Pinched nerve on the chest

What is a pinched nerve on the chest?

The nerves from the thoracic spine come from the spinal cord and run from there towards the chest. Entrapment can occur along the entire length of the nerve.
Typical spots for pinching are

• on the spinal cord along the vertebral body
• under the ribs
• between the lungs and the ribs

Often people speak of a pinched nerve on the chest / thoracic spine when actually only the muscles are tense and this results in a pain similar to that of pinching a nerve.

Causes of a pinched nerve on the chest

The most common acute cause of a pinched nerve on the chest / thoracic spine is sudden movement. This can occur, for example, when lifting a heavy load suddenly.
A traffic accident with whiplash and the fracture of a vertebral body or rib can also lead to entrapment.
If the entrapment occurs in a so-called minor trauma (a trauma / movement that is actually too weak to pinch the nerve), weakened back muscles are often the underlying cause. The back muscles become weaker due to the currently typical sedentary lifestyle. Bad posture accelerate this weakening. Due to the insufficiently developed muscles, the spine cannot be adequately stabilized, even with small movements and bumps. This allows vertebral bodies to shift slightly against each other and thus pinch a nerve.
As a sudden movement, physical protective functions such as coughing or sneezing can also lead to the pinching of a nerve. This usually affects the nerves that are on the ribs.
Other causes can be a herniated disc pressing on the spinal cord and congenital or acquired malpositions.

Do you think you have a herniated disc? Find out more about the here Symptoms of a herniated disc.

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Pinched nerve from coughing

When you cough, the lungs are jerked together in order to get rid of pathogens that have settled in the lungs as efficiently as possible.
The so-called intercostal muscles (the muscles between the individual ribs) are suddenly tensed, so that the rib cage shrinks quickly. The diaphragm also jerks against the lungs from below.
The two mechanisms press the lungs strongly against the ribs, which can cause the nerve to be pressed against the rib. Sometimes coughing can even move the nerve so that it becomes trapped between a rib and a muscle.

These symptoms can be seen as a pinched nerve in the thoracic spine

The typical pinched nerve in the thoracic spine manifests itself as a sudden stabbing or pulling pain in the back or in the area of ​​the chest.
In fact, the pain can be so severe that it causes people to sweat.
Sometimes the pain is referred to as burning, and it can radiate to different areas (such as the arms).

The nerves have different functions in the body: On the one hand, they supply the muscles of the body with information that leads to movements. On the other hand, they give feedback from the skin to the brain about touch, temperature and pain. Entrapment of a nerve can affect all of these functions.

Therefore, especially if you feel numb, tingling or paralysis that occurs suddenly, you should pay attention and think of a pinched nerve.

Because of the pain, the back muscles are often tensed reflexively, which in turn results in more extensive back pain.
It can also trigger headaches or pain in the lumbar spine area.

The typical course of pain with a pinched nerve in the thoracic spine is characterized by a sudden onset. In addition, the pain usually worsens every hour and can no longer be endured after a few hours or days.

Back pain associated with a pinched nerve

Back pain can be both the cause and the result of a pinched nerve in the thoracic spine.
The cause of the entrapment is usually poor posture, which weakens the back muscles and leads to tension. As a result, the spine is no longer as stable, which can lead to pinching of the nerve. This entrapment is accompanied by severe pain, which is usually specifically localized in the thoracic spine.
However, the pain in turn leads to tension in the back muscles, and a relieving posture is usually adopted. In return, however, this relieving posture increases the tension and thus promotes further entrapment of the nerve.

How is a pinched nerve different from a heart attack?

A pinched nerve on the chest / thoracic spine has many symptoms that are similar to those of a heart attack:
There is a sudden sharp pain in the chest area.
While sweats occur during a heart attack due to the heart problem, a pinched nerve can cause the pain to be so severe that it also causes a sweat.

However, the strong pressure on the chest is typical of a heart attack. This usually does not occur with a pinched nerve.
Instead, the nerve-related pain is often caused by a sudden movement and can in turn be intensified by this movement.
The nature of the pain is also sometimes slightly different: The nerve stings / pulls / tears, the heart attack tends to trigger stinging and pressing.
In addition, the pain of the heart attack tends to radiate into the left arm, while the radiation from the pinched nerve is strongly dependent on the location of the pinching.

However, in the hectic pace of the sudden onset of pain, the two diseases cannot always be clearly distinguished from one another, which is why an emergency doctor should be called in any case if a heart attack is suspected.

Learn more about the Signs of a heart attack

Therapy of a pinched nerve

There are several approaches to treating a pinched nerve in the thoracic spine.

Assuming that a displaced vertebral body is the cause of the entrapment, the vertebral body should be adjusted again. This is often done by osteopaths or chiropractors. The blockage in the vertebral joint is released by jerking it in and the nerve is released from its entrapment. Especially with nerves that are trapped in the thoracic area, a stretching of the chest can also cause the nerve to slip back into the right place.

For causes such as muscular tension and poor posture, therapeutic methods such as massage and the application of heat are indicated. Relaxation procedures can also correct bad posture. Although its mode of action has not yet been fully clarified, acupuncture also has a relaxing effect on many sufferers.

In the long run, the back muscles should first be strengthened through controlled physiotherapy, later through self-exercises (for example on strength machines or yoga).

Read more about sports and targeted exercises Strengthening the back muscles

In rare cases, such as vertebral body fractures or occasionally with herniated discs, an operation on the spine is necessary.

Diagnosis of a pinched nerve

The most important step in the diagnosis of a pinched nerve in the chest / thoracic spine is the anamnesis, i.e. the conversation in which the person concerned reports on their symptoms. Typically, terms such as “severe pain”, “it came suddenly”, “that was such a wrong move”, etc.

In the physical examination, pain-related restrictions on movement become apparent. Symptoms of paralysis and numbness can also sometimes be observed.

The functional limitation of the affected nerve can be objectified by measuring the nerve conduction velocity.

In order to rule out causes such as a herniated disc or vertebral body fractures, an X-ray, CT or MRI is often performed.

Duration of a pinched nerve

The duration of a pinched nerve on the chest / thoracic spine is highly dependent on the cause.

If sudden movements and blocked joints are the cause, this can usually be remedied quickly so that the pain disappears after a few hours to days.

Bad posture, missing back muscles, vertebral body fractures and herniated discs, on the other hand, often show a protracted course.
It usually takes about a year for a herniated disc to heal completely.
Controlled muscle building usually also takes several months before it is completely satisfactory. In addition, care must be taken to maintain the muscles throughout your life. Without such muscle exercises, the back pain from a pinched nerve can become chronic and last through the life of those affected.

Our article provides more information Duration of a pinched nerve