscles. Follow the instructions on the package.
- Follow your doctor's instructions for exercising.
- Even if it hurts, try to cough or take the deepest breath you can at least once every hour. This will get air deeply into your lungs. This may reduce your chance of getting pneumonia. Hold a pillow against your chest to make this less painful.
- Gentle stretching and massage may help you get better faster. Stretch slowly to the point just before pain begins, and hold the stretch for at least 15 to 30 seconds. Do this 3 or 4 times a day. Stretch just after you have applied heat.
- As your pain gets better, slowly return to your normal activities. Any increased pain may be a sign that you need to rest a while longer.
Musculoskeletal chest pain: When to call
Call 911 anytime you think you may need emergency care. For example, call if:
- You have chest pain or pressure. This may occur with:
- Sweating.
- Shortness of breath.
- Nausea or vomiting.
- Pain that spreads from the chest to the neck, jaw, or one or both shoulders or arms.
- Dizziness or lightheadedness.
- A fast or uneven pulse.
- You have sudden chest pain and shortness of breath, or you cough up blood.
Call your doctor now or seek immediate medical care if:
- You have any trouble breathing.
- Your chest pain gets worse.
- Your chest pain occurs consistently with exercise and is relieved by rest.
Watch closely for changes in your health, and be sure to contact your doctor if:
- Your chest pain does not get better after 1 week.
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