People suffering from fibromyalgia know all too well the daily struggle with pain. As a widespread pain syndrome, fibromyalgia can also cause other symptoms, like digestive upset and “fibro fog.” In some cases, there are separate comorbid syndromes that often occur in conjunction with fibromyalgia. This is the case with costochondritis and fibromyalgia. Here’s what you need to know about fibromyalgia chest pain.

Can fibromyalgia cause chest pain? 

Fibromyalgia is a syndrome that causes widespread pain throughout the body, often without any definitive root cause. Many symptoms resemble arthritis pain but involve soft tissue, not joints.

There is no known cause of fibromyalgia, but there are risk factors.

  • Gender: Women are more likely to have fibromyalgia than men. An estimated 80-90% of fibromyalgia sufferers are women.
  • Pre-existing conditions: People with autoimmune disorders like lupus and rheumatoid arthritis have higher rates of fibromyalgia.
  • Traumatic injury: For some, the pain of traumatic injury becomes chronic or spreads, leading to a fibromyalgia diagnosis.

Fibromyalgia symptoms go well beyond its characteristic widespread aches and can include the following:

  • Difficulty focusing or concentrating (known as “fibro fog”)
  • Headaches
  • Pain and stiffness in the jaw
  • Pain or fatigue in the muscles of the face
  • Poor or irregular sleep
  • Tingling or numbness in the extremities
  • Restless leg syndrome
  • Sensitivity to temperature
  • Digestive issues, including irritable bowel syndrome (IBS)
  • Fatigue
  • Depression or anxiety
  • Nausea
  • Pelvic pain and urinary problems
  • Dizziness

Other possible symptoms include weight gain, skin problems, and breathing problems.

Another common symptom of fibromyalgia that can be more than just a symptom is chest pain. Because overall pain and tightness is characteristic of fibromyalgia, many people don’t realize that fibromyalgia chest pain may, in fact, be costochondritis.

What is costochondritis?

Costochondritis is inflammation of the cartilage that connects your ribs to the breastbone. This cartilage allows the ribs to expand and open when you take a deep breath.

Since this constriction occurs in the center of the chest, costochondritis can be a frightening condition for people already suffering from fibromyalgia. Many sufferers report pain that feels like burning, aching, or stabbing. The level of pain depends on the level of inflammation in the cartilage.

Although exact causes of this syndrome are also not clear, there are three potential causes:

  1. Chest trauma: Car accidents or falls are the most common cause of chest trauma that can lead to costochondritis
  2. Overuse: Inflammation of the cartilage may result if that area of the body is used repetitively or incorrectly
  3. Viral infections: Upper respiratory infections in particular can cause costochondritis

So how are costochondritis and fibromyalgia connected? The answer to that is not completely clear. As cartilage is a type of fascia, and fibromyalgia occurs with inflamed fascia, it makes sense that costochondritis could follow. In fact, what is called “non-specific chest pain” is the most common symptom in patients hospitalized with fibromyalgia.

Another link is between costochondritis and fibromyalgia tender points. One of these 18 pairs of points is nestled just below the collarbone. Pain here is one of the diagnostic tools for fibromyalgia. Perhaps more mysterious is the fact that people can have costochondritis without fibromyalgia, but if left untreated this condition can lead to a widespread pain diagnosis.

What does costochondritis and fibromyalgia feel like?

Costochondritis and fibromyalgia share some common symptoms. Characteristic chest wall pain is possible in both conditions, as is pain that radiates down both arms.

This may be where the similarities end. Fibromyalgia pain sometimes flares up or goes into remission seemingly randomly, but specific actions increase the pain of costochondritis. Physical activity and exercise irritate the inflamed cartilage. Even something as simple as taking a deep breath can cause intense pain. Sneezing, coughing, or laughing can also cause pain.

People with fibromyalgia chest pain might also experience tightness in their chest or shortness of breath.

Is it fibromyalgia chest pain or something more serious?

Fibromyalgia chest pain is common if you’re suffering from fibro, but it’s crucial to know the difference between this type of chest wall pain and something else. Let’s look at some of the conditions that share similar symptoms.

Is it a heart attack?

Chest pain is a common heart attack symptom in most men and some women, so it can be scary to suddenly develop this fibromyalgia symptom. If you are concerned, call your doctor or head to the emergency room.

In general, though, heart attack symptoms also include:

  • Nausea
  • Pain between the shoulder blades (one of the most common symptoms of heart attack in women)
  • Pain radiating down one arm
  • Neck, jaw, or head pain
  • Sweating
  • Sudden onset of pain that does not diminish and is not caused by exertion
  • No previous fibromyalgia diagnosis

Is it gastroesophageal reflux disease (GERD)?

GERD usually occurs after a person eats. It does come with a burning sensation in the chest, often worse at night. Some people also have difficulty swallowing or feel a lump in their throat.

Is it a collapsed lung?

This can certainly cause pain, but a collapsed lung also comes with an increased heart rate, sudden tiredness, and shortness of breath. Onset is sudden and usually as a result of trauma to the chest, another cause of chest pain.

How can I know for sure?

The only way to know for sure if your chest pain is costochondritis is to check with your doctor. Because there are so many different causes of chest pain, this can help set your mind at ease – especially if it’s a new symptom.

What about breast pain?

Breast pain is not the same thing as the chest pain associated with costochondritis. Costochondritis pain is usually centered in the chest, or just slightly to the left or right of the breastbone (sternum). Breast pain can occur anywhere.

Many women experience increased sensitivity in their breasts throughout the month due to hormone fluctuations. This is normal, common, and most likely not serious.

If you experience breast pain with the following symptoms, it is a good idea to check in with your doctor. Symptoms to look for include:

  • A lump in the area of pain
  • Redness, swelling, or drainage at the pain site (signs of infection)
  • Discharge from the nipples
  • Pain that lasts more than two weeks and does not coincide with a menstrual cycle
  • Pain that gets worse and keeps you from daily activities

As with other forms of chest pain, if you are concerned, talk to your doctor.

What causes costochondritis to flare up?

Costochondritis and fibromyalgia share some similar triggers. For many people, stress is a major trigger and can cause painful episodes.

Other fibromyalgia chest pain triggers include:

  • Physical exertion (especially for costochondritis)
  • Changes in diet
  • Changes in temperature and diet
  • Hormone fluctuations
  • Inconsistent schedule
  • Poor or insufficient sleep

Essentially, anything that alters a person’s routine can trigger both costochondritis and fibromyalgia symptoms. These flare-ups can be brief, or they can last days or weeks.

The best way to prevent flare-ups is to be mindful about your schedule and work to manage emotional and physical stress. Keeping a journal (either by paper or in a pain app) that includes everything from the weather to a list of foods you eat and activities you do can help identify patterns. Once these patterns are identified, you can work towards preventative treatment.

How to treat costochondritis and fibromyalgia

Treatment of costochondritis and fibromyalgia is remarkably similar. The best place to start is with a pain journal or pain app. This helps you keep track of the level of your pain and its intensity but also notes any potential triggers that may have caused the flare up.

Other common treatments for fibromyalgia chest wall pain include the following.

1. Hot/cold therapy

Hot and cold therapy might be used at the same time to treat both costochondritis and fibromyalgia, with a cold pack on your breastbone and a heating pad on your lower back.

Heat loosens tight muscles, and cold helps ease inflammation.

2. Exercise

It can be incredibly challenging to exercise when your whole body is aching, especially if you know that heavy breathing can worsen costochondritis.

Exercise just means movement, though. You don’t have to move fast. A walk in nature or some gentle or restorative yoga can help heal body and mind.

3. Changes to diet

Caffeine, sugar, alcohol, and processed foods can trigger fibromyalgia flares. Make changes to your diet that include plenty of whole grains, leafy greens, and lean proteins. Incorporate anti-inflammatory foods, too.

4. Practicing proper sleep hygiene

Getting enough good sleep each night can go a long way in treating fibromyalgia chest pain. Practice good sleep hygiene.

That means keeping a clean bedroom, cool temperature, and screens off before bed for best results.

5. Mindfulness practices

Mindfulness practices, such as yoga, t’ai chi, and mindfulness meditation, can all help to naturally ease stress and manage chronic pain. Meditation in particular is effective at decreasing the perception of pain, even if the pain is still there.

6. Psychotherapy

There are many types of psychotherapy that help address the emotional and mental toll that chronic pain can take on a person.

This treatment option does not address the physical sensation of pain, but it does make chronic pain flare-ups easier to deal with.

7. Physical therapy

Physical therapy can help bring movement back into a stiff, sore body with targeted exercise.

If costochondritis and fibromyalgia have kept you sidelined for years, a trained physical therapist can help you loosen and strengthen muscles and develop better movement patterns.

8. Massage

More than just a soothing part of self-care, massage increases blood flow to all parts of the body.

Increase blood flow is associated with faster healing and a decrease in inflammation. One review of studies of massage and fibromyalgia found that massage significantly reduced pain, anxiety, and depression associated with this condition.

9. Chiropractic care

If you have held your body in an unnatural way to avoid the pain of costochondritis and fibromyalgia, a qualified chiropractor can help bring it back into alignment.

10. Acupuncture

A recent large review of studies found that acupuncture for fibromyalgia was significantly better at relieving pain in both the short and long term than sham acupuncture.

This ancient Chinese medical treatment uses hair-thin needles placed at distinct points to move energy through the body. Done by a licensed practitioner, it can be an excellent complementary care option.

11. Over-the-counter medication

Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen sodium are very effective at relieving the short-term inflammation of costochondritis and fibromyalgia.

These should only be taken as directed and in the short term, as long-term use can have side effects.

12. Prescription medication

While prescription pain medications are not recommended for any kind of chronic pain, some patients find relief with tricyclic anti-depressants. It is unclear why these work to relieve fibromyalgia pain. Anti-seizure drugs may also work.

Unfortunately, both of these types of prescription medications come with side effects that may erase benefits they offer otherwise. Work closely with your doctor to reduce the chance for side effects and find the right dosage and medication for you.

Get help

When it comes to fibromyalgia and costochondritis, most patients find relief with a combination of approaches. For example, a dedicated physical therapy regimen along with short-term medication use and mindfulness strategies can help you relieve the majority of your pain.

Pain specialists can help. They’ll use a variety of treatment approaches to design a comprehensive plan for costochondritis and fibromyalgia symptoms. You can find a pain doctor in your area by clicking the button below or looking for one in your area by using the tips here:

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