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Chest Pain

Chest pain can be from a variety of sources but the one which is most feared is the pain from restriction of blood flow to the cardiac muscle. Any suggestion of a heart related cause for chest pain should be immediately evaluated by a medical doctor.

Angina is the most common manifestation of heart disease, often just called chest pain. Angina symptoms can be a number of feelings, such as heaviness, pressure, discomfort, burning, aching, squeezing or just painful. It may feel like indigestion and can be mistaken for this. It can also spread out to the shoulder and arm, neck, throat and jaw or even through to the back.

Usually angina will be due to physical exertion and should be linked to that but any suspicion of angina and you should talk to your medical advisor for a proper opinion.

Other causes of chest pain can include a blood clot in the lung (pulmonary embolus), asthma, a chest infection such as pneumonia, pleurisy, a minor lung collapse (pneumothorax), anxiety with rapid breathing (hyperventilation), shingles, inflammation of the cartilage joints at the breastbone and a number of digestive conditions.

Musculoskeletal Causes - Middle Back Pain and Chest Pain

Middle back pain or mid back pain I have defined as pain in the lower half of the thoracic spine from the sixth to the twelfth thoracic vertebrae, just above the lumbar spine.

The upper half of the thoracic spine is more capable of referring pain round to the chest from the facet joints or rib joints but middle back pain symptoms can spread to the front of the lower chest and upper to lower abdomen.

Middle back pain spine structure is the lower thoracic spine which is specialised for rotation of the body and allows relatively little flexion and extension (forward and backward bending). The facet joints and rib joints are present at both sides and at each level, giving a large number of joints which can be strained by a sudden or awkward movement or subject to longer term postural stresses, all of which can cause painful problems to develop.

Physiotherapists can provide back pain relief by assessment and provision of treatments such as mobilisation techniques, postural correction and advice, explanation, fitness programmes and middle back pain exercises.

Chiropractors' middle back pain management is similar although they have their own specialised assessment methods, diagnostic categories and manipulation techniques.

Further information about middle back pain can be accessed at Backpainexpert and

Middle Back Pain – Neck Involvement

The neck joints have been shown to be able to refer pain down as far as the lowest point of the shoulder blade so can have a strong role in upper back pain but do not have much relevance to this type of mid back pain.

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