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Chest Pain and Spondylitis

Updated on September 07, 2021
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Anastasia Climan
Article written by
Aiden Lindow

If you frequently experience chest pain with spondylitis, you’re not alone. Chest pain is a common complication of spondylitis. Along with some of the more common symptoms of spondylitis, many MySpondylitisTeam members have also experienced chest pain related to their condition. This pain may be mistaken for a heart attack, heart disease, lung problems, or conditions like angina.

Here is what you need to know about chest pain in spondylitis, including what it feels like, what causes it, and how it can be managed.

What Does Chest Pain in Spondylitis Feel Like?

MySpondylitisTeam members describe their chest pain as a “crushing,” “stabbing,” or “searing” feeling in their chests that can be mistaken for a heart attack. Other members have described their pain in different ways:

  • “Mine feels like a heavy weight on my chest, and deep breathing causes coughing.”
  • “It feels like a wire brush scrubbing the inside of my chest.”
  • “I felt like I was being stabbed with a dull screwdriver.”
  • “Tightness and pressure in my chest wall. My breathing has become short and shallow.”
  • “I’ve had chest pains for years that feel like a hot knife through my chest when I breathe.”

What Causes Chest Pain in Spondylitis?

Below are some reasons why spondylitis may produce chest pain.

Costochondritis

The most frequently cited cause of chest pain among MySpondylitisTeam members is costochondritis. Costochondritis is inflammation of the cartilage that connects the ribs and breastbone. If you have costochondritis, your chest may feel tender, and sometimes sharp pains can travel to nearby areas like your stomach or back. Coughing or taking deep breaths can make costochondritis pain worse, so you may notice it more after exercise.

One member with “terrible chest pain” and difficulty breathing deeply said, “It turned out my sternum and ribs were inflamed, causing costochondritis.” Added another, “I’ve had a pretty bad case of costochondritis for the last few days. It’s tough to cough, sneeze, and breathe deeply. It’s starting to affect my sleep.”

Cardiovascular Disease

Between 2 percent and 10 percent of people with ankylosing spondylitis, a severe form of spondylitis, experience heart issues. These may include:

  • Aortitis — Inflammation of the aorta that may cause a leaky valve or high blood pressure
  • Cardiomyopathy — A weak and enlarged heart
  • Conduction disturbances — Irregular heartbeats that are either too fast (tachycardia) or too slow (bradycardia)
  • Ischemic heart disease — Restricted blood flow to the heart caused by atherosclerosis (hardened arteries)

Lung Inflammation

Sometimes chest pain with spondylitis has nothing to do with the heart, but is rather due to lung problems. Inflammation of the tissue that surrounds the lungs and lines the chest wall is called pleurisy. If spondylitis leads to pleurisy, you may notice shortness of breath; a sharp, stabbing chest pain; a dull ache; or pain that gets worse when you sneeze or cough. Pleurisy can also involve pain in the shoulders or back.

When To Seek Immediate Medical Attention

Chest pain should always be taken seriously. If you have chest pain, call your doctor or emergency medical services immediately to rule out a more serious condition such as a heart attack. A physical exam and other diagnostic tests (like an EKG or chest X-ray) can help determine the cause and severity of your chest pain.

Signs that you may be having a heart attack include:

  • Chest pain
  • Cold sweats
  • Flushing
  • Feeling faint
  • Nausea and vomiting
  • Pain or numbness that spreads to your back, jaw, left arm, or neck

It can be difficult to tell the difference between chest pain that’s dangerous and chest pain that’s a benign symptom of spondylitis. When in doubt, don’t hesitate to contact your health care provider for guidance and peace of mind.

Managing Chest Pain With Spondylitis

Many MySpondylitisTeam members have developed their own strategies for dealing with the chest pain that often comes with spondylitis. It is a good idea to talk with your doctor about the following options and others you may have for managing spondylitis-related chest pain, such as physical therapy. Experiment with different methods until you find what gives you the best pain relief.

Heat and Cold Therapy

Hot or cold compresses can help ease the pain of costochondritis. Heat helps alleviate pain and tension by loosening the muscles around the joints and increasing flexibility and circulation. Cold, on the other hand, helps reduce inflammation and dull pain. You may want to try alternating between the two to find which option provides the most relief.

Heat therapy can be done using hot water bottles and heating pads. Members have also recommended taking hot baths and showers to relieve pain. You can ice areas of chest pain using a cold pack or a bag of ice or frozen peas wrapped in a dishcloth.

Medication for Spondylitis Chest Pain

To alleviate chest pain, prescription and over-the-counter medications may help. Options include corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, Advil (ibuprofen), and Aleve (naproxen). As one member advised, take your prescribed medications or talk to your doctor about trying new medications to better manage spondylitis-related chest pain.

Breathing Exercises

Deep breathing exercises are typically the first line of defense for keeping the ribs flexible and the breathing muscles in good condition. The exercises are also important for long-term pain management. However, breathing exercises can be difficult for members with decreased chest expansion.

“My ribs are fused, and I only have 0.8-centimeter chest expansion,” shared one member. Another, who said their chest is “fully frozen and doesn’t get much movement,” relies on “belly breaths” for exercise.

One member offered the following advice: “Stretch, try breathing exercises to relax and rest, and then try, try again.” Another recommended: “Try to find a relaxing place in the house and do some deep breathing exercises.”

Physical Activity

A spondylitis exercise program is often recommended to improve posture and flexibility and to reduce pain. Exercise under the guidance of a physical therapist may also be helpful.

“Any exercise I can do always improves my pain and stiffness,” one member wrote. “I would say we must keep as active as we possibly can, no matter how slow we may be.” Others have used exercise bikes and tai chi training. Yoga helped one member get moving. “I have to modify some of the moves,” they said. “I also take restorative yoga, and it’s a perfect fit!”

Rest

Costochondritis can sometimes be due to physical stress, such as overexertion during exercise. Don’t forget to take time to rest, and avoid certain activities if you notice they tend to bring on chest pain.

Massage

Gently massaging the neck and shoulder area may help alleviate pain and tension associated with chest pain, some members have shared.

Surgical Intervention

If your chest pain is caused by heart disease, you may be referred to a cardiologist or cardiac surgeon for further evaluation and treatment. Some causes of chest pain require surgery — for instance, when the aortic valve doesn’t close properly (aortic regurgitation). People with atherosclerosis may need a stent or a coronary bypass to improve blood flow to the heart and to alleviate chest pain and other symptoms. A pacemaker can help treat conduction disturbances or cardiomyopathy.

Find Your Team

MySpondylitisTeam is the social network and online support group for people with spondylitis and their loved ones. Here, more than 69,000 members come together to ask questions, give advice, and share their experiences of living with spondylitis.

Do you experience chest pain due to your spondylitis? What are your go-to tips for managing the pain? Share your tips in the comments below or by posting on MySpondylitisTeam.

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Anastasia Climan is a dietitian with over 10 years of experience in public health and medical writing. Learn more about her here.
Aiden Lindow is a writer at MyHealthTeams with experience writing content in the medical and health care space. Learn more about him here.

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