Something hurts in the chest. What can pain in the chest, in the upper part, indicate?

Pain in the upper chest for various reasons, ranging from problems with the heart and blood vessels, ending with the usual contusion or myositis. Initially, the doctor needs to establish whether the discomfort that has arisen is dangerous for the life and health of the patient. The nature of the pain can also differ in strength, localization and frequency of repetition.

It is important to correctly diagnose the cause of the resulting pain in order to quickly prescribe the correct effective treatment.

Causes of pain

Diseases of the gastrointestinal tract

pain start after eating, for example, with a hernia of the diaphragm, a burning sensation appears, and with an ulcer, pain is fixed at the top of the abdomen and can be given to the sternum. If there are problems with the gastrointestinal tract, soreness rarely occurs during sports or movement. And pain in pathologies of the esophagus begins when the patient is actively moving and the pressure inside the peritoneum has risen.

Clinical picture

Ask your question to a neurologist for free

Irina Martynova. Graduated from the Voronezh State Medical University. N.N. Burdenko. Clinical intern and neurologist of BUZ VO "Moscow polyclinic".

Symptoms of pain in diseases of the gastrointestinal tract are different:

• With gastroesophageal reflux disease, pain manifests itself in the form of spasms and burning. Patients complain of bitterness in the mouth.
• With a rupture of the esophagus due to trauma, with pathologies associated with contractions of the esophagus, the pain is localized in the middle and at the top of the chest. After an injury, a sharp attack of pain occurs. Such painful sensations are unbearable, the patient vomits, the state of health is rapidly deteriorating.
• Peptic ulcer pain is given to the upper chest and localized in the center of the peritoneum. The nature of the pain: aching; when the disease is in the acute stage, the attacks intensify. If the patient eats foods without spices, then after eating it may subside.
• When the stomach is pinched by the diaphragm and with a diaphragmatic hernia, pain appears in the sternum and at the top of the peritoneum. The patient requires urgent hospitalization.
• With an inflammatory process in the pancreas, pain is fixed at the top of the thoracic region or in the center of the sternum. Increases when a person stands up, becomes less when a person leans forward.

Be sure to check out the following video

medical intervention

A gastroenterologist will help cure the disease, in extreme cases, the help of a surgeon is required.

Diagnostics

You can diagnose the disease by listening to the patient's complaints, by palpation, auscultation, percussion.

Probing through the esophagus to determine the pathology or endoscopy can be performed. One of the newest diagnostic methods has become sigmoidoscopy.

For a more thorough examination, doctors supplement the diagnosis with rectosigmycolonoscopy, ERCP.

Treatment

To quickly relieve pain, you can simply use antispasmodics that eliminate muscle contractions.

The doctor prescribes treatment after diagnosis. Usually, conservative methods of treatment with drugs are used. In urgent and complex cases, doctors decide on the need for surgical intervention.

Methods of treatment completely depend on the detected disease and examination of the patient. Often, doctors recommend the use of folk remedies in parallel with ongoing therapy.

Traditional medicine treatment is carried out under the strict supervision of a physician.

Disorders of the musculoskeletal system

Symptoms of diseases are very similar to pain in the heart area., so it is difficult to diagnose, they are easy to confuse. Pathologies arise as a result of a sedentary lifestyle, heavy physical exertion, injuries, and problems with metabolism. Basically, pain in the sternum is a sign of osteochondrosis of the thoracic region, may occur due to damage by osteophytes, pinched nerve endings, etc.

Diagnostics

To identify the causes of pain, MRI, X-rays are used.

Intervention of doctors

To diagnose the pathology and prescribe treatment, the patient needs to consult a traumatologist, neuropathologist, oncologist, gastroenterologist.

Clinical picture

• the sternum and cervical region, due to which the distance between the vertebrae is reduced, is characterized by severe incessant pain in the chest when inhaling, exhaling, moving, coughing and sneezing. The patient often has numb hands, difficulty breathing
• between vertebrae. Sharp paroxysmal pain radiating to the upper part of the sternum and back.
• . The nature of the pain in the upper part of the sternum: aching. When you change position, the pain becomes less. The vertebrae are gradually destroyed, due to small fractures of the bone tissue, the spine is bent, the patient acquires an incorrect posture. Growth decreases, it becomes more difficult to breathe, there is a violation of urination. The patient becomes nervous and irritable.
• Rachiocampsis. There are pains in the sternum, the patient quickly gets tired, pain in the back is possible, the occurrence of stoop. The trunk becomes asymmetrical, it becomes more difficult to breathe, often there is intercostal neuralgia, a tingling sensation in the limbs.
• In case of injuries of the spine, they can have a different character. It depends on the degree, site of damage, type of impact. If the patient does not move, then at rest the pain subsides, but becomes stronger with movements and deep inhalation-exhalation.

Treatment

Depending on the disease, doctors use:

• Drug treatment (anti-inflammatory drugs, analgesics, muscle relaxants)
• Severe cases require surgery
• A complex of exercise therapy aimed at restoring blood flow and strengthening the muscle corset.
• Massage
• Physiotherapy
• Acupuncture
• Acupressure.

Cardiovascular diseases

This kind of pain most common cause of chest discomfort. Their nature can be different: from aching pain to an acute attack, sometimes pressing discomfort occurs.

Expert opinion

Prikhodko Arkady Arkadievich

Rheumatologist - city polyclinic, Moscow. Education: FGBNU NIIR named after V.A. Nasonova, Astrakhan State Medical Academy.

It is formed most often in the upper part of the sternum or spreads throughout the cervical region.

Physician Intervention

For treatment, you will need an appointment and consultation with a therapist, a cardiologist.

Clinical picture

Symptoms of diseases can be different and depend on the diagnosed pathology.

• Myocardial infarction. As a result of blockage of the artery, blood cannot flow to the tissues and the heart muscle dies. The nature of the pain: acute paroxysmal. The patient is covered with a cold sweat, he is sick, vomits, there is a breakdown.
• Myocarditis. The patient complains of a breakdown and fatigue, the temperature rises due to an infectious lesion. The pain is sharp, similar to a heart attack.
• Pericarditis. The pain is aching, occurs due to the thickening of the outer shell of the heart and the accumulation of fluid in the cavity. The function of the heart is impaired. The symptoms are similar to those of angina pectoris.

Diagnostics

Diagnosis of heart disease occurs through a visual examination of the patient, a conversation with the patient.

X-ray, MRI, tomography, cardiac catheterization, ECG are performed.

Treatment

1. Pathologies caused by an infectious nature are eliminated by a course of antibiotics.
2. Conservative treatment with antiplatelet agents, nitrates, diuretics, anticoagulants.
3. Surgical intervention.

Pathology of the heart vessels

Clinical picture

• Angina. Pathology is characterized by incomplete blockage of the artery. The nutrition of the heart muscle becomes weaker, but does not stop completely. Pain is sharp, radiating to the shoulder, arms and jaw. The pain is paroxysmal and lasts from 15 to 25 minutes.
• Cardiac ischemia. It is characterized by a lack of blood supply to the tissues, a violation of blood flow. There are pains at the top of the sternum, which are first observed only during exercise, and then when the patient is at rest. The pain is acute, the duration of discomfort can last up to 30 minutes. The pain radiates to the shoulder blade, throat. The patient has shortness of breath, the heart beats strongly, there is a violation of the heart rhythm.

Diagnostics

To identify the causes of pain, the doctor uses a visual examination of the patient, a conversation with the patient.

In addition, x-rays, MRI, tomography, cardiac catheterization, ECG are performed.

Physician Intervention

For treatment, consultation and appointment with a cardiologist is necessary.

Treatment

1. Surgical intervention is used (shunting, stenting of the affected vessels).
2. Conservative drug treatment.

Frequent panic and anxiety states

Patient feels constant anxiety, excited.

Expert opinion

Astafiev Igor Valentinovich

Neurologist - City Pokrovskaya Hospital. Education: Volgograd State Medical University, Volgograd. Kabardino-Balkarian State University named after A.I. HM. Berbekova, Nalchik.

This condition occurs due to constant overwork, stress, chronic diseases.

Clinical picture

The patient complains of constant fear for no apparent reason, attention worsens, nervousness occurs. A person is easily irritated, quickly tired, his head is spinning.

There is dryness in the mouth, limbs tremble, there may be a slight tingling in the arms and legs.

The patient complains of muscle pain, nausea, migraine, sleep disturbances. His palms are sweaty.

The nature of the pain at the top of the sternum: frequent burning in the chest.

Physician Intervention

The patient needs the help of a neurologist.

Diagnostics

To determine the presence or absence of a condition in a patient, doctors use psychological tests, for example, a personality anxiety scale, etc.

Treatment

• Doctors are not in a hurry to immediately prescribe a lot of medicines, but recommend relaxation through yoga, meditation, sports, and walking.
• If all else fails, then the patient is prescribed selective serotonin reuptake inhibitors. These drugs raise the level of serotonin in the blood, relieving anxiety and improving mood.
• With severe anxiety, benzodiazepines (diazepam, lorazepam) are recommended.

Diseases of the respiratory system

Pathologies affecting the respiratory organs may present as chest pain.

The nature of the pain depends on the pathology, its stage and the area of ​​the lesion.

Physician Intervention

For the treatment of the patient, it is necessary to consult a ENT, pulmonologist, phthisiatrician.

Diagnosis

Methods for diagnosing pathologies of the respiratory system are divided into several groups:

• General methods (inspection, palpation, percussion)
• Laboratory methods (sputum analysis, blood gas analysis)
• Methods that allow to study the functioning of the lungs (spirometry, ultrasound of the lungs).
• X-ray.
• Computed tomography of the lungs
• Visual examination (laryngoscopy, bronchoscopy, etc.).

Clinical picture

The main symptoms of lung diseases: migraine, fever, cough. The patient complains of aching pain in the sternum or spasms that occur when coughing and breathing. It is difficult for him to breathe, breaks bones and joints. Febrile conditions often begin, pulmonary edema is possible with some pathologies of the respiratory system.

Treatment

• Conservative treatment with sulfonamides, bronchodilators, antiallergic drugs,.
• The use of mucolytic drugs and inhalations is recommended.
• Aerosol therapy

Neuralgia in the thoracic region a condition characterized by severe pain and irritation of the nerves between the ribs.

The spaces between the ribs change and compress nearby nerves.

Diagnostics

The diagnosis is revealed with the help of a cardiogram, because the pains are often similar to those of the heart. The doctor can also identify the disease by palpation, based on laboratory tests.

Diagnostic methods using instrumental studies will also help to exclude heart disease (for example, the use of an ECG). Fluorography and MRI will also help to identify neuralgia.

Physician Intervention

To prescribe treatment, you will need to consult a neurologist.

Clinical picture

Pain begins in the area of ​​the ribs, then gradually shifts up the chest, in the lower back, in the back. Often the pain is girdle, but it can move to the left and right side. The pain intensifies with movement, the nature of the pain is acute, similar to spasms. Individual muscles may twitch, the color of the skin may change.

The patient has increased sweating, numbness in some areas of the skin and loss of sensitivity.

• If the disease is caused by an infection, then the root cause must be eliminated before starting treatment.
• Medicines that relieve inflammation and relieve pain. The course of treatment is from 5 to 10 days
• . They relax the muscles, increasing the gaps between them, eliminating the gaps between the ribs.
• Massage
• Manual therapy.

Oncological diseases

This malignant or benign neoplasms developing in the chest.

Physician Intervention

The patient needs to consult an oncologist.

Clinical picture

Pain at first occurs periodically, as the tumor grows, intensifies and becomes permanent. The pain is unbearable, the person loses his appetite, suffocates, the skin turns pale.

The patient is losing weight.

Diagnostics

1. Fluorography, x-ray
2. Ultrasound of the lymph nodes
3. Blood tests

Treatment

1. Surgical intervention
2. Chemotherapy course
3. Targeted Therapy
4. Biological therapy course
5. Irradiation with gamma rays
6. Palliative care (used when the patient cannot be cured, but it is still possible to prolong life).

Localization of pain on the left

Pain in the chest begins on the left with the following diseases:

• angina,
• heart attack,
• pleurisy,
• pneumonia on the left side
• peptic ulcer of the gastrointestinal tract,
• diaphragmatic hernia.

Localization of pain on the right

Pain in the right chest begins due to:

• pneumonia localized on the right side,

• pleurisy
• for problems with the liver and gallbladder
• inflammatory processes in the diaphragm
• thoracic injuries
• pancreatitis.

In which case immediately see a doctor?

1. An acute attack occurred suddenly and for no apparent reason
2. The person began to choke, shortness of breath began, the heart beats faster
3. When trying to eliminate soreness with nitroglycerin, it is not possible to stop the pain
4. Cough with bloody sputum
5. The patient loses consciousness
6. Severe nausea and vomiting.
7. Pain is given to the neck, shoulder, jaw

First aid, how to relieve pain?

1. We release a person from clothes that pinch the cervical and thoracic regions
2. If the person is conscious, then try to understand what caused the attack (trauma, cardiac pathology)
3. A person suffering from heart disease usually carries pain-relieving drugs in his pocket. Your task is to help him drink them.
4. If the cause is trauma, then try not to touch the patient until the ambulance arrives, immobilizing as much as possible.
5. If it is impossible to relieve pain during heart disease, and the attack continues, urgently call an ambulance. Every minute counts.

What to do before the ambulance arrives?

• If a heart attack occurs during exercise, the patient should immediately stop it.
• We sit down a person so that his legs are lowered
• We give access to oxygen (unbutton the shirt, open the window)
• Call an ambulance urgently
• The patient is given nitromint, nitroglycerin or validol (1 tablet). If necessary, repeat the administration of the drug.
• If 5 minutes have passed and the pain has not subsided, then the patient is given an aspirin tablet (or 4 tablets of clopidogrel).
• In case of cardiac arrest or loss of consciousness with respiratory arrest, we do an indirect heart massage and artificial respiration.

Based on this, we can conclude that there are many causes of chest pain, but this formidable symptom should not be left unattended. It can be a sign of myocardial infarction or other serious pathologies.

Therefore, at the first signs of the disease, one cannot self-medicate, but a complete examination and treatment by a qualified specialist is necessary.

Summarizing

1. Sharp, constricting pain in the upper chest that prevents you from taking a full breath may indicate the development of a life-threatening condition and requires immediate medical attention.
2. Periodically manifesting pain in the upper chest is often found in pathologies of the gastrointestinal tract, respiratory organs and neuralgia.
3. If pain appears after an unsuccessful movement of the neck or chest, the cause may be associated with progressive osteochondrosis of the spine, which compresses the nerve endings, causing shooting pains.
4. Neoplasms in the larynx and bronchial branches, as they grow and increase in size, compress nearby tissues, irritating the nerve endings.
5. You should immediately consult a doctor if, along with acute pain, the breathing process is disturbed, the heart rate is lost, the color of the skin changes.
6. First aid is to provide vital processes, including breathing and heartbeat.

Pain in the middle of the sternum can occur for a variety of reasons. And this does not always indicate problems with organs that are directly in the localization zone. Often such sensations can be an echo of diseases even of those organs that are located in the abdominal cavity. In order to start the correct effective treatment, it is necessary to accurately establish the cause and in the future build on it, and not ignore the phenomenon. Our body always signals us in time about any problems that have arisen. Therefore, it is important to learn to hear and correctly understand these signals.

Possible causes of pain in the middle of the chest in women and men

One of the most common causes is, of course, all sorts of heart problems. For example, angina pectoris, ischemic disease and even myocardial infarction. In any of these cases, a person feels pain on the left side, but it can radiate to different places and be felt, including in the middle of the chest. Painful sensations are very strong and have a stabbing character. It seems to a person that thousands of needles are stuck into him. Such symptoms are extremely dangerous, since heart disease can even lead to death.

If the pain occurs suddenly and unexpectedly, then you can even lose consciousness. At this moment, the person's pulse quickens noticeably, and the face and lips become pale. You should call an ambulance or, if the attack was short, immediately make an appointment with a cardiologist. Nitroglycerin, which instantly dilates blood vessels, will help normalize a person’s condition.

Sometimes lung disease is the cause. For example, pleurisy, pneumonia, bronchitis and tracheitis. In this case, the pain will increase with a strong sharp sigh and cough. It is quite simple to explain the pain in this case - these diseases cause damage to the diaphragm and intercostal muscles.

Sometimes various problems with the gastrointestinal tract lead to pain in the middle of the sternum. For example, diaphragmatic abscess, duodenal ulcer or stomach ulcer. Because of them, stomach pain can radiate to the chest area.

Symptoms

Only an experienced specialist can accurately determine the cause of the appearance. Often during the appointment, the doctor asks the patient additional questions that allow you to identify other symptoms of a particular disease.

• For example, if a person begins to experience pain due to problems with the gastrointestinal tract, then additional symptoms will be pain in the stomach or in the left hypochondrium, frequent heartburn, nausea, and even vomiting for no apparent reason. Here, the patient will be assigned additional tests and examinations related to the state of the stomach, which will help to make an accurate conclusion about the cause of the pain.
• In lung diseases, additional symptoms are cough, sore throat and sore throat, often fever. If the diagnosis is confirmed, then the treatment will eventually be directed precisely at eliminating problems with the lungs.
• If the cause of the pain lies in an unhealthy heart, then the person will periodically feel tingling and discomfort in this area, will often get tired, he may experience shortness of breath even with minimal physical exertion, it will be difficult to breathe.

Diseases that can cause pain in this area

Diseases may include:

• , reflux esophagitis, gastric and duodenal ulcer, diaphragmatic abscess;
• pleurisy, pneumonia, tracheitis and bronchitis;
• thyroid disease;
• angina pectoris, heart failure and ischemic disease;
• osteochondrosis and other diseases that lead to unstable work of the thoracic spine.

Even despite the abundance of medicines and preparations on the shelves of modern pharmacies, it is almost impossible to instantly eliminate and even alleviate chest pain caused by all the diseases described above.

First, you will need to go to an appointment with a specialist who can diagnose the main cause of pain, and then the patient will be prescribed a long-term complex treatment.

Even if the pain appears rarely and is poorly felt, this may indicate the development and complication of a disease. Therefore, the sooner treatment is started, the less the disease will bring consequences for the human body.

Pain in the sternum with injuries

It can also appear due to injuries resulting from traffic accidents, falls or other damage. If a person received a blow in this zone, then this can lead to a rupture of the muscles, which cause severe pain. As a rule, in these cases, the pain will clearly increase with deep sharp exhalations and inhalations, turns, bends and some other physical exercises.

If the injury was especially strong and serious, then the pain can be felt even by pressing on the middle of the chest or simply by placing a hand in this area. Most likely, this indicates a fracture or crack in the bones.

In this case, it is necessary to urgently contact the surgeon, as well as take a picture that will allow you to establish the exact cause. Until the visit to the doctor, the patient should avoid physical activity and be at rest, so as not to worsen his condition by careless movement.

Discomfort after exercise

If the pain appeared after sports training, then there may be several reasons for this. More often it occurs in beginners in sports who perform exercises on the pectoral muscles, forgetting about safety precautions or exceeding their capabilities (excessive loads).

This also applies to athletes who prefer exercises such as push-ups on the uneven bars, especially with weights.

If the whole thing is a banal overload, then after 2-3 days the pain should go away. Otherwise, you need to consult a doctor.

Video with a professional doctor about the work of the thoracic spine

Chest pain with osteochondrosis signals problems in the thoracic spine. The nature of the pains is squeezing, stabbing, cutting, a burning sensation is felt. Pain can radiate to the heart, masquerading as diseases of the cardiovascular system.

Chest pain can be manifested by taking a deep breath, staying in one position for a long time, raising your hands, as well as coughing, sneezing. Often the syndrome can worsen at night, cause shortness of breath, and cause a person to panic.

Many people do not know that pain is due to and turn to a therapist or cardiologist. An experienced specialist is able to recognize the true cause of the disease and refer the patient to a neurologist for diagnosis and further treatment of the spine.

The chest hurts due to osteochondrosis: how can this be?

Pain in the chest is often a clear sign of thoracic osteochondrosis. This section is the most durable part of the spine, but it is not worth excluding the presence of pathology in it. Lack of physical activity, weight lifting are the factors that provoke the development of thoracic osteochondrosis. Their constant impact negatively affects the state of the cartilage and bone tissue of the spine: intervertebral discs are destroyed, osteophytes appear.

When moving, they compress the spinal roots and blood vessels: blood circulation in the chest organs worsens, their innervation is disturbed. If osteochondrosis progresses, the pressure on the paravertebral structures increases - pain appears.

The figure shows the pressure of the vertebra on the nerve endings of the spinal cord.

Localization of pain may be different. It all depends on in which area of ​​the thoracic region the intervertebral discs are destroyed. If the roots located in the zone of 2-3 vertebrae are pinched, pain manifests itself in the chest.

Pain in the chest can also appear with pathology in the cervical spine. However, in most cases, pain in the sternum indicates thoracic osteochondrosis.

Characteristics of pain in the chest with osteochondrosis

Thoracic osteochondrosis is the most "insidious" form of the disease, since in the first stages of its development it may not manifest itself at all. The pain syndrome occurs much later: when a protrusion or intervertebral hernia has formed. In this case, the pain:

• appears when moving, tilting and turning the body, sneezing and coughing;
• intensifies when trying to take a deep breath and exhale;
• gives to the stomach, liver or heart;
• accompanied by discomfort in the right or left hypochondrium;
• has a one- or two-sided character (with lateral and median hernia, respectively);
• disturbs constantly or occurs periodically.

All pain in the chest with thoracic osteochondrosis is divided into two categories (see table).

The most severe manifestation of thoracic osteochondrosis is acute pain in the ribs (intercostal neuralgia). In intensity, they are second only to renal colic.

In addition to pain in the chest with osteochondrosis, the patient may experience other symptoms of radicular syndrome:

• violation of skin sensitivity ("crawling") in the area of ​​the affected vertebrae;
• deterioration of reflexes, decreased muscle tone, which are located below the chest;
• cold snap, pallor of the skin of the lower extremities;
• heart pain;
• cough, shortness of breath.

The clinical manifestation of thoracic osteochondrosis resembles the symptoms of pneumonia, pathology of the cardiovascular system (see table).

It is impossible to determine why the chest hurts without consulting a doctor. Only a specialist can make a correct diagnosis.

Osteochondrosis or organ diseases: how to find out why it hurts in the chest?

It is possible to identify the exact cause of chest pain only after a comprehensive examination. In order to exclude diseases of the heart and lungs, the patient undergoes an ECG, echocardiography, and fluorography. If pathologies of the chest organs are not detected, the following methods of examination of the spine are prescribed:

1. Contrast discography - is performed to assess the condition of the intervertebral discs (the formation of cracks, protrusions).
2. Myelography is the diagnosis of the spinal cord using a contrast medium.
3. Computed, magnetic resonance imaging - help to determine the stage of osteochondrosis, the type of pinched root, to identify the place of destruction of the intervertebral disc.

The use of CT and MRI is relevant for suspected osteochondrosis, spondylarthrosis, tumor of the spine and surrounding tissues, preparation for surgery. Such diagnostic methods help to make a diagnosis, determine the nature of complications, the amount of necessary therapy. In severe cases, the results of the examination are transmitted to specialists around the world via the Internet.

If osteochondrosis is a “provoker” of pain in the chest, the pictures show the following:

• reduction in the height of the intervertebral discs;
• compression of the spinal cord, its roots and blood vessels (in the chest form of osteochondrosis, compression myelopathy is rare);
• the presence of osteophytes on the vertebrae, protrusion or intervertebral hernia;
• inflammation of the roots and tissues surrounding the spine;
• severe scoliosis, lordosis or kyphosis.

In patients with thoracic osteochondrosis, the risk of developing bronchial asthma and inflammation of the heart muscle is significantly increased. Therefore, after confirming the relationship between chest pain and spinal pathology, treatment should be started immediately.

What to do if osteochondrosis is the “culprit” of chest pain?

If chest pain occurs due to compression of the spinal roots, which are responsible for the nerve supply of the chest organs, the spine should be treated. Therapy of osteochondrosis involves the use of medications, auxiliary methods of treatment. Its main goals are to reduce pressure on the roots, improve metabolic processes in the tissues of the spine, and restore the functions of damaged neurons.

Drug treatment is indicated in the acute period of the disease. It includes the following medications:

Non-steroidal anti-inflammatory drugs:

• relieve inflammation at the site of compression of the roots, vessels of the spinal cord;
• reduce tissue swelling;
• reduce the severity of pain.

Chondroprotectors. Operating principle:

• restore the elasticity of the intervertebral discs;
• saturate damaged tissues with nutrients;
• prevent further destruction of cartilage.

Painkillers and warming drugs. Result after applying them:

• normalizes blood circulation in the affected area;
• muscle stiffness disappears;
• the metabolism in bone and cartilaginous tissues is activated.

Vasodilators and improving exchange processes:

• relieve spasms of blood vessels;
• stimulate blood flow to the chest organs and damaged tissues;
• speed up metabolism.

With severe pain in the chest, glucocorticoids or novocaine blockades are sometimes used.

Additional methods of treating osteochondrosis are used in combination with drug therapy. As a rule, appoint:

Physiotherapy procedures- help relieve pressure from the roots, eliminate muscle spasms. A positive effect in osteochondrosis is exerted by:

• mud treatment;
• exposure to laser, ultraviolet;
• shock wave therapy;
• acupuncture.

Massage, manual therapy(do not use in the acute period of the course of the disease). Therapeutic action:

• muscle functions are restored (pathological reflexes disappear);
• improves blood circulation in the tissues of the spine, chest;
• metabolic processes in the body are normalized.

Manual therapy is not used for severe pain in the back and chest, pregnancy, fresh spinal injuries, exacerbation of chronic diseases and high blood pressure.

Therapeutic gymnastics. The effect of training:

• the muscular corset is strengthened;
• the functions of the joints, ligaments and muscles are restored;
• the static tension of a backbone decreases.

The effectiveness of physiotherapy exercises is much higher if you perform exercises in warm water. Swimming is no less useful for chest osteochondrosis.

The recovery of the patient largely depends on how well he eats. A balanced diet helps to quickly cope with the disease, restore the functions of all organs and body systems. Therefore, with osteochondrosis, accompanied by pain in the chest, it is recommended:

1. Include in the menu dishes that contribute to the restoration of cartilaginous tissue (jelly, jellied fish, jelly).
2. Eat foods rich in fiber and calcium (fresh vegetables, fruits, milk, cottage cheese).
3. Eat 4-5 times a day: in small portions. Overeating is one of the causes of weight gain, and it is known to increase the load on the spine.
4. Minimize the consumption of salty foods, sweets, smoked meats.
5. Drink as much water as possible (lack of fluid in the body negatively affects the condition of cartilage tissue).
6. Refuse strong coffee and tea (caffeine leaches calcium).

It is possible to prevent exacerbation of thoracic osteochondrosis if preventive measures are observed. What do we have to do:

1. Perform a light warm-up every two hours of sedentary work.
2. Try to take a horizontal position of the body during the day for 30-50 minutes (so that the spine “rests” a little).
3. Give up bad habits (smoking, alcohol abuse).
4. Engage in active sports.
5. Monitor your posture, evenly distribute the load on your back when carrying heavy objects.
6. Get enough sleep (optimum sleep duration is 8 hours a day).
7. Avoid stress, go out into the fresh air as often as possible.

Pain in the chest can be a symptom of the pathology of the cardiovascular and respiratory systems or a sign of a complicated course of thoracic osteochondrosis. In any case, it is important to consult a doctor in time: he will make the correct diagnosis and prescribe treatment.

Pain in the sternum is an unpleasant phenomenon that can occur due to many reasons. To get rid of pains of such localization, you need to know what caused them. Some conditions may require emergency care. When exactly to “sound the alarm”, and when can you cope with the problem yourself? We'll talk about this and more later.

General concepts

Chest pain is a common symptom that anyone can experience. It is an unpleasant painful sensation in the area of ​​​​attachment of the ribs to the chest. Most often, pain in this part of the body occurs during movements - when walking, breathing, turning and bending, coughing, etc. More rarely - at rest.

Most patients are sure that pain in the sternum is a sign of heart disease. Official statistics show that only in 40-50% of cases, heart disease is the culprit of pain in the sternum.

In 90% of cases, pain occurs due to problems with organs that are located directly in the chest. Only in 10% of cases they are an echo of disorders in the functioning of the organs located in the abdominal cavity.

Such a disease can cause:

• diseases of the cardiovascular system;
• lung pathology;
• diseases of bone and cartilage structures;
• diseases of the digestive tract or diaphragm;
• trauma;
• psychogenic factors.

Causes

Most often, the pain of this localization occurs due to injuries and various diseases. Which ones? Let's consider in more detail.

Diseases of the cardiovascular system

The most common culprits for pain in the sternum are heart disease. We are talking about diseases such as:

• . Pathology in which there are blockages in the vessels supplying blood to the heart. This leads to oxygen starvation of the organ, as well as a decrease in blood flow, which causes pain in the sternum. Unpleasant symptoms appear not only in the chest, but also give to the arm, back area and even the jaw. It seems to a person that the entire chest is compressed. As a rule, such sensations occur during times of severe stress or emotional tension.
• . Pathology in which blood through the artery ceases to flow to the heart is no longer partially, but completely. Blockage of the vessel leads to such a dangerous condition, which is fraught with the death of heart muscle cells. In this case, the patient experiences more severe pain in the left side of the sternum (than with angina pectoris), which radiates throughout the chest and also gives into the arm, persists for a long time (from 30 minutes or more). Pain sensations are of a pronounced burning character.
• . A disease characterized not only by pressing pains in the center of the sternum, but also by violations of the respiratory function and an increase in body temperature. Blockage of the arteries with myocarditis does not occur. Despite this, the general symptoms of the pathology are very similar to those of a heart attack.
• . With inflammation of the pericardium (one of the membranes of the heart), this disease is diagnosed. Pain in pathology is very similar to those that disturb patients with angina pectoris. We are talking about acute pain in the entire sternum of a compressive nature, which is given to the shoulder and arm. With pericarditis, pain can spread not only to the sternum, but also to the neck muscles. Most often, the pain syndrome increases with deep breathing, eating, or lying on your back.
• . Thickening of the heart muscle causing heart failure. This condition interferes with the normal functioning of the heart. As a result, the patient develops left-sided sternal pain of a burning nature, as well as concomitant symptoms of pathology - fatigue, respiratory failure, insomnia, dizziness.
• Mitral heart disease. A disorder in which the heart valve does not close completely. With this diagnosis, a person is tormented by aching pains in the central and left side of the sternum, heart palpitations, and dizziness.
• Atherosclerosis of the coronary vessels. A dangerous condition associated with blockage of the coronary artery by cholesterol plaques. If the blood through the vessel ceases to pass completely, a rupture of the coronary artery may occur. Against the background of pathology, the patient experiences unbearable pain in the sternum or a feeling of a rupture in the chest. Pain can be given to the abdomen, back and neck.

It is not uncommon for lung diseases to cause chest pain. Most often, pain is provoked by banal viral infections, as well as bacterial lesions. More rarely, more serious diseases, such as cancer, become the cause of discomfort in the chest area.

Consider the most common:

• Pleurisy. Inflammatory lesion of the mucous membrane of the lungs, which is characterized by acute pain in the sternum during inhalation and exhalation. In addition to the pain syndrome, a person is disturbed by an intense cough, as well as frequent sneezing.
• Pneumonia. A common cause of sudden pain in the entire sternum that occurs against the background of an infectious process in the lungs. Pathology is accompanied not only by pain, but also by other symptoms - intense cough, fever, profuse sputum discharge.
• Pneumothorax. Damage to the lungs, in which the integrity of the organ is violated and air enters the chest cavity. This process is accompanied by severe pain in the left and right side of the sternum, which intensifies with deep breaths.
• . A disease in which the patient is determined by increased blood pressure in the lungs and nearby large vessels. In this regard, the right side of the heart muscle begins to work more intensively, which causes pain in a characteristic localization - on the right side of the sternum. With pulmonary hypertension, the pain syndrome is very similar to the pain that appears during an angina attack.
• Asthma. An inflammatory disease of the respiratory tract. The patient is tormented by a strong cough, shortness of breath, breathing "with a whistle", sometimes - pressing pains in the central part of the sternum, the trachea region.

Diseases of the gastrointestinal tract

When pain occurs in the sternum, patients rarely attribute them to problems and malfunctions in the gastrointestinal tract. As practice shows, in vain. They often lead to pain. The most frequent diseases:

• Gastroesophageal reflux disease. It is manifested by heartburn and pain in the central upper part of the sternum. It occurs due to the reflux of stomach contents into the esophagus. Very often, this disease can be confused with heart disease, as it seems to the patient that the heart hurts, which is located in close proximity to the esophagus and is connected to it by nerve endings. At the same time, a person complains of burning and pressing pains that occur after eating or intense physical exertion.

In addition to gastroesophageal reflux disease, other pathologies of the esophagus, for example, its hypersensitivity, can also cause chest pain.

• stomach ulcer. It can cause constant pain in the lower part of the sternum and throat. The main problem with this pathology lies in the presence of ulcers on the gastric mucosa. To help cope with the pain in this case, you can eat a light meal, regular baking soda, or tablets used in the treatment of the stomach.

In 90% of cases, ulcers and chest pains occur in people who often drink alcohol and smokers "with experience".

• Pancreatitis. Inflammation of the pancreas, as a rule, causes pain in the lower part of the chest. In this case, the patient's condition worsens with sharp bends forward or in the supine position.
• Diseases of the gallbladder and biliary tract. Pain in the sternum with pathologies of the gallbladder appears after eating fatty foods. A person complains of heaviness in the stomach area, as well as unpleasant pain in the lower right part of the chest.

Injuries

The main reason for the appearance of pain in the middle of the sternum is trauma. They can be very diverse - from a banal fall from a height to a chest hit on the steering wheel in an accident. If after the incident there was pain in the sternum, you need to see a doctor. The specialist will determine whether the pain is the result of serious damage to the internal organs. If the injury is minor, then within a few days the pain syndrome will pass after a properly selected treatment.

A frequent "culprit" of pain in the sternum is a fracture of a rib or several ribs. In this case, the pain is concentrated at the fracture site and is aggravated by pressure on the problem area, deep inspiration and coughing.

Other causes and diseases

In addition to the above diseases, pain in the sternum can cause:

• Stress. They cause pain in the chest, the so-called psychogenic nature. They appear with strong emotional stress and experiences against the background of spasm of the pectoral muscles.
• Sedentary lifestyle. It leads to compression of the chest muscles, which, with reduced physical activity, are squeezed even more.
• Any kind of cough. Cause irritation of tendons and intercostal muscles. Excessive muscle tension provokes pain in the sternum of characteristic localization.
• Enlargement of the thyroid gland.
• Diaphragmatic hernia.
• Osteochondrosis.
• Intercostal neuralgia.
• Congenital pathologies of the spinal column.

Without consulting a specialist, it is very problematic to establish the true causes of pain in the sternum. That is why when they appear, it is worth making an appointment with a doctor.

What to do?

When chest pains appear, one should act on the assumptions that they could cause them.

If the pain in the sternum occurred for the first time and is not too pronounced, you can try to drink any pain reliever. For example, paracetamol. The drug will help relieve muscle spasm and quickly alleviate the condition.

If spasmodic pain is suspected, doctors recommend taking a warm bath or applying heat to the chest (such as a warm but not hot heating pad). This technique will help the muscles to quickly relax, as a result, the pain will recede.

Patients suffering from diseases of the digestive tract, who are aware of their problem, should focus on fractional nutrition. If the pain appeared after eating, you can drink enzyme-containing preparations (for example, Festal or Creon) or a small amount of mineral water.

If you suspect a “cardiac” origin of pain, it is important to immediately call an ambulance team and provide the person with complete rest until the doctors arrive.

In most cases, in the presence of the above-described serious diseases of the heart, gastrointestinal tract or lungs, it is almost impossible to relieve pain in the sternum with lightning speed.

When should you call a doctor immediately?

With some types of pain in the sternum and associated symptoms, it is impossible to hesitate to call an ambulance. You should immediately call the "ambulance" in such situations:

• pain in the sternum appeared after intense physical activity;
• pain syndrome is accompanied by a strong cough (including with blood) or loss of consciousness;
• the pain has a burning character and extends not only to the sternum, but also to the area of ​​​​the shoulders, arms, neck, lower jaw;
• the attack does not go away within 10-15 minutes, including after rest and taking nitroglycerin;
• pain sensations are accompanied by tachycardia, dizziness, nausea or vomiting, increased sweating, fainting;
• soreness in the sternum feels like heartburn, but the usual pills for heartburn do not get rid of it.

Urgent Care

The sudden appearance of severe pain in the sternum of any localization can pose a threat not only to health, but also to the life of the patient, as it is most often caused by a dangerous disease or pathology.

• put the person in a comfortable position, ensure the flow of fresh air into the room;
• give an age-appropriate dose of nitroglycerin to drink;
• take an analgesic;
• apply a pepper plaster or mustard plaster to the place of localization of pain for 5-7 minutes.

Diagnostics

To cope with chest pain and forget about it for a long time, you should undergo a comprehensive examination.

The minimum diagnosis for patients with chest pain includes:

• consultation with a doctor and taking an anamnesis (a specialist asks the patient about diseases of the heart, stomach, lungs, symptoms of pathology, medications taken, etc.);
• ECG (if necessary, an additional load test is performed);
• radiography;
• gastroscopy (comprehensive study of the stomach);
• angiography of the coronary vessels (a series of images of the vessels of the heart muscle).

Additionally, auxiliary research methods can be prescribed - a blood test for markers of myocardial damage, CT, MRI, ultrasound of the abdominal organs and blood vessels.

It is much easier to treat any diseases and pathologies at the initial stage than in an advanced form. Therefore, with the appearance of pain in the sternum, you should immediately start diagnosing and, after making a diagnosis, proceed to treatment.

Most often, with pain in the sternum, the patient is shown:

• drug treatment;
• physiotherapeutic methods of influence.

Any therapy is prescribed only in accordance with a pre-established diagnosis, depending on the reasons that caused them.

If during the examination it was not possible to establish the exact cause of the pain, the person is placed in a hospital for a more thorough comprehensive diagnosis. At the time of the examination, the patient can only be prescribed painkillers.

Possible Complications

Even infrequent and not too intense pain in the sternum can lead to very sad consequences and complications. The latter depend on the cause of chest pains.

The result of ignoring pain attacks in the sternum can be:

• chronic pain syndrome in the chest area, feeling of stiffness between the ribs;
• oxygen starvation of the body;
• violation of the normal mobility of the arms and shoulders;
• pneumonia;
• neuralgia of various origins;
• respiratory failure, up to respiratory arrest.

The most serious complications of chest pain are associated with heart disease. We are talking about heart attacks and which can be fatal.

Forecast

It depends on the root causes of pain in the sternum, as well as the correctness and timeliness of providing assistance to the patient.

Are we talking about a short-term malfunction of the heart or gastrointestinal tract, not severe pathologies of the bronchopulmonary system? Adequate drug therapy can help solve the problem and get rid of it completely.

In 50% of cases, the prognosis for patients with chest pain is favorable.

With serious cardiac pathology, the prognosis is less favorable - the patient may face disability or even death.

Prevention

• give up bad habits that increase the load on the heart, increase blood pressure, and also negatively affect the condition of the lungs, digestive tract, other organs and body systems;
• regularly engage in sports, observing an adequate level of physical fitness training regimen;
• alternate any kind of physical and mental activity with proper rest;
• timely seek medical help for any infectious diseases of the organs of the bronchopulmonary system;
• when sitting at a computer, create comfortable working conditions, regularly perform special exercises to get rid of discomfort in the sternum and between the shoulder blades;
• focus on proper nutrition - abandon harmful foods in favor of healthy food that provides the body with all the necessary vitamins, micro and macro elements.

As you can see, chest pain is a common phenomenon that can occur with various diseases and pathologies. The main thing is to start diagnosing in time, accurately determine the causes of the pain symptom and start treatment. In this case, the risk of encountering complications will be minimal.

If it hurts somewhere, it means that not everything is in order with the body. So many people rightly think so. Pain cannot be tolerated, nor can it be ignored. Especially when the pain is concentrated in the middle of the sternum.

Causes of pain

The sternum is an oblong bone located right in the middle of a person's chest. The ribs are attached to the sternum and together they form the chest. This bone structure protects the heart, large blood vessels, lungs, esophagus from mechanical damage from the outside.

Pain in the sternum in the middle can be caused by such pathological conditions:

1. Diseases of the heart and aorta;
2. Diseases of the esophagus;
3. Diseases of the stomach;
4. Diaphragm diseases;
5. Diseases of the mediastinum;
6. Diseases of the skeletal system;
7. Neuropsychiatric diseases.

Heart disease

If you experience pain in the sternum in the middle, first of all, you need to exclude possible heart problems, as the most dangerous cause. Indeed, in most cases, pain in the sternum is caused precisely by heart disease, and more specifically by coronary artery disease. develops when there is insufficient supply of oxygen to the heart muscle. In conditions of lack of oxygen, the myocardium suffers greatly and gives a signal about this in the form of acute pain. Both , and are clinical forms of coronary artery disease. However, the nature of the pain in these diseases is different.

For angina pectoris, pressing pains behind the sternum are typical. Patients themselves describe this pain as if someone had put a brick on their chest. The pain often radiates to the left arm, neck. Painful attacks last up to twenty minutes, the pain either catches up or releases the person.

Note! A characteristic sign of angina pectoris is the elimination of pain after the use of nitroglycerin.

With a pronounced lack of oxygen, the death of the heart muscle occurs, this is how myocardial infarction develops. This disease is accompanied by pressing, burning pain behind the sternum, but the pain is much more intense than with angina pectoris. Pain can also radiate to the left arm, neck, under the lower jaw, to the entire chest and even the abdomen. Often pain is accompanied by a feeling of pronounced fear of death, cold sweat on the face. The pain is unbearable, does not go away after 15-20 minutes, and is also not stopped by nitroglycerin.

Pain in the sternum can also occur with inflammatory heart disease - and pericarditis. This pathology often occurs after an infectious disease. In general, inflammatory heart disease is characterized by the following symptoms:

• Pain on the left in the chest, as well as the sternum;
• elevated temperature;
• Weakness, malaise.

Aortic diseases

The occurrence of pain in the sternum can also be caused by disease of the aorta, in particular, its aneurysm. This is a local expansion of the aorta. in the early stages it is asymptomatic, but as the disease progresses, characteristic symptoms appear.

Symptoms of a thoracic aortic aneurysm are:

• Prolonged pain in the sternum, heart area (pain attacks can last several days);
• The pain does not radiate;
• It is not eliminated after the use of nitroglycerin.

The danger of the disease is that at any time a dissection of the aneurysm can occur, which leads to fatal bleeding. The rupture of an aneurysm of the thoracic aorta is evidenced by such symptoms as the appearance of a sharp pain behind the sternum, often radiating to the back, as well as a drop in blood pressure.

Diseases of the esophagus

The esophagus is located along the sternum. Therefore, it is not surprising that diseases of this organ are often manifested by retrosternal pain. One of the most common diseases of the esophagus is achalasia of the cardia.. This is insufficient relaxation of the lower esophageal sphincter (cardia), which disrupts the esophagus. Thus, during swallowing, the food bolus gets stuck at the level of the spasmodic lower esophageal opening and cannot pass further into the stomach.

The symptoms of achalasia are:

The appearance of pain in the sternum in the middle can also be associated with (synonymous with GERD). The disease is characterized by the development of inflammation of the mucous membrane of the esophagus due to the reflux of gastric contents. Retrosternal pain in GERD can radiate to the interscapular region, neck, lower jaw, left side of the chest. It is worth noting that esophageal pain is often mistakenly perceived as an angina attack due to a similar clinical picture. However, chest pain in GERD has its own characteristics:

1. Pain in the sternum occurs after eating;
2. Increases after tilting the body forward, as well as in a horizontal position of the body;
3. Decreases after the use of antacids.

Important! In favor of GERD, symptoms such as belching sour, regurgitation of food also testify.

Diaphragm diseases

The diaphragm is a muscular-tendon plate that separates the chest cavity from the abdominal cavity. The diaphragm has a natural opening - the esophagus, through which the esophagus exits the chest cavity into the abdominal cavity. The development of a hernia of the esophageal opening of the diaphragm is said to occur when the organs of the abdominal cavity protrude into the chest cavity through the indicated opening.

Diaphragmatic hernia occurs with pain in the sternum in the middle and below, spreading to the epigastric region. The pain can radiate to the back, the interscapular region, and even to the hypochondrium, which mimics girdle pain when. Features of retrosternal pain in diaphragmatic hernia:

• Pain often occurs after eating, aggravated by coughing, after lifting weights;
• Increases after tilting the body forward;
• Decreases after belching, deep inspiration, or if the person assumes an upright position;
• Pain can be described as moderate, dull;
• Pain accompanies the symptoms of GERD.

Stomach diseases

It is known to present with pain in the epigastric region, often extending to the lower part of the sternum. Depending on the location of the ulcer, pain can also radiate to the left half of the chest, right hypochondrium, and back. The occurrence of pain is directly related to food intake. Often, discomfort appears half an hour or an hour after eating.

Ulcer pains are relieved by drugs that reduce gastric secretion. In addition, at the height of a painful attack, a person may experience acidic contents, which brings relief. Belching also testifies in favor of peptic ulcer,. It is also worth noting that in rare cases, acute pain in the sternum is also manifested, although localization of pain in the upper abdomen is more characteristic of this ailment.

Respiratory diseases

Diseases of the lungs, pleura occur with pain in the chest from the side of the lesion. But pain directly in the sternum in the middle can manifest itself only tracheobronchitis. Usually this disease develops within. Therefore, at the beginning of the disease, a person is concerned about weakness, fever, and sore throat. Discomfort quickly descends, spreading to the trachea and bronchi.

Pain in tracheobronchitis is localized behind the sternum in its upper and middle third and intensifies in time. At the beginning of the disease, the cough is dry, unproductive. When a person coughs, he feels an unpleasant soreness behind the sternum. After a few days, the cough becomes wet, the sputum comes off more easily. The pain behind the sternum gradually decreases, the general state of health improves.

Diseases of the mediastinum

The mediastinum is the anatomical space located in the chest cavity. In front, the space is limited by the sternum, behind the spine, and the lungs are located on the sides of the mediastinum. The mediastinum contains the following organs:

• thymus;
• Trachea;
• Upper esophagus;
• Heart;
• main bronchi;
• Large vessels and nerves.

Inflammation of the tissue of the mediastinum is called mediastinitis. The disease develops when an infection enters the mediastinum from neighboring inflamed organs (trachea, lungs, esophagus, heart, etc.), or when the mediastinal organs are injured. Acute mediastinitis develops suddenly and its first sign is the appearance of intense pain behind the sternum. Pain is especially aggravated when swallowing and tilting the head back. There are also signs such as:

• Fever;
• Chills;
• Profuse sweat;
• Cough;
• Suffocation;
• Violation of the heart rhythm;
• Puffiness of the face and upper body;
• Blueness of the skin.

Note! Mediastinitis is a very serious condition and requires urgent medical attention.

Diseases of the skeletal system

It is logical to assume that pain in the sternum can be provoked directly by diseases of this bone. But it is worth noting that diseases of the sternum are very rare. Therefore, if retrosternal pain occurs, first of all, it is still necessary to think about a possible pathology of the heart or esophagus.

In trauma practice, doctors, although rarely, are still faced with. People get this injury as a result of an accident when their chest hits the steering wheel, less often - with a direct blow to the sternum or strong compression of the chest. With a fracture, the victim feels severe pain in the sternum, aggravated by breathing. In the area of ​​the fracture, edema and subcutaneous hemorrhage are determined. With the displacement of fragments of the sternum, damage to neighboring organs, in particular the lungs, with the development of pneumo- or hemothorax is possible.

The sternum, like any other human bone, can be affected by a malignant process.. Breast cancer is a rare disease, but it is still worth mentioning. Cancer can occur in the sternum primarily or secondarily - after the penetration of metastases into the bone. At the initial stages, the disease does not manifest itself in any way and the patient is not even aware of his diagnosis. As the disease progresses, weakness, malaise, anorexia, low-grade fever develop. Also at this stage, a person begins to be disturbed by pain in the sternum.

Neuropsychiatric diseases

Sometimes a person goes to the doctor with a disturbing pain in the sternum, but after conducting research, it turns out that the person is absolutely healthy. In this case, the pain is psychogenic in nature, this condition is also called cardioneurosis. The patient himself describes his painful sensations, as if a lump or stone behind the sternum. There may also be a complaint about a rapid heartbeat, interruptions in the rhythm, "as if the heart wants to jump out." As a rule, all these phenomena occur after emotional experiences. A person is very worried about retrosternal pain, suspects that he has a dangerous disease. In general, a person with cardioneurosis is characterized by anxiety, anxiety, multiple fears,