At Walker and Hall we know through personal experience how chest pain in all its forms can have an enormous effect on the every aspect of your life e.g., from caring for yourself and family, to work, to sports and leisure activities and even just on your concentration.
The most common types of chest pain we treat are
Sterno-costal joint pains
Costo-Chondral joint pain
Fractured Ribs
Referred pain
If your condition is not listed above please contact us
We have extensive experience in treating these conditions and managing your recovery.
To see how Walker and Hall can help you please click on the links below:
Sterno-Clavicular Joint Sprain (also known as SC Joint Sprain, Sterno-Clavicular Joint Injury, Sprained Sterno-Clavicular Joint, Sprained SC Joint, SC Joint Injury, SC Joint Subluxation, SC Joint Dislocation)
Whilst not a common injury we have considerable experience in treating Sterno-Clavicular joint sprains resulting from trauma such as a motor vehicle collisions and sports injuries. This condition can range from a small sprain resulting in minimal pain and allowing ongoing activity, to a severe sprain resulting in significant pain, deformity and disability.
Anatomy
Each collar bone (clavicle) attaches to the breast bone (sternum) at the top of the chest, just below the base of the neck and slightly to each side of the centre line. The bone ends are covered in shock absorbing cartilage which cushions the impact of one bone on another during activity. Strong ligaments and connective tissue hold the bones together and form the Sterno-Clavicular joint.
The Sterno-Clavicular joint is the only bony connection between the upper limb and the rest of the skeleton, providing stability to the front of the chest and shoulder and allowing for some shoulder movement. During certain activities, if stretching or compressive forces are placed on the Sterno-Clavicular joint and are beyond what the joint can withstand, tearing of the ligaments and connective tissue may occur. This is known as a Sterno-Clavicular joint sprain.
Causes of a Sterno-Clavicular joint sprain
The main cause of a Sterno-Clavicular joint sprain is trauma.
• Trauma – this occurs usually as the result of a specific incident such as a direct blow to the top of the chest or the point of the shoulder and can be associated with motor vehicle collisions (as the force of the impact is transferred through the upper limbs to the Sterno-Clavicular joint), with contact sports (due to a collision with another player) and also following a fall onto the point of the shoulder or an outstretched hand.
Signs and Symptoms of a Sterno-Clavicular joint sprain
• Pain – this is usually felt as a sudden onset of pain at the time of the injury at the top of the chest, just below the neck, slightly to one side of the midline. It may increase with activities involving lying on the affected side, moving the arm across the body, overhead activities, heavy lifting, pushing or pulling movements and even coughing and sneezing. In minor cases you may be able to continue the activity only to experience an increase in pain after activity and first thing in the morning. In more severe cases the pain may prevent you from continuing the activity and even cause you to cradle your arm
• Rapid onset of swelling – this is seen at the top of the chest over the Sterno-Clavicular joints
• Deformity – in more severe cases there may be a visible deformity or bump on the front of the chest where the collar bone attaches to the sternum, with the tip of the collar bone sticking out. This is due to a tearing of the connective tissue holding the Sterno-Clavicular joint together.
• Bruising, weakness and pain on application of direct pressure to the joint.
How can Walker and Hall help you?
A thorough musculoskeletal examination is required to determine the extent of the damage to the Sterno-Clavicular joint and exactly which structure(s) are causing the symptoms. This is essential if the optimum recovery is to be achieved and to reduce the likelihood of recurrence.
Following the diagnosis a treatment plan is devised and discussed with you.
The types of physiotherapy treatment used at Walker and Hall for a Sterno-Clavicular joint sprain include:
• joint mobilization techniques to improve the range of movements
• soft tissue massage to reduce pain and muscle spasm
• electrotherapy (e.g. Ultrasound, Interferential Therapy) to reduce pain, swelling and muscle spasm
• a home exercise programme to improve flexibility and strength
• activity modification advice
• anti-inflammatory advice. Anti-inflammatory medication may also significantly hasten the healing process by reducing the pain and swelling associated with inflammation. To check whether you are able to tolerate non-steroidal anti-inflammatory medication (NSAID) contact your General Practitioner or local pharmacist
Costo – Chondral joint pain (also known Costo-chondritis)
At Walker and Hall we know through personal experience how painful Costo-Chondral joint pain can be, affecting every aspect of your life.
Fortunately it is a condition that responds well to physiotherapy treatment.
Anatomy
The chest (thorax) comprises of 12 pairs of rib bones, one on each side of the body. Each rib attaches to the spine (thoracic spine) at the back of the body and then travels around to the front of the chest, the top 7 ribs attach via cartilage to the sternum. This area, where the cartilage joins the ribs to the breastbone is called the Costo-Chondral joint. When stress is applied to the Costo-Chondral joints, if the stress is more than the joints can withstand, then a Costo-Chondral joint sprain is the result.
The causes of Costo – Chondral joint pain
• upper respiratory tract infections, such as sinusitis and laryngitis
• severe coughing, which strains your chest area
• injury to your chest
• physical strain from strenuous exercise
The signs and symptoms of Costo – Chondral joint pain
Pain – usually localized to the joints involved and may range from a severe stabbing pain to a more general aching pain. It is often aggravated by sudden movements, physical activities such as racket sports, athletics or simply reaching up to a high cupboard, and even coughing and sneezing.
How can Walker and Hall help you?
A thorough musculoskeletal examination is required to determine which Costo-Chondral joint(s) are causing the pain. This is essential if the optimum recovery is to be achieved and to reduce the likelihood of recurrence.
Following the diagnosis a treatment plan is devised and discussed with you.
The types of physiotherapy treatment used at Walker and Hall to treat Costo-Chondral joint pain include
• joint mobilization techniques to reduce pain and increase the range of joint movements
• soft tissue massage to reduce pain and muscle spasm
• electrotherapy (e.g. Ultrasound, Interferential Therapy) to reduce pain and muscle spasm
• postural education including the use of a lumbar roll for sitting
• a home exercise programme to improve flexibility, strength and posture
• activity modification advice
• anti-inflammatory advice. Anti-inflammatory medication may significantly hasten the healing process by reducing the pain and swelling associated with inflammation. To check whether you are able to tolerate non-steroidal anti-inflammatory medication (NSAID) contact your General Practitioner or local pharmacist
Fractured Rib (also known as a Broken Rib, Rib Fracture)
This is a relatively common injury and involves a break (fracture) in one or more of the rib bones that form the chest (thorax) and upper back. It will possibly be the only time in your life when you realise that you breathe up to 18 times a minute because with a fractured rib, every breath can be agony.
Anatomy
The chest (thorax) comprises of 12 pairs of rib bones, one on each side of the body. Each rib attaches to the spine (thoracic spine) at the back of the body and then travels around to the front of the chest. The top 7 ribs attach to the sternum, ribs 8 to 10 attach via cartilage to the ribs above and ribs 11 and 12 are known as ‘floating’ ribs as they are only attached at the back and are unattached at the front.
Following a direct blow to the front or side of the chest, or the upper back, stress is placed on the ribs. If this stress is mild it can result in a bruised rib. However if the stress is more than the bones can withstand, then a fractured (broken) rib or ribs is the result. Occasionally if the fracture is severe and displaced it may result in damage to other organs of the body such as the lungs (e.g. a pneumothorax), liver, spleen or kidney.
Causes of a Fractured Rib
Trauma – this is the main cause of a fractured rib and is often the result of a direct blow to the rib from an object or person. This normally occurs due to a collision with another player during contact sports such as football or rugby, or from impact from a ball in sports such as hockey or cricket. A rib fracture(s) may also occur during other activities such as a motor vehicle accident or fall from a height.
Signs and symptoms of a Fractured Rib
Pain – a sudden onset of sharp severe pain over the chest or in the side of the ribs at the time of injury which may occasionally radiate into the back, shoulder and or neck. Activities such as lying on the affected side, touching the broken rib, deep breathing, coughing, laughing and sneezing may increase the pain. You may also experience pain during movements of the upper back such as bending and twisting and sometimes during certain activities involving the use of the arms such as overhead activities, heavy pushing, pulling and lifting.
How can Walker and Hall help you?
A thorough musculoskeletal examination is required to determine which rib(s) have been fractured. This is essential if the optimum recovery is to be achieved.
Following the diagnosis a treatment plan is devised and discussed with you.
The types of physiotherapy treatment used at Walker and Hall for a fractured rib include
• advice with regards to achieving comfortable sitting, standing and sleeping postures
• pPain relieving and anti-inflammatory advice. The appropriate pain relief is essential for comfort and anti-inflammatory medication may also significantly hasten the healing process. To check whether you are able to tolerate non-steroidal anti-inflammatory medication (NSAID) contact your General Practitioner or local pharmacist
• joint mobilization techniques to improve the range of movements
• soft tissue massage to reduce pain and muscle spasm
• electrotherapy (e.g. Ultrasound, Interferential Therapy) to reduce pain and muscle spasm
• a home exercise programme to improve flexibility, strength and posture
Referred Pain
Not all pain experienced in the chest is necessarily coming from the chest. Occasionally pain felt in the chest can be referred or caused by a problem in another area of the body such as the neck or spine. This is called referred pain.
What is Referred Pain?
Referred pain occurs when pain is experienced in an area away from the actual injury or problem. This is not uncommon, an example being sciatica, where pain is felt down the leg whilst the problem is in the back, or a heart attack, where the pain is felt in the shoulder, arms and neck.
What structures can refer pain into the chest?
The main sources of referred pain into the chest are the cervical and thoracic spines (from the 3rd cervical vertebra to the 8th thoracic vertebra – C3 to T8). Any problems affecting the intervertebral discs, ligaments, nerves and muscles of this area of the spine can mimic a chest problem.
How can Walker and Hall help you distinguish between a chest problem and referred pain
At Walker and Hall you will receive a thorough musculoskeletal examination which will examine all the structures that could possibly be responsible for your chest symptoms.
It is only following such an accurate examination and diagnosis that a treatment plan can be devised to address your problems.
You will be involved in all stages of your treatment given every opportunity to ask questions.
