Chest Pain While Sitting: Possible Causes and Solutions

Experiencing chest pain while sitting?

Hello, doctor.
I have been troubled by this issue for about two months.
When I sit, I sometimes feel a sharp pain in my left or right chest, and occasionally, I feel like something is stuck in my left back.
These symptoms almost never occur when I lie flat on my back in bed; sometimes, lying down can make the pain almost disappear.
However, if I sleep on my side or stomach, I experience discomfort in my chest, which feels like something is pressing on my chest.
As a result, I can only sleep lying flat on my back.
I would like to ask the doctor what this could possibly indicate.
Thank you, doctor.

Yang Wenping, 20~29 year old female. Ask Date: 2015/11/25

Dr. Chen Bozhang reply Family Medicine

Dear Mr.
Yang,
In your letter, you mentioned experiencing a stabbing or pressure sensation in your chest while sitting, as well as during side or prone sleeping.
There are many potential sources for your symptoms, including compressive lesions involving solid organs (such as the thorax or lungs) or neuropathic pain.
Since these symptoms have persisted for about two months, I recommend that you visit a pulmonology clinic for a thorough evaluation by a physician, who can then arrange for further testing and appropriate management.
I hope this information is helpful to you.
Sincerely,
Dr.
Chen Po-Chang
Department of Family Medicine
Keelung Hospital, Ministry of Health and Welfare

Reply Date: 2015/11/25

More Info

Chest pain can be a concerning symptom, especially when it occurs frequently or under specific conditions, such as while sitting. Your description of experiencing sharp pain in the left or right chest, along with a sensation of something being stuck in your left back, raises several potential causes that should be considered.

Firstly, it is essential to differentiate between cardiac and non-cardiac causes of chest pain. While you mentioned that the pain subsides when lying flat, which is a positive sign, it is still crucial to rule out any serious cardiac issues. Conditions like angina or myocardial infarction (heart attack) typically present with pain that may not be relieved by changes in position. However, given that your symptoms improve when lying down, it is less likely to be heart-related.

One possible explanation for your symptoms could be musculoskeletal issues. Poor posture while sitting, especially if you are hunched over a computer or desk, can lead to muscle strain or irritation of the nerves in the thoracic region. This can manifest as sharp pain in the chest or back. Conditions such as costochondritis, which is inflammation of the cartilage connecting the ribs to the sternum, can also cause localized chest pain that may worsen with certain movements or positions.

Another consideration is gastroesophageal reflux disease (GERD). This condition can cause chest pain that mimics heart pain, often described as a burning sensation. It can be exacerbated by certain positions, particularly if lying down or bending forward. If you notice that certain foods or eating habits trigger your symptoms, it may be worth discussing with your healthcare provider.

Anxiety and stress can also play a significant role in chest pain. Many individuals experience somatic symptoms, including chest discomfort, when they are anxious or stressed. This can lead to hyperventilation, which may cause a sensation of tightness or pain in the chest. If you find that your symptoms correlate with periods of heightened stress or anxiety, it may be beneficial to explore relaxation techniques or speak with a mental health professional.

Given that your symptoms have persisted for two months, it is advisable to seek a thorough evaluation from a healthcare provider. They may recommend imaging studies, such as a chest X-ray or MRI, to assess for any structural issues, as well as blood tests to rule out cardiac markers. A referral to a specialist, such as a cardiologist or a pulmonologist, may also be warranted based on the findings.

In the meantime, consider making some lifestyle adjustments. Maintaining good posture while sitting, taking regular breaks to stretch, and practicing relaxation techniques can help alleviate some discomfort. If you find that certain positions exacerbate your symptoms, it may be beneficial to avoid them as much as possible.

In conclusion, while your symptoms may not indicate a severe underlying condition, it is essential to have them evaluated by a healthcare professional to ensure proper diagnosis and management. Keeping a symptom diary, noting when the pain occurs, its intensity, and any associated factors can also provide valuable information for your healthcare provider.

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