| What We Treat
Chest Pain
Chest pain that catches when you move, breathe deeply or press on it? Musculoskeletal chest pain is common and treatable — but chest pain always deserves a proper think about the heart and lungs first.
Overview
What Causes Musculoskeletal Chest Pain?
The chest wall contains twenty-four ribs, their joints with the spine and breastbone, and the muscles between them — all of which can generate pain. Musculoskeletal chest pain is common and typically reproduced by movement, position or direct pressure. That said, the chest overlies the heart, lungs and major vessels, so screening for causes outside the musculoskeletal system is a routine and necessary part of any assessment.
Costochondritis
Inflammation where the ribs meet the breastbone, producing sharp, well-localised pain reproduced by pressing on the affected area. Often follows a period of coughing, unaccustomed lifting or upper body exercise. Self-limiting, though it can take weeks to months to settle fully.
Symptoms
How It Tends to Feel
Musculoskeletal chest pain has features that distinguish it from more concerning causes:
Reproduced by Pressing
Pain that can be brought on by pressing on a specific spot on the chest wall is highly suggestive of a musculoskeletal source.
Changes With Position
Pain that varies with posture, twisting or reaching is characteristic.
Catches With Deep Breathing
Sharp catching on inspiration, particularly if reproducible with movement.
Well Localised
A specific point you can indicate with one finger, rather than a diffuse heaviness.
Related to Recent Activity
Following coughing, lifting, a new gym programme, or a period of unaccustomed activity.
No Systemic Symptoms
No breathlessness, sweating, nausea, dizziness or feeling generally unwell.
Causes & Risk Factors
What Drives It
Chest wall pain usually follows a period of increased load on the ribs and their joints.
Coughing Illness
A prolonged cough loads the chest wall repeatedly and is one of the most common precipitants.
Unaccustomed Upper Body Exercise
A new gym programme, heavy lifting, or a return to training after time off.
Sustained Postures
Prolonged desk work and driving load the thoracic and rib joints, particularly where capacity is reduced.
Direct Trauma
A blow to the chest or a fall, which can bruise the chest wall or fracture a rib.
Stress and Breathing Pattern
Altered breathing patterns and increased muscle tension are common contributors and worth addressing directly.
How We Can Help You
Treatment & Management
Once a non-musculoskeletal cause has been excluded, chest wall pain generally responds well and relatively quickly to manual therapy, movement and reassurance.
What the evidence says
Musculoskeletal causes account for a substantial proportion of chest pain presentations in primary care, and reproducibility of the pain by palpation is one of the more useful features pointing away from a cardiac cause — though it does not exclude one entirely.
Costochondritis is self-limiting but frequently takes weeks to months to settle. Reassurance combined with graded movement is the mainstay, and it is worth knowing the timeline in advance to avoid unnecessary alarm as it drags on.
When to Seek Help
Red Flags — Don’t Wait
Chest pain always warrants careful thought. These features need emergency assessment:
⚠ Call 999 immediately if you have chest pain with:
- Pain spreading to the jaw, neck, shoulder or arm, particularly with a crushing or heavy quality
- Breathlessness, sweating, nausea, or feeling clammy and generally unwell
- Pain that is not related to movement or position and does not ease with rest
- Sudden severe tearing pain in the chest or between the shoulder blades
- Coughing up blood, or sudden breathlessness with sharp chest pain
Chest pain can indicate a heart attack, a clot on the lung, or a problem with the major blood vessels. If in any doubt at all, call 999. It is always better to be assessed and reassured than to wait.
Common Questions
Frequently Asked Questions
How do I know it’s not my heart?
Musculoskeletal pain is typically reproduced by pressing on a specific spot, changes with position and movement, and is well localised. Cardiac pain is more often a diffuse heaviness, unrelated to movement, and accompanied by breathlessness or sweating. If there is any doubt, that needs assessing medically rather than reasoning through.
What is costochondritis?
Inflammation where the ribs meet the breastbone. It produces sharp, localised pain reproduced by pressing on the area, often after a coughing illness or unaccustomed lifting. It settles on its own, but frequently takes weeks to months, which catches people out.
Why does it hurt when I breathe in?
Because the rib joints move with every breath. An irritated joint or strained intercostal muscle is loaded each time the chest expands, which produces a catching pain on deep inspiration. It’s a common and generally reassuring pattern.
How long will it take to settle?
Rib and thoracic joint pain often responds quickly, within two to four weeks. Costochondritis is slower and can take a few months. Knowing that in advance usually helps, because the slow ones cause a lot of unnecessary worry.
Get the Chest Wall Assessed Properly
A careful screen for the causes that need medical attention, then treatment aimed at the joints and muscles actually producing the pain.
Book Your Initial AssessmentThis page is for general information only and isn’t a substitute for individual medical advice. Chest pain can indicate a serious medical emergency — if you have any of the red flag symptoms above, call 999 immediately.