Fibromyalgia is a complex, long-term condition characterized by widespread musculoskeletal pain, profound fatigue, and heightened tenderness. The condition involves a disruption in how the brain processes pain signals, leading to chronic discomfort. A common symptom is pain felt in the chest. Fibromyalgia can cause chest pain, which is typically a symptom of a related musculoskeletal issue rather than a cardiac event.
Identifying the Specific Source of Chest Pain
The chest pain experienced by many people with fibromyalgia is often diagnosed as costochondritis, sometimes referred to as costosternal pain. This condition involves the inflammation of the cartilage that connects the ribs to the breastbone (sternum) at the costochondral joints. These joints allow the ribcage to move during respiration.
The pain from costochondritis is typically localized around the breastbone or where the ribs join the sternum. Patients frequently describe the sensation as sharp, stabbing, or pressure-like. Deep inhalation, coughing, or sneezing can instantly intensify the pain because the cartilage must flex with every breath. This chest pain is a common manifestation of fibromyalgia’s underlying musculoskeletal sensitivity.
How Fibromyalgia Chest Pain Differs from Heart Pain
When chest pain occurs, distinguishing it from a heart problem is extremely important. Costochondritis pain, unlike cardiac pain, is characteristically reproducible. Applying gentle pressure to the affected tender spots on the chest wall, typically near the sternum, increases discomfort, suggesting a musculoskeletal cause.
Heart pain is often described as a crushing or squeezing sensation that may radiate to the jaw, left shoulder, or down the arm. Fibromyalgia-related chest pain is usually localized to the ribcage area, though it can sometimes be felt in the upper back. Activities like changing position, bending, or twisting the torso frequently exacerbate costochondritis pain, which is less common with cardiac issues.
Symptoms accompanying a heart event, such as profuse sweating, lightheadedness, or sudden shortness of breath, are red flags requiring immediate emergency medical attention. While costochondritis can be worsened by deep breathing, it does not present with these systemic signs of circulatory distress. If there is any doubt regarding the source or severity of chest pain, seeking emergency medical care is always the safest course of action.
Understanding the Mechanism of Pain
The connection between fibromyalgia and chest wall pain lies in central sensitization, which fundamentally alters how the nervous system processes pain signals. This mechanism causes nerves in the spinal cord and brain to become chronically overactive, amplifying sensations that would not be painful for others. The central nervous system develops a lower threshold for pain, increasing discomfort throughout the body.
This heightened sensitivity makes chest wall structures, including muscles and costochondral joints, reactive to normal stimulation. Even without significant inflammation, this nervous system hypersensitivity can create severe pain. The tenderness often correlates with specific myofascial trigger points in the chest wall musculature, which are areas of localized muscle tightness. Consequently, the chest pain is a direct result of the systemic pain amplification inherent to fibromyalgia.
Managing Acute Chest Wall Pain
Once a healthcare provider confirms the chest pain is musculoskeletal, several strategies can manage an acute flare-up. The primary initial approach involves resting the area and temporarily avoiding activities that worsen the pain, such as heavy lifting or strenuous exercise. Applying either heat or cold to the tender area can help soothe discomfort, and some people find alternating between the two offers the best relief.
Gentle stretching of the chest and shoulders can relax tightened muscles contributing to the pressure and pain. Maintaining proper posture is important, as slumping can place undue strain on the ribcage and sternum joints. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) may be used to reduce pain and localized inflammation. Always consult with a healthcare provider before starting any new medication, including topical pain relief applications, to ensure they are appropriate for individual health needs.