Fibromyalgia And Chest Pain: What Does Fibromyalgia Chest Pain Feel Like?
A few years ago I began to have a “new" pain that was not one of my usual aches from fibromyalgia. I started hurting in my chest under my breastbone and above my ribs. It hurt when I moved, stretched, and if I took a deep breath. It was a stabbing pain which was aggravated as I moved.
Though I was quite familiar with fibromyalgia tender points, I had forgotten exactly where the ones in the chest area were. Because my pain was more in the center-left of my chest, I went to the doctor to rule out any heart issues.
Thankfully, the pain was not due to my heart. It was possible that it could’ve been due to over-extending a muscle, but most likely a new trigger point from fibromyalgia. Whatever it was caused from, it hurt terribly!
The truth is, fibromyalgia pain can sometimes extend to the chest. This pain feels like an intense stabbing sensation primarily in the center of the chest, around the breastbone and rib cage which is precisely where my symptoms were occurring.
The pain did mimic a heart attack to some degree and was both painful and frightening. Discomfort can vary depending on how active you are. During this time of my chest pain flare-up, I had been pushing myself to do a difficult level of yard work during the hot summer which worsened my pain and symptoms.
Symptoms of fibromyalgia chest pain include:
- Feelings of intense sharpness or stabbing
- Inflamed or burning sensation
- Mild ache or chronic chest ache
- Knotted muscles
- Tightness in the chest
This restrictive sensation can affect the respiratory system, making it difficult to breathe and causing shortness of breath. This breathing problem is something that I had not noticed in all these years of living with fibromyalgia until the last year, or so which leads me to believe that conditions can worsen over time.
Causes of Fibromyalgia Chest Pain
While there is still debate on what causes fibromyalgia and the accompanying pain such as chest pain, there are several factors that are believed to contribute to its symptoms:
- Heredity factors. Many believe that fibromyalgia-like other illnesses can be inherited. Studies have shown that there is a correlation with various conditions running in families.
- Trauma or injury to the chest. When our systems are weakened whether the muscular system due to injury or the neurological system due to mal-absorption of vitamins, it makes sense that we would be more susceptible to an auto-immune disorder such as fibromyalgia.
- Infections that affect how the nervous system responds to pain or heighten your sensitivities. When the nervous system is damaged in some way, sensors do not correctly gauge or react to pain as they should. I found this to be true after a prolonged undiagnosed span of time with malabsorption of vitamin B12. By the time the issue was discovered, I had irreparable damage to nerves in my body. I was suffering from peripheral neuropathy along with fibromyalgia.
- Low hormone levels - such as dopamine and serotonin - that prohibit communicating pain signals. I have also experienced this as well where my stress hormone cortisol was depleted putting me in adrenal fatigue and exasperating my fibromyalgia pain.
Treating Fibromyalgia Chest Pain
Treatment for fibromyalgia and accompanying chest pain focuses on reducing pain, minimizing symptoms, and incorporating self-care techniques. Not all treatments are effective for each symptom.
- Pain relievers: Some over-the-counter medications, like ibuprofen, naproxen, and acetaminophen. For example, can help to reduce pain temporarily. Depending on the severity of your discomfort, your doctor may prescribe a stronger painkiller. Keep in mind that if any of the pain is associated with nerves as well as muscles and cartilage, pain medication may not be nearly as effective. Most all FMS medications tend to become less effective over time as your system grows immune to them.
- Physical therapy: Exercises from therapy sessions can teach you how to build strength and stamina to deal with chronic pain symptoms.
- Counseling: You can express your discomfort healthily through counseling sessions. Your counselor can teach you strategies to deal with your pain and psychological strains. They may also recommend meditation techniques to help you learn how to live and breathe past your pain. Because pain is triggered by your brain and not your body, meditation is designed to allow you to focus, breathe and better control your reactions to pain.
Another Condition To Consider
It is believed that fibromyalgia chest pain, in particular, is not necessarily an effect of fibromyalgia, but a separate condition common among fibro sufferers called costochondritis.
Why Do They Go Together?
Estimates are that between 60 and 70 percent of people with fibromyalgia have symptoms very similar to costochondritis.
In one study, non-specific chest pain is listed as the most common reason people with fibromyalgia were hospitalized. Another study lists fibromyalgia as a frequent cause of musculoskeletal chest pain.
No one is exactly sure whether it is true costochondritis or why it occurs with fibromyalgia. If the hypothesis of inflammation of the fascia is accurate, that may explain it.
Also, the fibromyalgia tender points just beneath the collarbone may play a role. Myofascial pain syndrome, which is common in FMS, also could be a cause.
Costochondritis is typically a minor injury that heals within days. If symptoms don't clear up, they could be a sign that something else, such as fibromyalgia, is going on.
Before we talk about the what costochondritis is, symptoms of costochondritis, and how this condition can go hand-in-hand with fibromyalgia, let’s discuss one other condition that can be the culprit of chest pain so that we can make an accurate comparison.
Fibromyalgia and Pleurisy
Pleurisy is an inflammation of the lung lining rather than the connective cartilage of the ribs. Both costochondritis and pleurisy are due to inflammation but in different locations. The severity of pleurisy can range from mild to life-threatening.
Since many cases are mild and resolve themselves without treatment, it is hard to estimate how many people contract pleurisy worldwide.
Fast facts on pleurisy:
Here are some key points about pleurisy. Since the invention of antibiotics, pleurisy has become rarer.
- Pleurisy lasts from a few days to 2 weeks and often resolves without treatment.
- There are many potential causes of pleurisy, including pancreatitis, lung cancer, and chest wounds. It's important to know that there is no evidence that pleurisy is either caused by fibromyalgia nor is it a condition of fibromyalgia.
Pleurisy Causes
A variety of factors can cause pleurisy. In many cases, it occurs as a complication of other medical conditions.
Sickle cell anemia is a potential cause of pleurisy. It is characterized by the presence of red blood cells shaped like sickles.
The most common cause is a viral infection of the lungs spreading to the pleural cavity.
Other causes include:
- Bacterial infections, such as pneumonia and tuberculosis
- A chest wound that punctures the pleural cavity
- A pleural tumor
- Autoimmune disorders, such as lupus and rheumatoid arthritis
- Sickle cell anemia
- Pancreatitis
- Pulmonary embolism
- Heart surgery
- Lung cancer or lymphoma
- A fungal or parasitic infection
- Inflammatory bowel disease
- Familial Mediterranean fever
- Certain medications, such as procainamide, hydralazine, or isoniazid
Infections can sometimes spread, but it is rare to contract pleurisy from another person. It is not contagious.
Pleurisy more often affects people aged over 65 years, those with existing medical conditions, or those who recently experienced a chest injury or underwent heart surgery.
Also, pleurisy and smoking are not strongly connected. Cigarettes are rarely the direct cause. However, an individual with pleurisy is advised to avoid smoking as it often leads to coughing, and this can increase the pain.
It's important to know that ruling out pleurisy will assist in determining if your chest pain is due to fibromyalgia, costochondritis or both.
What Are the Symptoms of Pleurisy?
The main symptom of pleurisy is a sharp, stabbing pain, or a constant ache in the chest. The pain may be present on one or both sides of the chest, the shoulders, and the back. It will often get worse with the motion of breathing.
Other symptoms include:
- Shortness of breath, or rapid, shallow breathing
- Coughing
- Unexplained weight loss
- Rapid heartbeat
A viral infection often causes pleurisy. In these cases, symptoms may also include:
- A sore throat
- Fever
- Chills
- Headaches
- Joint pain
- Muscle aches
As you can see some of the symptoms are similar to those of fibromyalgia chest pain which is why it is important to see your physician for proper diagnosis.
Diagnosing Pleurisy
A physician will diagnose pleurisy through a physical examination and by asking about recent and general medical history.
They will search for the cause of the inflammation and rule out other potential triggers of the symptoms. Sometimes, a person with pleurisy may have a previously unnoticed rib injury or infection.
Simple physical exams will be carried out. Sometimes a doctor can hear the pleural membranes rubbing together using a stethoscope. This sound is known as a pleural friction rub.
Chest X-rays will most likely be ordered, and the doctor may take a blood sample to check for autoimmune disorders.
Fluid can build up in the lung in a process known as pleural effusion. The doctor might use a needle to take a fluid sample from the pleura for testing. This is called a thoracentesis.
Pleurisy can also be diagnosed through imaging tests, such as a CT scan or MRI scan. A biopsy can also identify pleurisy if cancer is suspected to be the cause.
Pleurisy Treatment
Treatment of pleurisy focuses on resolving the cause, such as a virus or other infections. Antibiotics will be prescribed if the inflammation is a result of a bacterial infection.
In some cases, an individual may need to have fluid drained from the pleural cavity through a tube that is inserted into the chest.
Pain can be managed with aspirin, ibuprofen, or non-steroidal anti-inflammatory drugs (NSAIDs). In severe cases, prescription pain and cough medicines may be used, including codeine-based cough syrups.
A blockage in the blood vessel that runs from the heart to the lungs is called a pulmonary embolism. The person with pleurisy may be placed on blood thinners if the physician diagnoses a pulmonary embolism.
If the cause is related to an autoimmune condition, such as lupus, then a rheumatologist will treat the disease with medication.
Treatment depends largely on the cause and the severity of the condition.
Costochondritis and Fibromyalgia: What Causes Costochondritis?
Costochondritis is an inflammation of the cartilage that connects your ribs to your breastbone. Depending on how much inflammation there is, it can range from a mild annoyance to extremely painful. People sometimes describe the pain as stabbing, aching, or burning – quite similar to the symptoms of FMS related chest pain.
The causes aren't clear but may include:
- Chest trauma, such as from a car accident
- Repetitive trauma or overuse
- Viral infections, especially upper respiratory infections
Some experts believe fibromyalgia may cause costochondritis as well. Regardless, FMS can make costochondritis much more painful because of the over-sensitivity to pain and the many surrounding trigger points in the chest.
Symptoms Of Costochondritis
Pain in the chest wall and rib cage is the chief symptom of costochondritis. It will get worse with activity or exercise. Taking a deep breath can also cause more pain because it stretches the inflamed cartilage. Sneezing and coughing can increase pain as well.
The pain can radiate to your shoulder and arms as well (another way the condition mimics a heart attack). Sometimes the pain is accompanied by redness and/or swelling in the most painful areas. When that's the case, it's called Tietze's Syndrome.
Diagnosis of Costochondritis
Your doctor can diagnose costochondritis by pressing on the area where the ribs and breastbone come together. If it's tender and sore there, costochondritis is the most likely cause of pain.
Doctors generally will perform other tests to rule out heart problems and other causes of pain before making a diagnosis. I was given an EKG to determine there were no heart issues involved when I began to display symptoms.
Treatment of Costochondritis
You can treat costochondritis the way you'd treat any inflammation - ice and anti-inflammatory drugs, including Aleve (naproxen) and ibuprofen-based medications such as Advil and Motrin.
This treatment sometimes runs counter to fibromyalgia treatments, which can include other types of pain relievers and heat. If you have both, you might find yourself with an ice pack on your chest and a heating pad on your back at the same time. Be sure to check with your doctor or pharmacist about any possible interactions between anti-inflammatories and your other medications.
Your doctor may recommend other types of treatment as well, including physical therapy or acupuncture.
Living With Both Conditions
It's bad enough to live with one source of chronic pain. The more you heap on, the more pain you'll have and the more it can impact your life.
Fortunately, costochondritis is fairly easy and inexpensive to treat, and managing it will keep it from exacerbating your fibromyalgia symptoms.