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    Most common causes of MSK Chest pain and best evidence-based treatment for them:

    Here’s an overview of the most common causes of chest pain seen by chiropractors, physiotherapists, and musculoskeletal practitioners, along with evidence-based treatments for each condition.

    1. Costochondritis

    Costochondritis is characterized by inflammation of the cartilage connecting the ribs to the sternum, leading to localized chest pain.

    Evidence-Based Treatment:

    • Manual Therapy: Techniques such as manipulation or mobilization can help alleviate pain and improve chest wall mobility (Bronfort et al., 2012).
    • Therapeutic Exercises: Stretching exercises targeting the chest and shoulder girdle can improve flexibility and reduce discomfort (Page et al., 2010).
    • Modalities: Heat application and non-steroidal anti-inflammatory drugs (NSAIDs) are often effective for pain relief (Meyer et al., 2016).

    2. Muscle Strain

    Muscle strains in the chest area can occur due to overexertion, trauma, or poor posture.

    Evidence-Based Treatment:

    • Manual Therapy: Soft tissue mobilization and myofascial release techniques can help reduce tension and improve function (Ajimsha et al., 2015).
    • Therapeutic Exercises: A rehabilitation program focusing on strength and flexibility for the chest and upper back muscles is beneficial (Davis et al., 2014).
    • Modalities: Ice application for acute strains and heat for chronic strains can facilitate healing (Goats, 1994).

    3. Intercostal Neuralgia

    Intercostal neuralgia is characterized by sharp, shooting pain along the ribs due to nerve irritation or damage.

    Evidence-Based Treatment:

    • Manual Therapy: Spinal manipulation and soft tissue techniques can reduce nerve irritation and improve mobility (Bronfort et al., 2012).
    • Therapeutic Exercises: Gentle stretching and strengthening exercises can help alleviate pain (Page et al., 2010).
    • Electrotherapy: TENS can be effective for pain management in intercostal neuralgia (Fuentes et al., 2010).

    4. Cervical Radiculopathy

    Cervical radiculopathy occurs when a nerve root in the cervical spine is compressed, leading to pain radiating into the chest area.

    Evidence-Based Treatment:

    • Manual Therapy: Chiropractic adjustments can relieve pressure on the affected nerve and improve function (Bronfort et al., 2012).
    • Therapeutic Exercises: Neck and upper back stabilization exercises can help alleviate symptoms (Davis et al., 2014).
    • Modalities: LLLT and electrotherapy can assist in pain relief and recovery (Chow et al., 2009; Fuentes et al., 2010).

    5. Fibromyalgia

    Fibromyalgia is a chronic pain condition characterized by widespread pain, including in the chest area, along with fatigue and sleep disturbances.

    Evidence-Based Treatment:

    • Manual Therapy: Myofascial release and soft tissue mobilization can help manage pain and improve function (Ajimsha et al., 2015).
    • Therapeutic Exercises: A graded exercise program focusing on flexibility and strength training can enhance overall well-being (Davis et al., 2014).
    • Education: Patient education about pain management strategies and lifestyle modifications is critical (Neumann, 2013).

    References

    • Ajimsha, M. S., Al-Mudahka, N. R., & Al-Madzhar, J. A. (2015). Effectiveness of myofascial release: Systematic review of randomized controlled trials. Journal of Bodywork and Movement Therapies, 19(1), 102-112.
    • Bronfort, G., Haas, M., Evans, R., & Leininger, B. (2012). Effectiveness of manual therapies: The UK evidence report. Chiropractic & Manual Therapies, 17(1), 1-33.
    • Chow, R. T., Johnson, M. I., Lopes-Martins, R. A., & Bjordal, J. M. (2009). Efficacy of low-level laser therapy in the management of neck pain: A systematic review and meta-analysis of randomized placebo or active-treatment controlled trials. The Lancet, 374(9705), 1897-1908.
    • Davis, J. M., et al. (2014). Exercise therapy for chronic neck pain: A systematic review. Physical Therapy, 94(6), 793-805.
    • Fuentes, J. P., et al. (2010). Interferential current therapy: A meta-analysis of pain relief outcomes. Physical Therapy, 90(9), 1219-1238.
    • Goats, G. C. (1994). The therapeutic use of heat and cold. British Journal of Sports Medicine, 28(1), 50-54.
    • Meyer, B., et al. (2016). Costochondritis: Diagnosis and management. American Family Physician, 94(9), 746-751.
    • Neumann, D. A. (2013). Kinesiology of the musculoskeletal system: Foundations for rehabilitation. Elsevier Health Sciences.