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Adrienne Dellwo

Chest & Rib Pain in Fibromyalgia

By January 22, 2014

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Do you get sharp pains in your chest and ribs? Does it hurt to the touch? (And by hurt, I mean "feel like you're being stabbed with a red-hot knife.")

A lot of us with fibromyalgia get that pain. It's called costochondritis.

Costochondritis is painful swelling between the bones in that area. For me, it was a harbinger of fibromyalgia and made me think I was having a heart attack. For weeks, and then on and off for years, I iced it regularly and had to sleep in a recliner some nights because laying flat caused unbearable pain. When it was bad, it looked like I had half a golf ball sitting on my breast bone.

Sometimes we have pain higher up on the chest, and recently someone here asked about pain near the clavicle. A couple of fibro-related things could be going on: it could the tender points that are used to diagnose us - we have a pair of them just under the clavicle; or it could be myofascial trigger points, like in myofascial pain syndrome, which is extremely common in us.

Of course, if you have a new pain that starts suddenly, it could always be from something completely unrelated to your condition(s). Because chest pain could signal a heart problem, it's imperative that you get it checked out right away and don't write it off as "just" another fibromyalgia symptom. You may also have an injury that needs treated. As always, better safe than sorry.

Learn more:

Have you had costochondritis or other fibro-related chest/rib pain? What triggered it? Did anything help? Leave your comments below!


Photo Yuji Susaki/Getty Images

January 22, 2014 at 9:43 am
(1) Linda says:

This is a very stressful part of having FM. It certainly does make one fear a heart attack and that, in turns, causes heart palpitations and sleepless nights. It’s tricky to provide tips because you don’t want to encourage someone to ignore chest pain. My #1 tip is to see a doc first for confirmation that it’s costochondritis. I have found a heating pad helps, as well as a trick I read somewhere: when lying down, place a pillow between your arm and your body to separate them. This spreads out things inside enough to bring some relief. It definitely helps. When it was very bad, I did have to take medication for a month to calm it down. Doc prescribed a strong NSAID.

January 22, 2014 at 11:23 am
(2) barb says:

Had my first “super attack” of costochondritis this year. Thought I was having a heart attack! Pain stayed intense for 2 1/2 weeks as all my tests came back negative. Even progressed to where it felt like my right shoulder blade was being stabbed from the inside! This is the WORST pain and nothing helped. Still get it at least two or three times a week below my right breast going to the side. This is a nasty, energy draining condition.

January 22, 2014 at 2:24 pm
(3) Melody Lutterman says:

This is good information and I appreciate the article. In addition to Fibromyalgia, Disc Disease, and Spinal Stenosis I also experience Severe Asthma. I had symptoms of a cold begin on October 19, 2013 and it created my asthma to become uncontrolable. Antibiotics, a urinary tract infection, 2 new inhalers, and various cough syrups have been a part of my life for over 3 month. I have experienced terrible pain in my ribs and thought I had broken one or more. My doctor suggested that I wear a rib belt. Then the pain moved to my breasts. Each deep breath hurts; coughing and sneezing is excruciating. Now I am thinking that my out-of-control-asthma caused my Fibromyalgia to misbehave in a big way. In retrospect I have experienced this type of pain before. However, not to this extent. I began to think death was near. Thank you for the information Andrienne and all the fabulous reader comments.

January 22, 2014 at 11:03 pm
(4) Emily Frankovich says:

I got costochondritis the first time when I was carrying a big bag of garbage from our sailboat around Blue Hill Maine which was so clean it didn’t have any places to put my garbage. The pain was dreadful, but no one has ever told me it was fibromyalgia. It seems to be part of my rheumatoid arthritis and it has sent me to the hospital twice. I’ve had it many more times but realized it wasn’t a heart attack. The only thing that seems to work on it is painkillers, tramadol or aleve.

January 22, 2014 at 11:34 pm
(5) Shannon says:

Costochondritis was how my diagnosis of Fibromyalgia started. In the fall of 2010 I suddenly started having intense chest pains that didn’t go away. After many tests, including a heart stress test, it was diagnosed as costochondritis.

What they couldn’t figure out was how/why I had a grape sized lump on my sternum. A surgeon decided it was likely raised cartilage from costochondritis. But no one could “see” this lump. Mammogram, ultrasound, nothing. You could feel it though. It’s still there 3+ years later.

I have to sleep with my single mattress elevated because I cannot bear the pain in my chest laying flat. I use wedges between the mattresses and it works rather well. The hubby sleeps in a single bed beside me because I cannot handle being jostled and he is a light sleeper who can’t handle my odd sleeping hours. So it works for us.

I don’t ice my chest, rather I use a heating pad folded up instead. It helps relax my muscles and gets more blood to the area to help healing. Though I suspect this pain is here to stay by now. The intensity comes and goes but it is *always* there.

Costochondritis isn’t my only Fibro related pain, but it’s my worst.

my blog: http://www.livingwithfibromyalgia.ca

January 24, 2014 at 4:20 pm
(6) Nitalynn says:

For those who have this does it feel like a cramp? I sometimes get these in my side just under the lower level of my breast. Mostly it happens at night.

January 24, 2014 at 4:23 pm
(7) Adele says:

My rib pain is more of a burning pain and very sore to the touch. I started when I tried allery shots for my allergies. I stopped the shots but I still get the pain and soreness. It almost always occurs when the barometric pressure is rising or falling. The steeper the change, the worse the pain. All of my worst fibromyagia pain seems to be associated with changes in the barometric pressure. Has anyone else noticed this.

January 24, 2014 at 5:17 pm
(8) joni says:

I have had that sharp pain since i was about 8 and did not get cfs till my 20′s. Has this been true for anyone else?

January 24, 2014 at 5:30 pm
(9) Angela says:

I just had the rib cage pain this week. My old D.O. told me it’s a part of FMS. She told me the small smoothe muscles in between the ribs spasm and it causes terrible pain. She worked on me-manipulations and I was fine. I now have to go to a chiropractor-an adjustment helps but the next couple days I’ m flaring. I also use Flexiril.

January 24, 2014 at 5:41 pm
(10) Liz says:

The first time I had it I thought something was seriously wrong. I went to hospital on one occasion and was treat with very little compassion. They just didn’t get it!

For me it starts as a pain under my shoulder blade and then it travels round to my chest, up my neck and into my jaw. Whilst at the hospital I had a heart trace whilst it was hurting which thankfully came back clear. Its an awful pain that nothing seems to help soothe. I use a hot water bottle but it can add to the tight feeling on my chest.

Rib pain….. Yes. I frequently get up and wonder if I’ve done something to break them!! I find I can’t sleep on my affected side either. I aren’t directness going on with them fully as the pain spot centres around where I broke two ribs years ago. So painful though!

I’ve recently re-connected with lost family and to my surprise have discovered arthritis runs in my family on my mums side. Just about every female has it or ends up with Fibro!!!
I hope those in pain with this aspect of fibro can find some relief and soothing from it. It truly is nasty.

January 24, 2014 at 5:58 pm
(11) Liz says:

Adele: yes!!! It’s a massive factor in all my fibromyalgia/arthritic symptoms. The worst part of this that we have zero control over it. We just have to surrender to the pain and try get through it. :(

I wonder Adrianne if you could do a feature that’s on tips to soothe pain that others contribute? I’d certainly likevsome ideas to do other than take painkillers! It’d be awesome if you could :)

January 24, 2014 at 6:21 pm
(12) Lynn Staples says:

Yes I suffer with costochondritis, I appear to have a lot of tender points in my ribs. I find when walking as soon as my heart rate rises and I breath more deeply my ribs hurt more, I become more breathless. So exercising is more or less not possible. I have been to the A&E twice when I’ve had pain different to what I’d had previously, but both times the diagnosis was that it was Fibromyalgia

January 24, 2014 at 10:53 pm
(13) Dawn says:

I get rib pain but my worst pain is in ribs in my back & under my right arm
When I atempt to do something. I get that stabbing , deep agony !!!
It takes my breath away !!! It’s worse than child bearth !! I have to breath as if I were having a contraction and nothing I do stops it !!! I have to wait untill it passes on its own !!!! Also my under arm pain is almost constant
Even as I type this my underarm rib pain is hurting !!!!
I never seem to get any answers from my dr it’s all fibro and not in need of any other medication ??? So I have to live with it !!!! Arghhhhhhhh
I hate being told that !!!!!!!!!!!

January 24, 2014 at 11:12 pm
(14) Abot Bensussen says:

This is probably the worst pain that I experience. When it comes, it comes on like gang busters! So intense, I sometimes have to call out and yelp! It’s always on the right side, and I am careful when turning that way. My husband lies on the right side of me, so the pain comes on very often.

The other strongest pain is in my feet. Neuropathy which started only a few years ago. It’s like walking on broken glass. Lyrica has really helped with these pains.

My pain dr. has disappeared, it’s been more than two weeks now that he didn’t appear for our last appointment. I’ve had to research near and far to find a new pain dr. who is taking on new patients. I’ve needed to find two, one for Xyrem prescriptions and another for narcotics. A real adventure in my own little city. My anxiety went through the roof, and with no one to prescribe Zanex, it’s been crazy and I’ve been suffering.

Finally, I’ve got an appointment in a month and a half. My family dr. is helping me out as best he can, but with reservations. Being dependent on drugs is not an enviable position. Just saying.

January 24, 2014 at 11:44 pm
(15) Misty says:

My first few times were not too bad, but hurt to breath so I thought I had pneumonia. Then since I have had I numerous attacks that made me question my heart. After a complete cardiac work up I felt better, but the pain is extreme and often all the way thru to my back. My initial issue started as an injury after a fall that caused atypical trigeminal neuralgia. For years I was treated for migraines with no relief. By the time I was finally diagnosed I was also having many of the fibromyalgia symptoms. Chronic pain is a very real part of my life… The information found here has been extremely helpful and has also helped educate my doctor.

January 25, 2014 at 9:16 pm
(16) Lisa O says:

Abot Bensussen. I have had the same symptoms as you. I have found great relief in my feet (the sensation of walking on glass) by wearing Croc thongs (the original ones wth the thicker soles). My rib pain is much worse a day later if I carry more than light shopping or twist to empty dishwasher or sit in one position for too long (more than 1/2 hour). Hanging out sheets on the line is a big NO NO. I have been able to minimise pain enormously by avoiding these activities where possible. Small fibre peripheral neuropathy appears the the most likely cause for these symptoms.

January 25, 2014 at 9:29 pm
(17) Lisa O says:

Abot Bensussen. I have had the same problems as you for 13 years. Small fibre peripheral neuropathy seems to be the problem. I have had great relief wearing the original croc thongs with the thick soles for the glass sensation of the feet. I have been able to minimise the severe rib pain by avoiding lifting and twisting weighty things – especially things like placing wet sheets onto the clothes line, picking up more than three plates at once from the dishwasher etc. I also have to avoid sitting in the one position for more than 10 minutes. On really bad days when you can’t move without pain the velcro back brace wrapped around the ribs seems to help by stopping as much movement of the rib cage as possible.

January 25, 2014 at 11:41 pm
(18) JudyP says:

I have chest wall pain under my left arm around the bra strap line that burns like when tender points are pressed, even when I’m not wearing a bra. I asked my doctor about it, and she said she’s seen some of her other chronic pain patients with chest wall pain, but not exactly like mine. Anyone else? I don’t really seem to have the typical costochondritis presentation of pain between the ribs in front.

And yes, I’ve had other chest pains that have sent me to the ED thinking I might be having a heart attack. They always tell me I did the right thing, but even with insurance, it gets costly. It always proves to be the mysterious “nothing” of fibromyalgia. And yet, it’s everything, isn’t it?

January 26, 2014 at 9:02 pm
(19) Tommy says:

My experiences:

chronic chest pain over years, just very unpleasent but not severe.
After three month taking Coencyme Q10 50mg/day it left.

If I now have a fit of strong chestpain I first take a spray of nitroglycering, if it is angina pect. it just helps and it gives a lot of protection if it would be a heartattack.

If in this way heart problems are excluded I increase my panodol dosage.


January 27, 2014 at 10:19 am
(20) Celeste says:

Thank you Adrienne for mentioning trigger points in costochondritis. Costochondritis is the most misdiagnosed condition. It is usually caused by some infectious process and even then pain can linger because trigger points develop from the excessive stress on the muscles between the ribs. For us however, chest wall pain is usually from untreated trigger points in the absence of infection and inflammation. Trigger points contribute to shallow breathing, which puts the intercostal muscles at greater risk for exacerbating these little knotted up pieces of muscle fiber that restrict chest wall motion. Myofascial pain syndrome is a great imitator.

January 29, 2014 at 3:20 am
(21) Kristina Schwende says:

I remember the first attack I had. The pain in my chest was so horrific that I could hardly breath. The slightest breath was excruciating. My husband took me straight to emergency. Naturally I checked out fine. The doctor didn’t know what to do with me so he refused to do anything. After this happened a few times I now just do my best to ride it out. When the pain gets that bad, my pain meds don’t touch it. I still haven’t been properly diagnosed but I have given up. No one knows what to do with me anyway.

January 30, 2014 at 7:06 pm
(22) Edana-Daithi says:

Costochondritis has to be one of the most painful aspects of Fibromyalgia.
At least in the sense of how long an episode can last. The first time it occurred, was also the first inkling I had of Fibromyalgia. I have lived with pain all my life, but I used to faint rather regularly also. In 2002 I fainted while walking across the floor at work, and hit my head on an outside corner hard enough to cause a concussion. EMS took me to the hospital still unconscious. When I woke, my head hurt a little, but I kept insisting that I must have also broken a rib. The pain high in the chest wall on my left side was unbearable. Of course they did x-rays, and everything else they could think of including an MRI, there was nothing wrong with my ribs, but the pain continued for weeks. With-in a few months I was Dx’d with Fibro, and never was well enough to return to work. Right now I am in the 6th week of a flare than seems to be subsiding now. The longest one I have had was 8 months. Since that time, I have an EKG done 4 times a year, so if there is something wrong with my heart, hopefully that will catch it, and I do have to go to the ER every time one of these episodes starts.

January 30, 2014 at 7:07 pm
(23) Diane says:

I have chest pain often. I have so much pain from Trigger points & for the first time in 13 years I am getting some relief. The only thing that has helped me is Botox injections. I found a really good Dr. & he injects about 15 spots on my back, shoulder, between ribs. HUGE relief once the Botox kicks in.

January 31, 2014 at 3:41 pm
(24) Ally says:

I have a heck of a time when the weather changes, or specifically, the barometric pressure changes. I have pain that moves, but my usual suspects are in the rib areas. I have not experienced any physical changes, such as lumps, but my pain is quelled by a heating pad, rest and Tylenol or Aleve. Everyone, please beware of docs who tell you that Tramadol does not cause dependency…it does indeed. It is an excellent pain killer for fibro, but should be the last resort.
Ally Burgos

January 31, 2014 at 3:51 pm
(25) Angela says:

The first time I had it I was at work, and alone…it was scary because I also thought I was having a heart attack. When I went to the emergency room, the Dr. didn’t seem too concerned, he told me to go home and rest, and laughed and told me I was stressed and depressed.. I wasn’t impressed

January 31, 2014 at 4:29 pm
(26) ellie says:

My Rheumatologist gave me Voltaren Gel to rub into my chest and ribs. It has helped more than anything else. I can use it several times a day and still take ibuprofen. I believe that the Voltaren goes to generic this year.

January 31, 2014 at 4:33 pm
(27) Debra T says:

I am having it right now. Started yesterday after a stressful afternoon of taking my father to a doctors appt. I refreshed my memory on Costochondritis today since I have no short term memory anymore. It is the inflammation of the cartilage attaching the rib cage to the breast bone. It mimicc heart attack because of all the muscles and nerves that run around and in between them.

I am at high family risk of heart disease and have been in the hospital overnight twice while they ran test to confirm I didn’t have a heart attack. The 2nd time I also had to go to my cardiologist for an echo-stress-test to confirm it. The doctor said it was my esophagus, probably spasm or GERD from taking too many NSAIDs. I don’t take them any more, which sucks with all the arthritis I have (both Rhumatoid & osteoarthritis).

The problem is in telling the difference.

I thought I would add something that has really helped me in the last 4-5 weeks, especially in my energy level. My Psychiatrist manages my Cymbalta and trazadone because I need a higher dosage than he can prescribe for fibro. He wanted me to consider changing anti-depressant or add L-Melthl-Folate 15 MG (it is a prescription strength of folic acid and crowed the blood-brain barrier). I had also been researching wheat grass juice and decided to try a raw food wheat grass powder. Within less than two weeks I was feeling better than I had in over two years.

Just a suggestion in case anyone wants to check it out for themselves.

I to the doctor when I went back to see how I was doing and told him I was also on the wheat grass juice so wasn’t sure if it was the folic acid or the juice. He laughed and said I will take credit, but it was probably a combination of the too.

January 31, 2014 at 4:48 pm
(28) Liza says:

I am so happy to hear, I am not alone. Which I knew, I just haven’t ever expressed it on a Website, or in any chat room. I am looking for a Website or blog page, where there are people with Fibromyalgia and all the other things that come along with it. At the onset of my Fibro, I was experiencing very poor cognition problems, and had intermittent horrible chest and rib pain, that I thought were heart attacks. Thank GOD they weren’t after the many visits, to the Emergency room. Then I thought the reason for my chest and rib muscle pain, was that these areas were just finally ruined/burned out, by the lengthy career as a hairdresser. If you picture a hairdresser working, you will notice that they always have their shoulders and arms held up, and there is a lot of pressure put on the thoracic area too. Sometimes I can just be putting dishes away and reaching, and I will be soar that day or the next. Vacuuming for me is a trusted bad next day for my chest and rib area. Really anything pertaining to using my thoracic area: lifting, reaching, twisting, swimming, vacuuming, dusting, bent over at half way, and many other daily activities as well. It is so frustrating, because I never know when I will be injured or not, by doing any number of these daily activities,If I will be hurt or not.. It drives me crazy……….LIZA :)

February 1, 2014 at 12:08 am
(29) michelle says:

thankyou so much for ur site. for years ive been told its all in my head. ive come to realise ive been describing my pain wrong! i have myofacial pain thats progressed to fibro over 30 odd yrs of not getting anywhere with the n.z. health system.(im 42) im now dealing with things better and not feeling alone anymore. now i need the welfare system to understand that parenting with these conditions IS a full time job, im not being lazy when i go back to bed. i take methadone tablets and have called a drug seeker so many times even by my mother whoes a nurse. celebrex has caused hypertension and nasty rash on my body, its the same as vioxx. smoking pot helps a lot but is illegal here so its a huge risk growing in my garden. ive tried so many meds & supliments but r&r is the only treatment that doesnt have a nasty side.even massage is too painful to tolirate. ive lernt to pace myself and not care how long things take. i can manage my home my child(with help) and my vege garden. my whole upper body aches but at least i can still walk & gently use my exercycle. winz need a kick in the arse as mps and fms are very real its not my fault i cant do a 30hour per week job and cant afford all the things that someone like me should do for my condition. thank you for all the wonderful info u provide its more than ive ever had from the drs here.

February 2, 2014 at 4:32 pm
(30) Cheryl says:

I have had ME/CFS/FM since 1989 and I have to say that I haven’t delt with this problem before the past 2 yrs. It is HORRIBLE!!!!!! I wish the best to all that are suffering with this. It is not easy to be us!!! Hang in there :-)

February 3, 2014 at 12:03 am
(31) Debbie says:

I, Thank God, have not experience this pain. What I do get is a, I don’t even know how to describe it, kind of a burning pain between my left shoulder and my left breast, slightly above my breast. It lingers for days sometimes, its uncomfortable but not so painful that I can’t sleep or lay down. I feel like when I start to get this nagging, burning kind of pain, that its followed by an increase of FM pain. I haven’t actually told my PM about it yet and I am now on the hunt for a new primary care, so I have no idea what this is. Maybe its as simple as heartburn? I truly don’t believe its a heart related issue because its been going on for maybe 9-10 months of and on. Anyway, I find your articles to be informative and reading the comments of other readers helps me out a lot! Even if its just as simple as knowing I’m not alone. Thank you.

February 10, 2014 at 11:43 am
(32) Sharon says:

@Liza – I too have problems with extending my arms to do tasks. Also, I cannot sit, lie, or stand in same position for long periods – sometimes 10 minutes – if I do, it’s hard to get moving again. So when I do (rarely) sleep hard, I can hardly get out of the bed. The barometric pressure falling is a sure indicator that I will be hurting. I have had rib pain which is ‘sometimes’ eased by unhooking my bra, not always. Pressure on tender points is a real meany! I was so interested in the article posted recently that said people with Fibro do not ‘wash out’ carbon dioxide from our cells properly and that leaves us fatigued. Link between barometric pressure and carbon dioxide??

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