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What Are the Common Causes of Musculoskeletal Chest Pain?

By C. Webb
Updated Mar 03, 2024
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Musculoskeletal chest pain is pain generated in the rubbery cartilage areas of the chest wall. The exact cause of musculoskeletal chest pain can be difficult to ascertain, as there are many possibilities and the pain can cover a large area. Most musculoskeletal chest pain falls into two areas: isolated pain and systemic pain. In each case, several common causes are linked to its presentation. For most cases, the cause is determined through a process of elimination.

The chest pain must be quickly differentiated from other types of chest pain that can become life-threatening, such as a heart attack or pulmonary embolism. Once it is determined these and other potential life-threatening conditions are present, examination for common causes of musculoskeletal chest pain can begin. Types of examinations vary depending on the suspected category.

The most common cause of musculoskeletal chest pain is costochrondritis, which creates pain in the cartilage connecting the breastbone and ribs. This type of chest pain falls into the isolated category and presents a sharp pain where the ribs and breastbone meet. Patients often believe they are having a heart attack, as the pain level and location are similar to that of a heart attack. There is no obvious cause for costochronditis. Doctors treat the pain symptoms and advise the patient that it will take time to resolve and for the chest pain to dissipate.

Common symptoms of this disorder include painful coughing, breathing difficulties, and sharp pain during deep breaths. The main difference between musculoskeletal chest pain caused by costochronditis and a heart attack is that the pain in costochronditis is very specific, while heart attack pain is more widespread. Both conditions frequently cause pain to the left of the breastbone.

Another common cause of musculoskeletal chest pain is arthritis. Both non-rheumatic and rheumatic disease can cause chest pain as a primary symptom. Blood tests can help determine whether the patient has arthritis and if so, further testing can be done to figure out what type is present. Treatment for chest pain due to arthritis includes arthritis medications and pain relievers.

Fibromyalgia patients frequently complain of musculoskeletal chest pain. The disorder presents itself with widespread pain at identified trigger points, including the chest. Psychological stress, injury, and physical trauma, including accidents or surgery, are precursors to fibromyalgia with accompanying chest pain. Treatment for the chest pain symptom includes pain medication and fibromyalgia medication.

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