Chest Area Pain (Muscular)

It is always important to see a doctor for chest pain, since it may indicate a problem with your heart, lungs, or digestive tract. But frequently, chest pain comes from the muscles of the neck, chest, upper back, or is due to a rib or spinal joint. The Imbue Pain Patch can help with minor muscular and joint pain in the chest.

Usual Suspects:

  1. The muscles of the chest
  2. The muscles of the front/side of the neck
  3. The muscles of the upper back
  4. The diaphragm and abdominal muscles

The Imbue Pain Relief Patch temporarily relieves minor aches and pains of muscles and joints. In the diagrams below, the X’s show the locations of common trigger points (localized muscle strain), and the colored shading shows the pain pattern each trigger point produces. This pain is often several inches (or more) away from the trigger point at which it originates. If application of the Imbue Patch directly to the location of the pain does not significantly improve your pain, applying the patch at the site of strain in nearby muscles sometimes yields better results.

Chest Pain Due to the Muscles of the Chest

There are several chest muscles (pectoralis major and minor, intercostals, subclavius, and sternalis) that can cause chest pain when strained or irritated. Feel thoroughly in the areas indicated, pressing firmly, and looking for tender spots – especially points that either produce the pain you have been experiencing or make it go away. Then use the Imbue Pain Relief Patch on these areas.

There are four main sections of the chest to cover. First are the pectoral muscles (commonly known as the “pecs”). They cover the surface of the chest from the collar bone at the top, to the armpit at the outside, to the sternum (breastbone) at the center, to just below the nipple at the bottom. The black X’s in this diagram show common sites of pectoral trigger points. Unless you understand the underlying anatomy, there isn’t an obvious pattern. So, your best bet is to methodically and firmly press on this entire area.

Be sure to feel the vertical line from your nipple up to your collar bone, and a couple inches to each side; the outside edge of the pec muscle, near the armpit; the bottom edge of the pec, below the nipple and a few inches to each side; and a vertical line along the edge of the sternum (breastbone). Besides causing pain in the chest, trigger points in these muscles can produce pain that radiates into the front of the shoulder and all the way down the arm.

For women, lying on your back or side will allow the breast tissue be more easily moved out of the way so that you can feel the lower aspect of the chest muscles. Be careful not to press through the breast, since these tissues can be easily hurt, and are often somewhat tender by nature.

The next muscle to feel while you’re in this area is called subclavius, and it’s underneath the collarbone. In this diagram of the chest and arm, the collarbone is shown in yellow and subclavius is blue. Starting below the innermost end of the collarbone (where it joins with the sternum), push in and up, as if trying to get your thumb under the bone. Gradually work your way outward toward the shoulder. The highest X in the pec diagram (just below the collar bone) shows the most common site for subclavius trigger points (about halfway between the center of the chest and the armpit). When using the Imbue Pain Relief Patch on subclavius, apply a large enough piece of patch to cover above and below the collar bone by a couple inches.

The next set of muscles to feel are the intercostals. Intercostal means “between rib,” because these bands of muscle run between the each of the ribs (see the pink strips between the ribs in the diagram above). These muscles are beneath the pectorals and other muscle groups. The best way to feel them is to start by running your fingers up the center of your sternum (breastbone) until you pass over a prominent ridge of bone near the top. This ridge (called the sternal angle or “angle of Louis”) is where the second rib joins the sternum. Above the second rib is the first band of intercostal muscle you will be able to feel easily. Work your way outward from just above the sternal angle, pressing between the ribs, following the arc of the rib toward the shoulder. Then start back at the edge of the sternum, slide down over the second rib and feel the next “intercostal space” (that is, the space between the ribs), and so on, until you are at the bottom of the ribcage. While you’re at it, feel over the ribs themselves, near where the join to the sternum (the costo-sternal articulation).. If you find any very tender spots, place the Imbue Patch here.

The last muscle to feel is called sternalis, and it is right on top of the sternum (breastbone). Since this muscle only occurs in about 5% of people, chances are, you don’t have one. However, it’s very easy to feel the area it covers (see the red shaded area in the diagram). Simply press along the whole length of the sternum, from top to bottom. It may take a few passes to cover the entire width of the muscle. If you find a very tender spot, especially one that produces broad pain the center of your chest, massage this area and place the Imbue Pain Relief Patch here.

Chest Pain Due to the Muscles of the Front/Side of the Neck

Two groups of muscles – sternocleidomastoid and scalenes – which cover the sides of the neck toward the front, can cause broad and unusual patterns of discomfort, including chest pain. Problems with the scalenes are more common in chest pain, so let’s look at them first.

Scalenes:

These muscles, a group of three (sometimes four) bands on the front/side of the neck, can cause very unusual patterns of pain sensations in the arms, hands, chest, and back (see red shaded regions on diagram). People almost never suspect them because there is rarely discomfort at the muscle itself (except when pressed). They are fairly unpleasant to have massaged, but when the scalenes are implicated in pain, getting them to relax can yield profound results.

The scalenes are partly buried underneath the sternocleidomastoid (SCM). This diagram shows the SCM in red, which is easily visible through the skin. The scalenes are shown in yellow and are only partly visible. The blue area is muscles of the back and shoulder.

Start by pressing just above the middle of your collar bone on the side that you have pain on. Then gradually work your way toward the front of the neck where you will feel a superficial band of muscle (SCM), which lies on top of the scalenes. Then begin working your way up the neck, pushing the SCM aside, pressing instead on the harder deeper muscle beneath. Next work back, going as far back as the very side of the neck. Try to cover the entire area in the red triangle in the lower diagram. Pay special attention to points that produce an unpleasant painful or nervy sensation that may travel to other areas. These are key spots for self massage and placement of the Imbue Patch.

Sternocleidomastoid:

Less common is chest pain that is referred from the sternocleidomastoid (SCM) muscles. If you place a hand on one cheek and then try to turn your head against that hand, your SCM will stand out on the side of the neck you are turning away from. This muscle is composed to two bands that attach to the skull behind the ear at the top. At the bottom, one band attaches to the top of the sternum (breastbone) and the other attaches to the clavicle (collarbone). It is the top band, which attaches to the sternum, that we are concerned with. Besides potentially producing pain at the top of the chest, it can also cause pain all around the eye and cheek, under the jaw, at the back of the skull, and at the top of the head. Oddly, there is rarely any discomfort felt in the muscle itself – except when it is pressed on.

In this diagram, the X’s indicate common sites of strain (trigger points) and the red shading indicates possible areas of pain. You can grasp this muscle between your thumb and fingers and squeeze it or pull on it, and you can methodically press on the whole length of it. It may take a few passes to cover the whole width of the muscle. If you find an especially tender region, especially if pressing on it reproduces the head pain you have been experiencing, this is a good site for massage and application of the Imbue Patch.

Chest Pain Due to the Muscles of the Upper Back

Two main back muscles should be considered in chest pain – the superficial paraspinal muscle group and serratus posterior superior. The superficial paraspinal muscles (actually three muscles – iliocostalis, longissimus, and spinalis) run along the spine as long vertical bands. When trigger points occur in these muscles, besides producing pain, this can cause a large segment of the back to tighten up. The muscles may feel hard and bulging. And (with iliocostalis especially), they can refer pain clear through to the chest. Serratus posterior superior is a muscle that runs diagonally from the spine to the ribs, ending beneath the shoulder blade. This diagram shows the general location of trigger points in serratus posterior superior and the red shading shows the pain pattern it may cause. Besides potentially causing pain at the shoulder blade itself and down the arm, you’ll notice a highlighted region of the chest. With either of these muscles, it’s possible to feel pain only in the chest; we might never consider that it could be coming from the back.

It is best to feel this area methodically, as shown in the next diagram. First press right next to the spine (red line on diagram). Then move slightly outward to press along the firm ridge of muscle that runs parallel to the spine (orange line). Then move a bit more outward to work right against the inside border of the shoulder blade (green line). Feel both sides of the back just to be sure you’re not missing anything. The best way to scan this area is with the help of a friend, who can firmly and thoroughly press on these muscles while you lie face down. However, you can also accomplish this on your own with the use of a Theracane or by rolling on a firm ball (a lacrosse ball is best, but a tennis ball will also work) while lying on your back on the floor with your knees bent and your feet flat on the floor. You can also place the ball between your back and a wall, and then slowly bend your knees to roll the ball up and down your back (see diagram).

If you find any spots that are quite tender, especially if they produce pain in your chest, these are areas to massage and apply the Imbue Pain Relief Patch.

Chest Pain Due to the Diaphragm and Abdominal Muscles

This form of chest pain is somewhat less common than pain due to the other muscles mentioned. It is usually felt somewhat lower in the chest, below the nipple line.

The central muscles of the abdomen, rectus abdominis (shown in yellow in this side view picture), sometimes give this region the famous “six pack” appearance (or eight pack or ten pack, depending on the body). The abdominal obliques (shown in blue in this picture) are sheets of muscle that cover the sides of the abdomen. These muscles are prone to developing trigger points, especially when we suddenly become inspired to do a thousand sit-ups after not exercising for months. Besides potentially causing chest pain, they can also cause bands of pain in the back. The second diagram shows the location of a typical upper abdominal trigger point (marked X) and the pain pattern it may produce (red shading).

Feel along your ribs, pressing firmly and methodically, from the center of your rib cage outward to the side. Start just below the breast area and work gradually downward, continuing down to a few inches above your navel. You may find tender points either on or between ribs. Any points that are quite tender, especially if they produce broad, intense pain like what you have been experiencing, should be massaged and treated with the Imbue Pain Relief Patch.

The diaphragm is an umbrella shaped muscle that attaches to the inside of the rib cage at the lowest few ribs. In its relaxed state, it is raised, which compresses the lungs and causes exhalation. When it is contracted, it drops and flattens out, creating a vacuum in the chest which causes inhalation (inflation of the lungs). When it spasms, we call this “hiccups.” It can also cause chest pain, which is usually experienced around the lower ribs. It is just barely accessible under the base of the rib cage. The best way to get at it is with curled fingers. Lie on your back with your knees bent and your feet flat. Working along the entire lower border of the rib cage, use your fingers to dig under the ribs as much as you can (you may wish to trim your nails first). This tends to be a tender process, even when the diaphragm is undisturbed. If you find any spots with significant tenderness, especially if this produces the pain you have been experiencing, massage them gently and apply the Imbue Pain Relief Patch here. Because the diaphragm is mostly inaccessible, the Imbue Patch may not be effective for this kind of pain.

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