What causes chest wall pain?

Breast pain can have a lot of causes and is not always associated with breast cancer. A pulled chest muscle may be due to angina, gall stones, costochondritis, and other things.
Breast pain can have a lot of causes and is not always associated with breast cancer. A pulled chest muscle may be due to angina, gall stones, costochondritis, and other things.

Breast pain can have a lot of causes and is not always associated with breast cancer. Sometimes, it can be caused by a pulled muscle in your chest wall. This is also called extra-mammary pain

Several things can cause chest wall pain, including:

More serious causes of chest pain can include blunt trauma to the chest and a bone fracture.

Extramammary breast pain means pain outside the breast instead of inside. Pulling a muscle in the chest can cause this type of pain.  Arthritis within the chest can also cause extramammary breast pain.

A pulled muscle can also be expressed as intercostal muscle strain.  The intercostals are the muscles in between your ribs. They work by expanding your ribs so that you can breathe in and out. If they are stretched too far— either by sudden or repetitive movement — they can become strained. Because of their location, these strains can be mistaken for breast pain.

Common causes include:

  • Repetitive movements in sports
  • Coughing 
  • Extreme range of motion, twisting 
  • Injuries to the chest.

What is chest wall pain like?

Symptoms of chest wall pain can vary. It can be one-sided or occur over a broad area of the breast. It may be sharp or burning. It can be aggravated with movement. It also can be felt if the area is touched. 

When dealing with chest wall pain from an intercostal muscle strain, symptoms can include:

  • Pain when moving strained muscles
  • Pain from coughing, sneezing, or breathing
  • Muscle tightness
  • Swelling to the area.

What other conditions can mimic pulled chest muscle pain?

Sometimes breast pain or chest wall pain can have other causes. For women, an unsupportive bra can cause pain. Without that support, ligaments that connect the chest wall and breasts can become overstretched, resulting in soreness. 

A cyst in the breast or chest muscle can cause pain. A cyst is a lump with fluid in it.  Cysts are not dangerous but may be uncomfortable. Inflammatory breast cancer, too, causes pain in the chest area but is rare. This type of cancer is only found in one to five percent of United States breast cancer cases. 

Who can get chest muscle pain?

Intercostal muscle pain is a very common cause of musculoskeletal chest pain.  Anyone can potentially get pulled muscle pain. But older people and those who are sedentary — or do not engage in a lot of physical activity — are more at risk. 

How is chest muscle pain diagnosed?

Your doctor will diagnose if you have a pulled chest muscle versus other causes of chest pain. They will examine your breast during a physical exam and take the history of your pain.  If chest wall pain is suspected, you could be asked to lean forward.  This is to evaluate if the pain is in your breast instead of the chest wall.

If the doctor feels your pain is in the breast, they may order the following tests:

  • Mammogram — an x-ray of the breast imaging the area of concern 
  • Ultrasound — uses sound waves to evaluate an area if a mammogram is normal 
  • Breast biopsy — a small tissue sample is sent to the lab for analysis.  

If chest wall pain is suspected, your doctor may order other tests to rule out all conditions, such as an electrocardiograph, X-ray, CT, or MRI

How is a pulled chest muscle treated?

Home remedies and rest usually help with the healing process of a pulled chest muscle injury like an intercostal muscle strain. If not, the following could be used:

  • Ultrasound — a wearable device with ultrasound energy to aid healing
  • Ointments — used for pain
  • Physical therapy — may include stretching exercises and the uses of transcutaneous electrical nerve stimulation (TENS)
  • Nonsteroidal anti-inflammatory (NSAID) —NSAIDs may be recommended when your pain is bad.  

Preventative methods include not smoking, which can make inflammation worse. Rest and activities like Yoga may also help. Any muscle strain may take four to six weeks to heal. Proper diagnosis and treatment are essential for positive outcomes. 

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Medically Reviewed on 1/10/2022
References
SOURCES:

BreastCancerNow.org: "Chest wall pain."

Cleveland Clinic: "How to Cope with an Intercostal Muscle Strain."

John Hopkins Medicine: "Breast Pain: 10 Reasons Your Breasts May Hurt."

Mayo Clinic: "Breast Pain," "Costochondritis."