Chiropractic & Chest Pain

Non cardiac chest pain is a common problem presenting to a chiropractors’ practice. Chest pain can present in various ways and if there is any question that the pain is anything but musculoseletal in origin and may arise from a heart or lung problem I refer directly for medical assessment. More often than not the patient who has experienced chest pain has already seen their medical practitioner and appropriate tests have revealed no heart or lung problem.

There are many presentations of chest pain arising from the spine and attached ribs. The ribs articulate with the spine so a dysfunctional (or subluxated) spinal joint can affect the rib(s) that articulate with it. The rib is like the rung of a barrel as is wraps around to join the sternum (or breast bone). Pain may occur anywhere along the rib as it wraps around and we are mindful that there is a nerve called the intercostal nerve as well as the intercostal muscle between each rib that can react as soon as there is a change in its normal movement.

Sometimes the pain is deep in the chest and seems to radiate between the back and the chest. This is the greatest mimic of pain arising from a heart problem. Sometimes the pain is in the side of the chest and sometimes where the ribs join the sternum on the front of the chest. Sometimes patients present with pain lower in the chest which is more in the epigastric region just under the front of the rib cage. This can also radiate through to the mid back. This can also arise from the spine and lower ribs causing a functional effect on the diaphragm and hiatus region. Functional problems in this region can also cause the patient to experience symptoms they describe as ‘heart burn’, ‘indigestion’ or ‘reflux’. The diaphragm is a big sheet of muscle the attaches up inside the lower ribs and rises up and down with the lungs as we breath. Again, a medical assessment can rule out things like a hiatus hernia or gastric ulcer leaving the possibility of musculoskeletal origin.

Chest pain arising from the spine!? I’ve experienced it myself and spent the night in hospital getting my heart checked out for peace of mind, which I encourage anyone to do. A regular adjustment to my spine by my colleague as well as remedial massage keeps it under control!

Here are some useful links if you want to read a bit more:
https://www.mja.com.au/journal/2013/199/1/approach-patients-possible-cardiac-chest-pain
http://www.tihcij.com/Articles/Management-of-Non-cardiac-Chest-Pain-With-Chiropractic-Care-A-Case-Report-and-Brief-Review.aspx?id=0000308
http://www.sayerclinics.com/conditions-treated/mid-back-rib-chest-pain/

Dr Patrick Maher – Chiropractor Brisbane CBD