What causes back and chest pain

People who sit for long periods of time often suffer from back pain, and sometimes severe chest pain. Milder symptoms can be relieved by hammering with a hammer, or getting up and walking around, but for some more serious cases, all these methods may not help. So what causes back and chest pain?

Chest and back pain refers to pain in the 3rd to 12th thoracic vertebrae and the direct area of ​​the two shoulder blades. It is often manifested as pain in the chest, costal hypochondrium on both sides, upper abdomen, back and thoracic vertebrae. In severe cases, it involves the entire chest, breathing and turning pain. The pain is usually dull or stabbing and can be chronic or acute. Most patients visited multiple departments and underwent a large number of auxiliary examinations, which basically ruled out abdominal, cardiopulmonary lesions. The location and severity of chest pain may not necessarily correspond to the location and severity of the lesion. Tissue damage caused by trauma, inflammation, tumors and certain physical and chemical factors can stimulate the intercostal nerves, phrenic nerves, dorsal roots of spinal nerves and vagus nerve endings distributed in the esophagus, bronchi, lungs, pleura, heart and aorta, all of which can cause chest pain. Overwork, gallbladder inflammation or gallstones, cold and dampness, and insufficient qi and blood can also cause back pain.

(I) Intercostal neuralgia

Intercostal neuralgia refers to neuropathic pain along the intercostal nerve distribution area caused by various reasons. One or more intercostal nerves may be affected, which is clinically divided into primary and secondary types. 1. Causes Most intercostal neuralgia is secondary and is related to the following factors:

(1) Trauma: chest soft tissue injury, rib fracture, sternocostal joint dislocation, chest surgery and radiation injury. (2) Inflammation: herpes zoster and other viral infections, tuberculosis, rheumatism, ankylosing spondylitis, intercostal soft tissue fibrosis, and abscesses.

(3) Metabolic diseases: diabetic peripheral neuritis, osteoporosis, ethanol poisoning, nephritis, etc. (4) Tumors or metastatic cancer, etc.

(5) Degenerative changes: thoracic vertebrae bone hyperplasia and nucleus pulposus degeneration.

2. Clinical manifestations: Pain in the superficial area along the intercostal nerves, which is semicircular from the thoracic vertebrae in the back to the front chest. It may be located in one or more intercostal nerves. The pain is distributed along the intercostal nerves with obvious boundaries. The pain is usually continuous or worsens in paroxysmal forms, and can feel like a knife cutting, acupuncture or burning. The pain worsens when coughing, sneezing, or taking a deep breath. The patient has a feeling of being restrained, and sometimes the pain radiates to the shoulders and back.

During physical examination, skin allergy, decreased sensation and superficial tenderness may occur at the affected site along the course of the intercostal nerves. The manifestations of the corresponding diseases in X-ray examinations are also the basis for excluding other diseases.

3. Diagnosis The diagnosis can be made based on medical history and clinical manifestations. X-ray and CT examinations can reveal the cause of secondary intercostal neuralgia.

4. Treatment: Secondary intercostal neuralgia should be treated according to the cause. General treatment includes bed rest, nonsteroidal analgesics, acupuncture, and transcutaneous electrical analgesia. Intercostal nerve block: It is the most effective treatment for intercostal neuralgia and also has diagnostic significance. However, improper operation may cause pneumothorax, so special attention should be paid clinically.

(ii) Costochondritis

Costochondritis, also known as chest wall syndrome, is the most common cause of anterior chest pain. Because the pain is located in the anterior chest and may radiate to the shoulders and upper limbs, it is easily confused with angina pectoris. Sometimes it causes patients to feel nervous and they mistakenly believe that they have coronary heart disease.

1. Cause The exact cause is still unclear. It is generally believed to be related to trauma, viral infection, local malnutrition of costal cartilage, inflammation of the sternocostal joints, and myofascial inflammation.

2. Clinical manifestations: Patients present with pain in the anterior chest, which is mostly sore and swollen and is relatively superficial. The onset is acute or slow, the pain is sometimes mild and sometimes severe, and it is continuous pain. The course of the disease is generally long, and there is a tendency for recurrence. The pain may be aggravated by turning over, coughing, sneezing, deep breathing and upper limb activities. You may wake up in pain due to changes in body position during sleep. Sometimes the pain radiates to the shoulders and upper limbs. Physical examination may reveal tenderness over 2 to 5 costal cartilages and possible spindle-shaped swelling, but no local redness or swelling of the skin.

3. Diagnosis Based on clinical manifestations, diagnosis is not difficult, but it should be differentiated from other diseases, mainly from coronary heart disease, angina pectoris, chest tuberculosis, pleurisy, costal cartilage tumors, etc. Electrocardiogram and X-ray examinations can help identify other diseases.

As the saying goes, eating too many grains will cause a hundred diseases. Especially now that people in society lack exercise and physical activity, many people are in a sub-healthy state. There are many reasons for back and chest pain. We can ask the doctor and when it is very serious we can also go for a check-up.