This section covers pain anywhere between shoulders to the bottom of ribs. It can arise from
Inside the thoracic cavity (inside chest)
From the chest wall including the thoracic spine
Be referred from the neighbouring areas and structures such as abdomen, cervical spine.
Chest wall pain can originate from any of the chest wall structures including bones, joints, muscles, cartilage, ligaments, tendons, nerves, skin and soft tissue. It generally increases with arm movement and is accompanied by localised tenderness.
Some common conditions/situations leading to chest wall pain are
Prolonged unaccustomed physical activity. This may cause muscle soreness which can persist
Trauma/fall with fracture of ribs or vertebrae. In presence of osteoporosis even trivial trauma can lead to fractures. The event may be difficult to remember specially when the onset of pain is delayed
Spine can be a source of posterior chest pain. Pain may arise from joints including those between the vertebrae (facet joints), between the ribs and vertebrae (costovertebral joints, costotransverse joints), discs, spinal ligaments, muscles (paravertebral muscles) and the nerves. The pain can radiate towards the side of chest and as far as the front of chest and abdomen
Other joints such as the one between the collar bone and sternum or the ones between the ribs and sternum can also be a source of chest wall pain. Inflammation of the cartilage connecting the ribs to the sternum is known as chostrochondritis
Infections such as Shingles commonly affect the thoracic area (Post Herpetic Neuralgia)
Rheumatological disorders such as rheumatoid arthritis, ankylosing spondylitis
Post surgical pain arising after surgeries such as heart, lung, breast surgery
Nerve injury or damage as a result of surgery, trauma or otherwise.
Cancer which has spread to chest wall or bones
Management
The treatment will depend on the cause of pain. A multi disciplinary approach using a combination of medications, physiotherapy, psychology and injections is the preferred approach. Please follow the links to read more about these.
Details of some of the treatments available via the pain clinic are given below
Dr. Amod Manocha is a Senior Consultant and Head of Pain Management Services at Max Multispecialty Hospital, Saket. He is trained as a Pain Management Specialist and an Anaesthetist in the UK. He has over 13 years of work experience in the UK including working as a Chronic Pain Consultant in many UK hospitals.
https://www.removemypain.com/thoracic-spine-and-chest-wall-pain.html