Fibromyalgia Rib & Chest Pain

Pain in the ribs or chest can be alarming, and should not be taken lightly. However, because fibromyalgia is characterized by widespread pain, many people with the condition do experience fibromyalgia rib and chest pain.

We unpack these symptoms, what to do and when to call for help.

Contact your local emergency services immediately if chest or rib pain is a new symptom for you, if your chest pain gets worse, if you are at all worried about your chest pain, or if you experience chest pain or pressure along with any of these symptoms:

• pain that spreads to the shoulder, arm, back, neck, jaw, or teeth
• pain in combination with a cold sweat, fatigue, heartburn, dizziness, nausea, or shortness of breath
• sudden chest pain that lasts more than 15 minutes.

It's very important to get a qualified medical professional to rule out any potential cardiac conditions, or diagnose and treat any underlying issues first. Although some of the treatment options for fibromyalgia pain might help to relieve pain caused by other conditions, you should always get clearance from your doctor first. In addition to being very important for your health, having your doctor eliminate heart or lung problems as the cause of your pain can put your mind at ease, and help you to engage in other pain relief methods.

Symptoms of fibromyalgia rib pain

Is it normal to experience fibromyalgia rib & chest pain?

Any sort of chest pain can be less scary, but when should you worry about it? Is chest pain normal when you have fibromyalgia?

As stated above, chest pain can be serious, and it's very important to get a medical professional to confirm that your heart and lungs are healthy, before you start treating your pain as a symptom of fibromyalgia.

After a doctor has eliminated cardiovascular conditions as the cause of your pain, continue to check in with yourself regularly, know your symptoms, and speak to your healthcare provider if things change, get worse, or cause you any concern.

Hopefully once you've been cleared by your doctor, your symptoms can be less worrying, and you can start exploring other causes of your pain. Because widespread pain and an array of other discomforts is a hallmark of the condition, it is common for people with fibro to experience rib and chest pain.

What does fibromyalgia rib & chest pain feel like?

Rib and chest pain in fibromyalgia varies widely – from intense stabbing sensations to mild tenderness – and everyone experiences fibromyalgia differently.

It is commonly described as a sharp, piercing feeling in the central chest area surrounding the breastbone and ribs, and this discomfort might also extend to other areas like your back or arms.

Other symptoms and sensations might include:

• sharp, stabbing pain
• inflamed or burning sensation
• a dull ache in the chest
• tight or knotted sensation
• tenderness in the ribs upon touch
• upper chest pains
• radiating pain up the back of the neck and shoulders
• chest pain triggered by coughing or sneezing
• restricted breathing or shortness of breath
• rapid or irregular heart rate.

How does it feel different from other types of chest pain?

If you're experiencing rib and chest pain due to fibromyalgia, it's unique from other types of chest discomfort.

Unlike heart-related pain, which may present with weakness, lightheadedness, and a squeezing sensation, or lung-related pain that feels sharp and worsens with breathing, fibromyalgia pain in the rib and chest area is more about persistent muscle and bone aches.

These aches come with tenderness and fatigue that don't necessarily worsen when you breathe.

Your experience might vary, with some feeling a burning sensation and others a dull ache, highlighting the personal nature of fibromyalgia symptoms.

What causes fibromyalgia rib & chest pain?

Fibromyalgia is a complex condition that influences pain perception. It’s a central nervous system disorder that also involves the immune system, and is impacted by genetics and life experiences – such as an infection, an injury, or high emotional stress.

Fibromyalgia rib and chest pain mainly result from central sensitization. This is when the nervous system has become overprotective and responds to stimuli such as touch or temperature with pain¹.

The pain is real, but arises from the body's protective mechanisms rather than physical damage.

Fibromyalgia rib pain & costochondritis

Costochondritis is a condition in which the cartilage that the ribs to the breastbone (sternum) is inflamed. When this cartilage becomes inflamed, it can result in chest discomfort, particularly when pressure is applied through physical touch, tight clothing, coughing, sneezing or deep breathing.

A key feature of the many symptoms of fibromyalgia is that although these symptoms are genuine, there is no corresponding structural damage. However, many people with fibromyalgia do have low grade inflammation in the body, which could make them more likely to also have costochondritis².

One study found that over a quarter of participants who lived with fibro also had either current or past experiences with costochondritis³.

Is costochondritis the same as fibromyalgia?

Costochondritis and fibromyalgia are similar, and you can have both at the same time. However, these two conditions have distinct features that set them apart.

Costochondritis commonly presents as sharp or pressure-like pain that is focused on the left side of the breastbone, potentially radiating to several ribs. In contrast, fibromyalgia is characterized by a persistent, dull ache that might be more generalized or present in different locations on different days. Fibromyalgia usually also causes pain elsewhere in the body, although with other symptoms such as fatigue, brain fog, gut troubles, and sleep and emotional disturbances.

How is costochondritis diagnosed?

To diagnose costochondritis, your doctor might perform physical exams. These include testing whether pressing on the chest reproduces pain, as well as X-rays, ECGs, and blood work – some of which may be necessary to rule out other conditions.

To diagnose fibromyalgia, your doctor will rely on your symptoms and medical history, so tracking your symptoms can be really helpful. They will also conduct tests such as scans and blood tests to rule out other potential causes.

Can fibromyalgia make costochondritis worse?

Fibromyalgia can heighten the discomfort linked to costochondritis by increasing pain sensitivity rather than directly causing inflammation in the chest cartilage. If you have fibromyalgia, you might experience sharper or more burning chest pain sensations because of how your nervous system responds to stimuli.

What other conditions could cause rib & chest pain?

If you’re concerned that your rib and chest pain might not be due to fibromyalgia or costochondritis, what else could it be? Various other conditions can also lead to similar discomfort. For example^4,5:

• Anxiety or panic attacks: These episodes may lead to chest pain along with symptoms such as dizziness, heart palpitations, sweating, and breathlessness. They can persist for up to 20 minutes.
• Angina: Poor blood flow to the heart muscle can result in angina, often triggered by factors such as exercise, anxiety, cold weather, or after a large meal. Angina can be a serious condition and should be diagnosed, monitored and treated by a qualified doctor.
• Arthritis: Chest pains related to arthritis may manifest as difficulty breathing and chest discomfort. In cases of rheumatoid arthritis, the chest pain is usually not severe.
• Axial spondyloarthritis: Although this particular type of arthritis primarily affects the spine and sacroiliac joints, it can also lead to chest pain and tenderness in the chest wall.
• Chest infections: Conditions such as bronchitis and pneumonia can cause chest pain as part of their symptoms.
• Cervical spinal stenosis: Narrowing of the spinal canal in the neck due to disc bulges or cartilage wear can lead to radiating pain from the neck and upper back to the chest.
• Indigestion or reflux: When stomach acid rises up the esophagus, it can lead to a burning sensation in the chest, commonly referred to as heartburn.
• Lupus: An autoimmune disorder characterized by inflammation and pain throughout the body, including the lungs and heart. Lupus patients are susceptible to myocarditis, an inflammation of the heart muscle tissue.
• Pericarditis: Inflammation of the tissue surrounding the heart, often caused by viral or bacterial infections, can result in chest pain.
• Physical injuries: Pulled muscles, broken ribs, internal damage, sports accidents, and muscle spasms can all cause rib pain.
• Pleurisy: Inflammation of the tissues that line the lungs and chest cavity can cause sharp chest pains that worsen during deep breaths, coughing, sneezing, shortness of breath, and dry cough.
• Shingles: This viral infection can cause pain preceding the appearance of a skin rash.

All of these conditions are unique and should be investigated with the help of your doctor who can accurately diagnose your issue and offer effective treatment advice.

Treatments to help relieve fibromyalgia rib pain

Effectively managing the discomfort of fibromyalgia rib pain requires a comprehensive approach. This may include retraining how the body responds to pain, participating in physical therapy and exercise, as well as utilizing medications for short-term pain relief.

Other mind and body practices, such as counseling sessions, stress reduction and improved sleep quality can also aid in managing pain.

Retraining your pain response

To retrain your pain response, it's important to realize that pain isn't just about physical sensations; it's influenced by the full range of your biological, psychological and social circumstances.

Taking the time to understand your pain triggers, whether they're caused by stress, beliefs or behaviors can help. Once you've identified our triggers, you can start to change them, for example through nutrition, sleep and movement, or use techniques based on neuroplasticity to change how your brain reacts to these triggers. With practice and dedication, you can gradually reshape your brain's response, leading to a reduction in the intensity and impact of your pain.

These include the following.

Stress management

Stress hormones such as cortisol can heighten the body's pain response, exacerbating discomfort. While avoiding stress entirely may not be feasible, there are ways to reduce stress and reduce your reaction to stressful situations. These include cognitive behavior therapy (CBT), mindfulness meditation, relaxation practices, and emotional and social support from a friend, therapist, or community.

Movement & exercise

Movement and exercise can reduce pain, boost your mood and energy levels, and improve your sleep quality. You can tailor movement to your own limitations and symptoms and it doesn't have to be a formal exercise either! Any active hobbies count, including yoga, dancing, or even gardening.

Our two top tips are to start slowly and be kind to yourself. Starting with small, low-impact exercises and gradually increasing intensity and duration allows the body to adapt safely. And practicing self-compassion will allow you to embrace challenges with resilience and confidence.

Sleep quality

Sleep plays a crucial role in managing fibromyalgia symptoms, forming a vital component of self-care strategies for pain reduction. The interplay between fibromyalgia symptoms and sleep quality creates a challenging cycle, where poor sleep exacerbates symptoms, and symptoms cause sleep disturbances.

Improving your sleeping patterns can help alleviate many fibromyalgia symptoms, including associated chest pain. Tips for improving your sleeping patterns include:

• Establish a consistent sleep routine with fixed sleep and wake times, aiming for eight hours of sleep each night.
• Limit daytime naps to short durations to avoid disrupting nighttime sleep patterns, ensuring they remain refreshing power naps.
• Engage in physical activity during the day to promote better sleep onset.
• Reduce screen time before bed to create a conducive environment for restful sleep.
• Create a dark, quiet sleep environment to support uninterrupted sleep.
• Moderate caffeine intake, especially in the afternoon and evening, it can linger in the body for hours and interfere with sleep.
• Avoid consuming large meals and alcohol close to bedtime to improve sleep quality.
• Incorporate various forms of rest for the heart, body, and mind to complement sleep hygiene practices and manage fibromyalgia symptoms effectively.

Medication

While medication can be a part of your comprehensive pain-management plan, it's important not to rely on it as the primary treatment. Medication should be seen as a tool that enables you to engage in other effective pain management strategies to improve your condition. These strategies may include education, lifestyle adjustments, and psychological support.

Common medications prescribed for fibromyalgia chest pains include:

• over-the-counter medications such as aspirin and ibuprofen
• antidepressants such as amitriptyline and duloxetine, which can help manage pain and improve mood
• pain and inflammation modulators such as Low Dose Naltrexone (LDN)
• anti-seizure medications such as pregabalin and gabapentin can help regulate the over-sensitized nervous system.

Your doctor is the best person to speak to about which medication or pain relievers may be suitable for your individual situation.

More information

At MoreGoodDays®, we embrace a multidisciplinary approach tailored to support you in managing fibromyalgia. Recognizing the comprehensive impact this condition has on your life, we integrate diverse strategies to address your unique needs.

Through educational resources and self-management techniques, you'll gain insights into fibromyalgia and effective symptom management. We'll guide you in making lifestyle adjustments, focusing on areas such as exercise, nutrition, and sleep habits to enhance your overall wellbeing.

Our program also provides psychological support, including cognitive behavioral therapy (CBT) and stress management tools, empowering you to navigate the emotional challenges associated with fibromyalgia.

Together, we're committed to helping you lead a healthier, happier life despite the challenges of fibromyalgia.

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