The chest wall is composed of skin, subcutaneous tissue. muscles, bones that make up the rib cage and fascia of the anterolateral aspects of the thorax. The same structures that lie posteriorly (towards the back) are considered as part of the back and not as the chest wall. Within the wall lies a number of nerves, blood and lymphatic vessels, cartilage and joints.

The structure of the chest wall allows it to be flexible so that it expands and contracts during breathing and absorbs the force of a blow. At the same time, it is rigid enough not to collapse due to the negative pressure within the pleural cavities, support the upper limbs, neck and head, protect the inner organs of the thorax and serves as a point of attachment for a number of muscles of the upper limb.

Considering the number of parts of the chest wall, its complex structure and diverse functions, the chest wall is prone to a number of pathologies that can result in pain.

Symptoms associated with Chest Wall Pain

One or more of the symptoms below may accompany chest wall pain.

  • Difficulty breathing due to the pain upon inspiration and expiration
  • Tenderness – sensitivity/pain upon applying pressure on the affected area
  • Pain when moving upper limbs, changing position, deep breathing
  • Skin patches – redness, darkening, rash
  • Areas of swelling  or lumps on the chest wall

Coughing, nausea, vomiting, shortness of breath and dizziness needs to be investigated immediately.

Causes of Chest Wall Pain

Skin

This includes the subcutaneous tissue.

  • Acne
  • Sunburn
  • Trauma – hematoma
  • Cellulitis
  • Paresthesia

A number of skin diseases may also contribute to chest wall pain, often along with itching and a various types of skin rashes.

There are a host of pathologies that may result in breast pain. The breasts are modified skin appendages and are an important consideration of chest wall pain, especially in women (refer to Female Breast).

Some of the causes of chest wall pain related to the breasts includes :

  • Trauma
  • Mastitis
  • Breast abscess
  • Breast cancer
  • Menstruation
  • Pregnancy
  • Breast milk engorgement

Muscles

The larger muscles on the chest wall are primarily responsible for upper limb movement and the pain would be more prominent upon moving the limbs. These muscles may also contribute to chest wall movements to some degree, especially during labored breathing.

  • Muscle strain – overuse, weight bearing, persistent coughing, retching and vomiting
  • Torn muscle
  • Trauma
  • Fibromyalgia
  • Myositis :
    • Infectious – Cosackie B virus (Bornholm’s disease), cytomegalovirus (CMV), Mycoplasma bacteria, Streptococcus pneumonia, toxoplasmosis, schistomsomiasis.
    • Non-infectious – polymyalgia rheumatica, dermatomyositis.
  • Myopathy due to drugs like statins and alcohol.

Related Articles :

Bone

Breastbone (sternum), ribs (12 pairs) and clavicle (collarbone).

  • Fractures
  • Osteoporosis
  • Trauma

Related Articles :

Nerves

Related Articles :

Cartilage and Joints

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Article reviewed by Dr. Greg. Last updated on December 30, 2010