Chest Pain Trigger Points
Trigger Point Therapy for Chest Pain and Breast Pain
Important: If you are experiencing any type of chest pain, you should see your doctor immediately. Only after your doctor has ruled out any Cardiac involvement should you investigate trigger points as a source of your chest pain.
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Trigger points in the chest and neck muscle groups can cause pain that is experienced in the chest region. Typically these muscle groups are overload by starting a new exercise program or heavy physical labor. Additionally, various sleeping positions can activate trigger points in these muscles. Besides pain, these trigger points may produces symptoms such as breast tenderness and cardiac arrhythmia.
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The three muscle groups that can contain trigger points that refer pain to the chest region are:
The Pectoralis Major Trigger Points that Cause Chest Pain and Breast Pain
The Pectoralis Major muscle group is the large, flat muscles found in the upper chest region. The muscle has four overlapping sections that attach to the ribs, collarbone, chest bone, and upper arm bone at the shoulder.
This muscle group contracts as you push with your arms in front of you (e.i. the bench press) and when you rotate your arms inward towards your trunk. The Pectoralis Major can contain up to five different trigger points that refer pain in the chest, shoulder, and breast regions.
Additionally, pain or numbness may radiate down the inside of the arm and into the fingers. Trigger points in this muscle group tend to activate trigger points in the upper back muscles that produce pain between the shoulder blades.
Pectoralis Major Trigger Point Symptoms
Patients with active pectoralis major trigger points will present with chest pain, front shoulder pain, and pain traveling down the inside of the arm to the elbow. If this referred pain occurs on the person’s left side, it can be confusingly similar to cardiac pain. Important Note: If you have chest pain please see a cardiologist to rule out cardiac involvement before investigating trigger points as the source.
The pain from the pectoralis major trigger points initially will occur on one side of the chest but will spread to the trigger points on the other side as it intensifies.
In woman, breast pain and nipple sensitivity will often occur with these trigger points. The breast may also be enlarged because the tension in this muscle can impair normal lymphatic drainage.
A simultaneous pain in the mid-back, between the shoulder blades, frequently occurs with these trigger points. Sometimes this back pain component is the only symptom from these trigger points.
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In most patients, the pain from the pectoralis major trigger points is only experienced with movement of the arms and is absent or minimized at rest.
The Pectoralis Minor Trigger Points that Cause Chest Pain
The Pectoralis Minor muscle is a small muscle that lies underneath the larger Pectoralis Major muscle group. This muscle attaches to the Shoulder Blade behind the collar bone, and runs downward to attach to the upper ribs in the front of the upper body.
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This muscle can contain two trigger points that refer pain over the chest and shoulder regions, and sometimes the pain may extend down the inside of the arm.
Pectoralis Minor Trigger Point Symptoms
​Patients with active Pectoralis minor trigger points complain of chest pain and shoulder pain on the front of the shoulder. The pain will often extend down the inside of the arm to the inside of the elbow, and to the wrist and hand. A hallmark of these trigger points is pain in the pinky, ring, and middle fingers.
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A tight Pectoralis Minor muscle with active trigger points is likely to compress the nerve and blood vessels as they exit the armpit region to supply the arm. This can simulate or cause Thoracic Outlet Syndrome and Carpel Tunnel Syndrome with symptoms such as pain and numbness that travels down the arm into the wrist, hand, and fingers.
The Scalene Trigger Points that Cause Chest Pain
The Scalene muscle group is found deep in the lower neck. It flexes the neck to the side and helps to lift the rib cage when you inhale sharply.
Trigger points in the Scalene muscles can produce a variety of upper body symptoms including chest pain, shoulder blade pain, and radiating pain down the arm, skipping the elbow joint, and into the hand.
Scalene Trigger Point Symptoms
Patients with active Scalene trigger points will complain of simultaneous chest pain and upper back pain. Sometimes these symptoms will be accompanied by difficulty breathing. Obviously, chest pain and difficulty breathing scream heart attack, so if you are experiencing these symptoms get to your doctor or an ER to get examined.
If the doctor doesn't find any problem with your heart, you will most likely be diagnosed with panic attacks. At this point you should come and see me. Treatment of the scalene trigger points (and trapezius trigger points) can do wonders for panic attacks.
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The upper back pain created by the Scalene trigger points is typically described as pain between the shoulder blades, while the chest pain is described as two-fingers of pain starting below the clavicle and traveling down the chest.
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The arm pain can be caused by both trigger point activity directly and by entrapment of the nerves and blood vessels (indirectly) by a tense Scalene muscle in the neck. Like with Pectoralis Minor, this entrapment can cause Thoracic Outlet Syndrome symptoms such as pain and numbness down the arm, forearm, and hand. Unlike the Pectoralis Minor, the fingers affected are usually the thumb and index finger. These symptoms may also mimic Carpel Tunnel Syndrome.
Related Instructional Videos from Dr. Perry
While the videos below were created to teach therapists how to locate and release these trigger points, many non-professionals have used them to learn these techniques successfully.
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If you have a partner, a little time, you can use these videos to learn how to treat your own trigger points.
Related Articles from Dr. Perry
More extensive articles on these muscles and trigger points are available from Dr. Perry on our sister website TriggerPointTherapist.com. Click on the titles below to read them:
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