Chest wall pain can be caused by broadly diverse ailments. Injuries, infections and chronic diseases that affect the lungs, ribs, chest muscles or heart sac can lead to chest wall pain. The character of the pain, aggravating or alleviating factors, and other signs and symptoms can help determine the underlying cause of chest wall pain.
Chest Wall Injury
Rib fractures and bruising of the chest wall due to falls, blunt force injury and accidents can cause significant chest wall pain. Deep breathing, coughing and twisting of the torso typically provoke pain with chest wall injuries. According to Trauma.org, the primary concerns with rib fractures are ensuring adequate breathing is possible, and avoiding the development of pneumonia. Often those with chest wall injuries avoid coughing because it causes pain. However, this can lead to a buildup of mucus in the airways, which increases vulnerability to pneumonia.
Fibromyalgia
Fibromyalgia is a condition marked by chronic tenderness and pain in muscles and joints throughout the body. The upper chest wall is a common site of fibromyalgia pain. Tenderness in the region near the second rib is included in the American College of Rheumatology's diagnostic criteria for fibromyalgia. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, an estimated 5 million adults in the United States meet the diagnostic criteria for fibromyalgia, with a marked preponderance of women.
Costochondritis and Muscle Soreness
Costochondritis is an inflammation of the area where the ribs connect to the breastbone. Inflammation of the cartilage in this area can be provoked by heavy lifting, infection or minor injury, notes the Mayo Clinic. Soreness of the chest muscles due to overuse or strain may accompany the pain of costochondritis. The area is typically tender to pressure. Twisting motions, strenuous activity, deep breathing and coughing characteristically intensify the pain. Over-the-counter anti-inflammatory medications such as ibuprofen or aspirin may alleviate pain.
Pleurisy
Tissues called the pleura cover the surface of the lungs and line the inner chest wall. The National Heart, Lung and Blood Institute explains that infections or other irritation of the pleura can cause chest wall pain. This condition goes by the medical term pleurisy. Coughing and deep breathing trigger shooting or stabbing pain. In severe cases, any movement that causes friction between the lungs and chest wall provokes pain. The University of Maryland Medical Center reports possible causes of pleurisy include cancerous tumors, collapsed lung, viral lung infections, bacterial pneumonia, asbestosis, tuberculosis and pulmonary embolism. Treatment of the underlying condition typically resolves the pain of pleurisy.
Pericarditis
A tissue sac containing a small amount of fluid surrounds the heart. This sac, the pericardium, enables the heart to beat without rubbing against other structures in the chest. Inflammation of the pericardium is termed pericarditis, which is typically accompanied by sharp chest pain over the heart. The National Heart, Lung and Blood Institute reports the most common cause of pericarditis is a viral infection of the pericardial sac. However, other conditions can also cause pericarditis, including autoimmune diseases, radiation injury, kidney failure, tuberculosis, HIV/AIDS and certain medications.
References
- Trauma.org: Chest Trauma, Rib Fractures and Flail Chest
- National Institute of Arthritis and Musculoskeletal and Skin Diseases: Questions and Answers About Fibromyalgia
- National Fibromyalgia Research Association: The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia
- Mayo Clinic: Costochondritis
- Mayo Clinic: Costochondritis Causes
