Chest Pain - Muscular?


Earlier in the year I started getting chest pain. I thought it might be costochondritis or enthesitis. I saw a GP who ordered a chest xray because I'm on methotrexate, which came back clear and no further action.

When I saw the rheumy over the summer he thought it was more likely a muscular pain caused by back pain (I have spondyloarthropathy), because costo would hurt more around the breast bone and my pain is more like wearing a very tight corset, I can't pinpoint a source. It usually hurts more in the mornings but last night it got really quite bad.

Has anyone been told similar? And are there any exercises I can do to strengthen the chest muscles? I've tried looking on YouTube but it came up with some scary body builder stuff!


6 Replies

  • This is the national ankylosing spondylitis society website Back to Action exercise programme.

    I can't quite remember but I would think there are (arm and breathing) exercises within that which would help.

    FWIW, I have costochondritis quite badly as part of my spondy, and while I do have distinct tenderness around the edges of the breastbone, I also get incredibly tender over the cartilage between pretty much all my ribs - worst on the lower ones and around my side. Enthesitis can happen throughout your ribcage, though as the doctor said, usually concentrated at the junction with the breastbone. My physio did tell me to keep trying to fully expand my ribcage when breathing, though I think that opportunity has long gone - I have had only around half an inch chest expansion for many years now.

  • Thank you. I've been doing some of those exercises but not all of them, and I haven't been doing them properly with the 'neutral spine' posture. I've become a lot more aware of my stooped posture recently after seeing how I move on video, and I'm trying to be conscious of it and correct it, despite the pain! I've downloaded the app to remind me to do all the exercises every day. The breathing 'wine glass' one looks particularly good, but it does make me long for a nice cold glass of white wine!

  • Ive had something similar for a few months. They even ran a CT scan on me in case it was a pulmonary embolism. Both CT scan and x ray was clear, and they sent me away saying it was probably costo chrondritis. My Osteopath disagrees. He says that with Costo, you feel the pain more around the front of your rib cage, whereas mine is more around the back of the ribcage (and difficulty filling up a breath). He thinks its muscular and is working on easing out all the muscle groups from the neck down to shoulder and down ribs. It is making it gradually better. As it improves, the main becomes more focussed and less generalised.

  • Thank you. The last couple of nights I've been very close to dialing 111, but I know they'll recommend going to the hospital as soon as I mention chest pain, and I'd feel very silly wasting their time over muscular pain. It's a relief to know that someone else has been told similar. I think it's more of a worry when it's the chest area, as I store some of my most vital organs in there! It's scary when it gets bad and it's late at night, I'm on my own and I can't be sure what's causing it. I do trust my rheumy though, so if he says it's muscular then I'm 99% sure he's right.

  • I know what you mean. My GP has sent me to A&E TWICE over it now. The first time I found myself being admitted to the Cardiology Ward and I had an overnight stay with alot of very sick cardiac ladies (like, heart transplant people), because the hospital wouldn't discharge me until they had run a CT scan on me, and it wasn't available until the next day. And they started pumped warfarin into me just in case it was an embolism (to be fair, I was 2 days post a minor general anaesthetic hand op). They really push the boat out if they think there is a risk of it being heart related.

    When it first started up for me, it was really scary. It came on overnight and I could only groan at the top of the breath, and it was painful lying on my back at night. Now, 8 weeks on, its more like an irritation when I get to the top of my breath. The doc's did say to try to take painkillers to make sure that I could fully fill up my lungs on every breath, as otherwise there was a risk of developing an infection in the chest because the lungs weren't being used to their full capacity .....

  • Please don't just take what they say. I had jaw/throat pain and between shoulder-blades getting worse over 2 years. Had all sorts of x rays including for tmj, they concluded pinched nerve in neck/spine (no reason for this conclusion). 6 weeks ago was rushed to hospital from work. Sent for angiogram and turns out it has been unstable angina! 2 main arteries 70-80% blocked plus 3rd one blocked. Now waiting to see if they will do stents as I don't want triple bypass surgery. For those 2 years they had only been looking for RA reasons for the problem!

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