Pain in the chest or abdomen can sometimes come from the muscles, joints and nerves of the chest wall, ribs and spine, rather than from the organs inside. This kind of mechanical, musculoskeletal pain is common and usually not serious. However, chest and abdominal pain can also have important medical causes, some of them emergencies, so the single most important message on this page is that such pain must be taken seriously and assessed medically first. At Back in Action in Penwortham, we care for people across Preston and Lancashire with musculoskeletal chest-wall pain — once medical causes have been excluded.
An important safety message
This comes first because it matters more than anything else here. Call 999 immediately if you have chest pain that is crushing, tight or heavy, that spreads to the arm, jaw, neck or back, or that comes with breathlessness, sweating, nausea or light-headedness, as these can be signs of a heart attack. Seek emergency care, too, for sudden severe breathlessness, coughing up blood, or sudden severe abdominal pain. Chest and abdominal symptoms can signal serious problems with the heart, lungs or internal organs, and these always take priority. If there is any doubt, treat it as an emergency and seek medical help first.
Understanding musculoskeletal chest and abdominal pain
Once medical causes have been considered and excluded, it becomes clear that a good deal of chest-wall and abdominal-wall pain is mechanical. The chest is a moving structure: the ribs form joints with the spine and breastbone, they move with every breath, and they are wrapped in layers of muscle. The abdomen, too, has a wall of muscle that can be strained or overused. Pain from these structures — from an irritated rib joint, a strained muscle between the ribs, or inflammation where rib meets cartilage — is genuine but not dangerous. The difficulty, and the reason for caution, is that this mechanical pain can feel similar to pain from more serious causes, and the two cannot always be told apart from the symptoms alone.
Musculoskeletal chest and abdominal pain is closely related to the thoracic spine and to rib pain, and it often has features that help distinguish it from pain coming from inside: it tends to be related to movement, posture or breathing, and can frequently be reproduced by pressing on a specific spot or by particular movements. Even so, these distinctions are for use after medical assessment, not instead of it.
A common example is an irritated joint where a rib meets the spine, which can refer a sharp pain around the side of the chest and make a deep breath uncomfortable. Reassuring as this is once explained, it can feel alarming precisely because of where it is felt — which is all the more reason for proper medical assessment before assuming pain is mechanical.
What musculoskeletal chest-wall pain can feel like
Where pain is musculoskeletal in origin, it may include:
- Sharp or catching pain with certain movements, twisting or deep breaths
- Pain that can be reproduced or worsened by pressing on a specific spot
- An ache across the chest wall, the side of the ribcage, or into the upper back
- Discomfort that clearly changes with position, movement and breathing
- Pain that can often be pinpointed to one spot rather than felt deep inside
- Tenderness where a rib meets the breastbone at the front
These features point towards a mechanical cause — but only a medical assessment can confirm that pain is not coming from the heart, lungs or internal organs, which is why that assessment always comes first.
When to seek help
To reiterate, because it is so important: any new, severe, unexplained or worrying chest or abdominal pain needs medical assessment, and the emergency symptoms above need urgent care. Even where pain seems mechanical, it is worth seeing your GP to be sure, particularly the first time it occurs. We will only consider musculoskeletal care for chest-wall pain once we are confident, and you have been appropriately assessed, that a medical cause has been excluded.
How chiropractic care can help
For genuinely mechanical chest-wall pain, once medical causes have been excluded, chiropractic care can be helpful, and this kind of problem often responds well once the stiff joints are freed and the surrounding muscles settle. Following a thorough assessment, our hands-on, drug-free care may include gentle mobilisation and manipulation of the thoracic spine and rib joints, soft-tissue work to ease the surrounding muscular tension, and advice on posture and breathing. Because we are a multi-practitioner clinic, we can also draw on physiotherapy and massage. We will always be honest about what care can realistically offer, and if anything about your symptoms gives us cause for concern, we will not hesitate to direct you for medical assessment.
What to expect at Back in Action
Your first visit is mostly about understanding your pain and, crucially, satisfying ourselves that it fits a mechanical pattern and that medical causes have been appropriately considered. We will take a careful history and carry out a physical examination of the thoracic spine, ribcage and surrounding muscles. This careful filtering is central to how we approach chest and abdominal pain: our priority is your safety, and we would always rather direct you for medical assessment unnecessarily than miss something important. We will explain what we have found in plain language and be honest about whether musculoskeletal care is appropriate or whether medical assessment should come first.
You can read more on our new patients page, with current charges on the fees page. Where care is appropriate, we will set out a realistic plan and review your progress as we go.
Helping yourself: self-care for mechanical chest-wall pain
For pain confirmed to be musculoskeletal, sensible self-care often helps:
- Keep gently moving rather than holding the chest and ribcage rigid
- Avoid the specific movements that clearly aggravate it while it settles
- Use simple measures such as gentle heat to ease muscular tension
- Pay attention to your posture, particularly during prolonged desk work
- Allow time, as rib and chest-wall strains often take a few weeks to settle fully
Above all, if your symptoms change, worsen, or concern you at any point, seek medical advice rather than assuming they are mechanical.
Related conditions and treatments
Musculoskeletal chest and abdominal pain is closely linked to rib pain and upper back pain, and relates to the thoracic spine. The care we provide draws on approaches such as chiropractic manipulation and exercise and rehabilitation, and may form part of a wider plan alongside our chiropractic, physiotherapy and massage services — always alongside, and never instead of, appropriate medical care.
Take the first step
If you have chest or abdominal pain, please be guided first by the safety advice above and by your doctor. Where pain has been confirmed as musculoskeletal, we are happy to talk through how we may be able to help. You can get in touch to ask any questions or to book an appointment.
This information is for general guidance and does not replace individual medical advice. Chest and abdominal pain can have serious causes and should be assessed by a doctor; in an emergency, call 999.