Chest and Neck Pain: Causes, Symptoms, and Treatments

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chest and neck pain

Chest and neck pain are common symptoms that can have many different causes, ranging from minor muscle strain to potentially serious medical conditions. 

According to our experience at Kaly, chest and neck pain can arise from musculoskeletal problems, lung conditions, acid reflux, anxiety, heart disease, and more. Pinpointing the source involves a medical evaluation and diagnostic testing. 

While severe chest pain should receive prompt emergency care, many non-urgent cases can be managed with rest, lifestyle changes, medication, physical therapy, and stress management techniques.

What causes pain in the neck and chest area?

chest and neck pain

Chest and neck pain often results from musculoskeletal causes like muscle strain, arthritis, or nerve impingement in the cervical spine. Moreover, gastrointestinal issues such as acid reflux can also cause chest and neck discomfort when stomach acid irritates the esophagus

Less commonly, pain in the chest and neck can stem from lung conditions like pneumonia or pleurisy, based on our experience. Infection and inflammation of lung tissue and membranes can refer pain perceived in the chest, neck, and shoulder areas.

Cardiac problems including angina and heart attack may also manifest with chest and neck pain. Restricted blood flow and oxygen deprivation of heart muscle often cause pain that radiates from the central chest into the neck, arms, and jaw.

Did you know that a study found that the global pooled prevalence of musculoskeletal chest pain in the emergency department is 16%?

Can stress cause neck and chest pain?

Yes, stress can manifest with physical chest and neck pain. When the body is under stress, muscles tend to tense up. This can cause discomfort or tightness in the chest, neck, shoulders, and back. 

Some key facts about stress-induced pain of this type:

  • The chest pain associated with stress and anxiety is often described as a squeezing, pressure, tightness, or heaviness in the chest area and along the breastbone.
  • Sharp stabbing chest pains can also sometimes occur with anxiety and panic attacks.
  • Stress causes the neck and shoulder muscles to tighten and spasm which translates into stiffness, achiness, and soreness.
  • Hyperventilation caused by anxiety may also lead to chest tightness and a sensation of breathlessness.

Kaly recommends learning stress management techniques like mindfulness or meditation as they can help control stress levels and associated muscle tension. Talk therapy, medication, breathing exercises, and lifestyle changes also help manage stress and anxiety.

Can acid reflux cause chest and neck pain?

Acid reflux is a common cause of chest and neck discomfort. When stomach acid backs up into the esophagus, it can irritate the lining and cause a burning sensation in the chest along with pain that radiates into the neck or throat. 

A case study published in the National Center for Biotechnology Information (NCBI) discusses a 35-year-old female patient who presented with sharp pain in the neck, upper back, and sternum area, along with gastroesophageal reflux disease (GERD). 

The patient’s symptoms, including a burning sensation in the chest, were worse in the evening and aggravated by lying on her back while sleeping. After a month of treatment involving cervical adjustment and soft tissue massage, the patient reported full pain resolution and her GERD symptoms concurrently resolved.

A study on the roles of gastro-oesophageal afferents in the mechanisms and symptoms of reflux disease, published in PubMed, explains that oesophageal pain is often caused by acid reflux from the stomach. This can result in heartburn and non-cardiac chest pain.

  • Reflux can feel like burning, warmth, tightness, or soreness from the mid-chest up into the lower throat.
  • It may worsen when lying down, bending over, or eating trigger foods.
  • The pain often starts shortly after eating a large, acidic, or fatty meal.

Based on Kaly specialists’ experience, implementing dietary and lifestyle changes can help manage acid reflux. Avoiding trigger foods, not eating late at night, elevating the head when sleeping, and losing weight if overweight can all minimize reflux symptoms. 

Kaly advises over-the-counter antacids or prescription medication for more persistent cases.

Can swollen lymph nodes in the neck cause chest pain?

Enlarged or swollen lymph nodes in the neck can occasionally cause chest pain. Lymph nodes contain immune cells that filter fluids and fight infection. When they become enlarged due to an infection or illness, they can press on nearby muscles, nerves, and blood vessels. 

This compression can sometimes translate as pain referral into the chest region, even without direct injury to chest structures. If swollen lymph nodes in the neck persist for several weeks, it’s a good idea to see a doctor to identify and properly treat the underlying cause.

A study published in Medical News Today explains that swollen lymph nodes in the chest can cause symptoms such as chest pressure and fullness. The lymph nodes sometimes swell when fighting an infection, and this swelling can push on organs or other structures, which may cause pain.

An NCBI case study discusses a patient with COVID-19 who presented with pericardial effusion along with enlarged mediastinal lymph nodes. The patient experienced chest pain and discomfort. 

The study suggests that lymphadenopathy (swelling of the lymph nodes) may be related to pericardial effusion or myopericarditis, both of which can cause chest pain.

The American Cancer Society also provides evidence that when lymphoma starts in the thymus or lymph nodes in the chest, it may press on the nearby trachea (windpipe), which can cause a feeling of chest pain or pressure.

Can a pinched nerve in the neck cause chest pain?

Yes, a pinched or compressed nerve in the neck frequently causes pain to radiate into the chest. The cervical nerves transmit signals and sensations between the neck and chest. Any one of these nerves that gets irritated can cause pain along the length of the nerve. 

Nerve impingement in the neck often manifests with chest pain, as well as numbness or tingling in the arm and hand on the affected side. Seeing a physical therapist or chiropractor for neck mobilization exercises, stretches, and manual adjustments can often effectively treat a pinched nerve.

One study titled “Cervical Radiculopathy as a Hidden Cause of Angina: Cervicogenic Angina” provides a detailed case of a 56-year-old man who presented with chest pain and chronic neck pain, along with numbness in his fingers. The patient was diagnosed with cervical radiculopathy, a condition where a nerve in the neck is compressed or irritated. 

After treatment, which included pain medication, cervical traction, and physical therapy, the patient reported a 50% improvement in chest pain, neck pain, and radicular symptoms within the first two weeks. After three months, the patient reported complete resolution of neck or chest pain and regained neck mobility.

Another study titled “Cervical Angina: A Literature Review on Its Diagnosis, Mechanism, and Management” further supports the claim. The study defines cervical angina as chest pain that resembles true cardiac angina but originates from disorders of the cervical spine. 

The study suggests that cervical nerve root compression is a common cause of cervical angina. The pain may be present at rest or exacerbated by cervical range of motion or movement of the upper extremity.

A study titled “Efficacy of neck stabilization exercises for neck pain: a randomized controlled study” found that neck stabilization exercises were superior in managing neck pain compared to isometric and stretching exercises in combination with physical therapy agents.

Why does my chest hurt when I turn my neck?

Twisting or straining the neck while turning the head can pull on muscles and tissues connected between the neck and chest. This exaggerated motion and tension get translated into pain that you perceive in the chest region. 

The nerve supply, lymph drainage, and muscle attachments that span from neck to chest facilitate this referred pain. Protecting your neck by avoiding abrupt, forceful movements can help prevent recurrence. Proper stretching and posture are also crucial.

A study conducted at Saint Vincent Hospital in Massachusetts, USA, between 2008 and 2011, identified cervical angina as a potential cause of noncardiac chest pain. This condition originates from disorders of the cervical spine. The study found that the majority of cases with cervical angina, up to 70%, have been attributed to cervical nerve root compression. 

Radicular pain is likely mediated by compression of the C4 to C8 nerve roots, which supply the sensory and motor innervation to the anterior chest wall through the medial and lateral pectoral nerves. This means that issues in the neck can lead to perceived pain in the chest.

Another study on “Mechanisms of cardiac pain” explains that the innervation of the heart contributes to the anginal pain experienced in the neck and jaw. The spinothalamic tract, which carries pain and temperature sensations to the brain, projects to the medial and lateral thalamus and contributes to the anginal pain experienced in the chest and arm.

A case report on “Thoracic outlet syndrome of pectoralis minor etiology mimicking cardiac symptoms on activity” explains that if the pectoralis minor muscle is involved in the condition, the patient may present with chest pain, along with pain and paraesthesia in the arm. These symptoms are also commonly seen in patients with chest pain of a cardiac origin.

Is sudden discomfort in the neck and chest a sign of a heart attack?

While many benign causes exist for neck and chest discomfort, the combination of sudden, acute chest pain radiating into the neck can indicate a heart attack in some cases. Crushing chest pain spreading to the left arm and neck is specifically associated with a heart attack. 

However, pinching a nerve or having a panic attack can also produce similar symptoms. Given the potential severity of myocardial infarction, acute onset of neck and chest pain should prompt urgent medical evaluation to rule out cardiac causes. 

Call 911 or go to an emergency room for rapid diagnosis and care.

Can left-sided chest and neck pain indicate a heart problem?

Chest discomfort isolated to the left side that radiates into the left neck or shoulder raises greater concern for potential cardiac issues. But musculoskeletal problems can also cause one-sided pain in some cases. Heart attacks usually cause central chest pain that radiates, not side-specific pain alone. 

While left-sided chest and neck pain are more suspicious for cardiovascular disease, like blockages in the left anterior descending artery, diagnostic testing is required to confirm the true cause. Make an appointment with your doctor promptly to discuss your symptoms.

What does it mean if chest pain radiates to the neck?

When chest pain radiates, spreads, or shoots into the neck, it is often a signal that the cause is something more than superficial muscle tension. Radiating pain indicates the deeper structures like nerves, lungs, or heart are involved. 

  • As discussed above, cardiac conditions like angina can refer to pain through nerve pathways that connect these two areas. It is often felt as tightness or pressure.
  • A pinched nerve in the cervical spine can also send sharp, shooting pain signals from the impinged nerve root into the chest.
  • Lung problems like pleuritis that cause chest pain often radiate an achy, stabbing sensation into the shoulders and neck too.
  • Gastroesophageal reflux disease can radiate burning chest pain or tightness up into the lower throat and neck areas.

The NCBI Bookshelf explains that chest pain is a common symptom that can indicate serious cardiac or cardiovascular disorders. Pain can originate from various structures within the chest, including the heart, and can be transmitted by different nerves, making it difficult to localize the source of pain. 

Kaly recommends you take note of any other associated symptoms and be sure to discuss radiating chest and neck pain promptly with your doctor. Describe the type of pain and any triggering actions to help determine the cause.

What is the connection between chest, shoulder, and neck pain?

The chest, shoulders, and neck share common neurological innervation, making them susceptible to referred pain syndromes. The nerves running through the cervical spine branch out to stimulate and transmit sensations from tissues in the neck, shoulders, chest, and arms. 

When a nerve gets pinched or inflamed, the pain signal can travel and materialize distally from the original source. Muscle tension and restricted blood flow can also spread through neighboring tissues via anatomical linkages. 

This means tightness starting in the shoulder could irritate nerves and manifest with pain in the chest or neck. The National Heart, Lung, and Blood Institute (NHLBI) mentions that angina can also spread to the shoulders, arms, and neck.

The Cleveland Clinic provides information on Thoracic Outlet Syndrome (TOS), which can cause pain in the neck, upper chest, shoulder, and arm. TOS occurs when there’s compression of nerves or blood vessels in the lower neck and upper chest, leading to pain and other symptoms in these areas.

What does sharp pain in the neck and chest indicate?

Sharp, sudden, stabbing sensations in the neck and chest often result from acute muscle spasms or pinched nerves. Compressed nerves tend to shoot pain down the arm in addition to causing localized neck and chest pain. 

Less frequently, lung conditions like pleuritis can make each breath feel like a sharp knife, including up into the chest, neck, and shoulders. Cardiac chest pain is rarely described as sharp by patients, but rather as fullness, pressure, aching, or crushing.

Can a headache accompanied by chest and neck pain signify a serious health problem?

Yes, concurrent headaches with chest and neck pain can potentially indicate an underlying neurological or vascular condition requiring prompt medical care. Migraines involving neck stiffness and chest pain may precede vascular headaches.

A 2014 study in the Journal of Emergency Medicine revealed that chest pain can be a symptom of migraines. However, this is very uncommon and the exact cause of chest pain occurring as a migraine side effect is not known.

A particularly severe, sudden headache with chest and neck pain could signify a hemorrhagic stroke. Thunderclap headaches accompanied by chest symptoms are considered a medical emergency. In rare cases, some types of neuralgia can manifest with neck, chest, and head pain. 

Can neck stiffness be associated with chest pain?

Yes, neck pain and stiffness can be related to chest discomfort in some cases. Tight, inflamed muscles in the neck and upper back region can refer to pain in the chest area. Muscle tension triggered by poor posture is a common cause of stiffness and pain between the neck and chest. 

The study that discussed cervical angina found that the most frequently affected levels of cervical nerve root compression were C5-C6 (37%), C6-C7 (30%), C4-C5 (27%), and C3-C4 (4%). 

Inflammatory conditions like arthritis that affect the cervical spine can also contribute to a stiff neck and associated chest pain.

Sometimes, neck tightness happens concurrently with chest pain, rather than directly causing it. For example, acid reflux can provoke esophageal spasms that generate chest pain and neck stiffness simultaneously. 

Sleeping in a strange position could also strain both the chest and neck muscles. If simple stretching does not alleviate chronic neck tightness and chest pain, consult your doctor to diagnose and treat the underlying source.

The Sleep Foundation discusses how poor sleeping positions can lead to neck pain and strain, which can potentially cause chest discomfort. The article suggests that poor support during sleep can trigger pain in the neck and other areas of the spine.

How to relieve chest and neck pain?

Kaly advises you to follow these tips to help relieve this discomfort:

  • Apply ice packs to tense neck and chest muscles to reduce inflammation. Heat packs can also relax tight muscles and increase blood flow.
  • Take over-the-counter analgesics like acetaminophen or ibuprofen to ease musculoskeletal aches and pain.
  • Perform gentle neck stretches and exercises to improve mobility if stiffness is present.
  • Use correct posture when sitting at a desk or driving to prevent neck and chest muscle strain.
  • Avoid trigger foods and eat smaller meals to minimize acid reflux episodes. Sleep with the head elevated to reduce nighttime heartburn.

For chronic, persistent, or worsening discomfort, make an appointment with your doctor for an evaluation. According to our experience, prescription medication, physical therapy, pain management injections, or other treatments may be required depending on the underlying cause. 

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