The chest


The chest (lat. thorax) contains the vital organs heart and lungs. In addition, large vascular and nerve structures pass through it. Below the diaphragm, which borders the chest, lies the abdomen with the liver and stomach.

For this reason, many people are concerned when it stings, burns, hurts, or cracks in the chest. What occurs in most cases due to tension should still be observed.

Illustration of the rib cage

Illustration of the skeleton of the rib cage (from the front)

I - XII ribs 1-12 -
Costa I-XII
1st - 3rd sternum -

  1. Sternum handle -
    Manubrium sterni
  2. Sternum body -
    Corpus sterni
  3. Sword extension -
    Xiphoid process
  4. Rib - Costa
  5. Costal cartilage -
    Cartilago costalis
  6. Collarbone - Clavicle
  7. Raven beak process -
    Coracoid process
  8. Shoulder corner - Acromion
  9. Costal arch -
    Arcus costalis

You can find an overview of all Dr-Gumpert images at: medical illustrations

Chest disorders

The following common points are among the diseases surrounding the chest:

  • Pain
  • bruise
  • Feeling of pressure
  • Crack
  • Broken rib
  • Tension
  • Burn
  • Painful breathing
  • Pain during pregnancy
  • cramps
  • pinched nerve
  • blockade
  • Sharp pain

In the following, each topic is discussed in detail, the causes addressed and therapeutic methods shown.

Chest pain

Chest pain can have a variety of causes. Many people first think of a more life-threatening cause, such as lung or heart disease. These should be excluded first. The breathing is strongly adjusted by the existing pain and is usually shallower. If there is a serious lung or heart disease, this can usually be recognized by the fact that a severe reduction in performance is associated with the pain. However, if all diagnostic tools have been used to rule out such a cause, there are other possibilities that may have triggered the pain.

One of these possibilities describes the intercostal neuralgia, translated it means something like "Pain between the ribs“, Which can come from the nerve tracts there. Intercostal neuralgia can only be treated in rare cases.

However, the muscles that lie between the ribs or around the chest can also cause chest pain due to tension, previous injuries or excessive exercise. Tensions can come from emitted tension in the neck area or other parts of the body or from a relieving posture in which the body is located.

Even previous injuries, some of which have healed for a long time, can lead to chest pain due to the permanent, unnaturally tense muscles due to a relieved posture.

Excessive exercise, as an extreme example at Bodybuilding, can cause chronically tense muscles. If the muscles in the intercostal spaces are permanently contracted (= tense), they severely restrict the natural movements of the chest when breathing and can be perceived as a feeling of a straitjacket or armor.

Fascia, which are located between the muscle layers like a kind of muscle skin, can restrict the chest and thus be the cause of feelings of anxiety and breathing problems.

More information here: Chest pain

Chest contusion

A bruise describes a degree of damage to body parts that is not necessarily visible from the outside, but sometimes through Hematomas, popularly called 'bruises', can be seen. These are mostly caused by dull external violence. Often there are bruises Sports injuries, traffic accidents, or household accidents drawn.

The consequential damage is diverse and can be both harmless and life-threatening, for example if the heart or lungs are damaged. Therefore, after a bruise, the extent and any injuries must be examined by a doctor, who can use various diagnostic tools, such as X-rays, ultrasound or electrocardiogram, to rule out more serious injuries.

The bruise is usually associated with severe pain, which is breath-dependent and is particularly aggravated when you inhale deeply. They cause breathing problems and a reduced supply of oxygen to the body. Muscle cramps and tension can also occur, which ensure a relieving posture and the resulting back pain.

In many cases, chest bruises heal without any further interventions, the chest must be immobilized as much as possible and pain therapy with various medications is possible, depending on the severity of the bruise. The acute pain often subsides after about two weeks, but the entire healing process often takes much longer. If necessary, it can be accelerated by physiotherapy.

Click here to go to the main page: Chest contusion - symptoms, duration, therapy

Pressure in the chest

The rib cage is bounded by the ribs and the muscles lying on them, upwards by the neck and downwards by the diaphragm, the most important respiratory muscle in humans. In addition to the lungs and heart, this area also includes the esophagus (esophagus), the trachea (windpipe) and all kinds of vessels and nerve tracts.

So it is conceivable that pressure in the chest can have numerous causes. The first clinical picture that may come to mind is the heart attack and angina pectoris, a narrowing of the coronary arteries, which causes a strong feeling of pressure in the chest area. Cardiac arrhythmias, both harmless and disease-related, can also be the cause.

The lungs can cause pressure in the chest with a wide variety of diseases, from pneumonia and pulmonary embolism (circulatory disorder) to pneumothorax, in which air enters the pleural space (gap between the lungs itself and the surrounding tissue) and has to be treated as quickly as possible.

Injury to a large vessel such as the aorta can also cause chest pain. Since the esophagus is also located in the chest, stomach upset and subsequent reflux, i.e. heartburn, or injuries to the esophagus can also be the cause.

Inflammation of the pleura (pleurisy) or the middle pleura (mediastinitis) are life-threatening diseases that can occur in the chest.

However, much more harmless things, such as sore muscles in the intercostal muscles or tension, can also cause pressure in the chest. In addition, changes in the spine or vertebral misalignments are sometimes responsible for the feeling of pressure.

Find out more at: Pressure in the chest - these are the causes

Cracking in the chest - what can it be?

In most cases, cracking in the chest is a harmless phenomenon that cannot and does not need to be treated. The cracking usually occurs when the chest is stretched and stretched after a long period of rest. Especially when you get up in the morning or after long periods of sitting down, for example in the office, you may hear noises when you move again.

The cracking is often not painful and is sometimes even perceived as a liberating feeling, especially when there is pressure in the chest. It usually comes from a movement in a joint in the chest. This can be a joint between the ribs and the sternum or in the cervical spine. By stretching or stretching, the muscles applied there pull on the ribs and can move them into a different position. In this way, previous movement restrictions can be resolved but also triggered.

As a preventive measure, it pays to work on your posture and not sit rigidly for too long. In addition to the cracking in the chest, poor posture can cause neck, back and shoulder pain. Another possible cause of chest cracking could be previous surgery that may have partially compromised bones or joints within the chest. If this is the case, the cracking should be clarified by a doctor

Read also: Chest crackling - what is causing it?

Broken rib

A broken rib can be an accident-related illness. A rib fracture can result from direct impact. Breaking three or more ribs is called a serial rib fracture.
Breast fractures (sternum) are rare. The rupture can lead to a compression of vessels in this area, which is then associated with the symptoms of thoracic outlet syndrome.

Read more about: Broken rib

With less severe impacts, a rib bruise can also occur, which occurs with symptoms similar to a broken rib.

Read more on the topic: Broken ribs or bruised ribs

Tense chest

There are many muscles around the bony rib cage, some of which pull around the sides of the body from behind, some extend to the arm and some lie between two ribs. These muscles must be stretchable enough that there are no restrictions when moving the bones through inhalation, i.e. expansion of the lungs.

When restrictions occur, there is difficulty breathing, oxygen deficiency and then possible blue discoloration of the skin (Cyanosis). The victim has the feeling of being trapped in a tank and is quickly very scared. The feeling of the armor is created by tense muscles around the bony rib cage.

Tense means nothing else than permanently contracted, i.e. permanently tense. This tension often comes from bad posture that can be found everywhere in our everyday life. Bad posture is most common in people who sit too much and move too little or people who adopt a relieving posture due to pain from injuries. This is often unnatural for the muscles. This makes it tense. Tensions that arise in the back and neck area, for example, can also spread to the chest muscles.

More information can be found here: Chest pain from tension

Painful breathing

Pain when breathing is associated with a feeling of fear in most people that they cannot get enough air. When you breathe in, the pain is more pronounced because there are so-called auxiliary breathing muscles that pull the chest forward and apart to make room for the two lungs to expand. Exhaling is associated with relaxing these muscles, so the pain usually eases somewhat.

The painful breathing can have many causes. They often have an infection, such as the flu or rubella which can affect the bronchi, i.e. the airways that supply air, or the lungs themselves in the case of pneumonia. The lung membrane can also be inflamed, this is referred to as one pleurisywhich needs urgent treatment. Tension in the auxiliary breathing muscles, some of which are also applied to the back, can lead to painful breathing. Often pain also occurs from a previous injury, for example a broken rib that has grown incorrectly. Even acute injuries, such as bruises or broken ribs, naturally cause severe pain.

Breathing pain is to be taken seriously in any case, since theoretically every organ in the chest can hurt. Therefore, if you do not already know the cause, you should consult a doctor and try to get an accurate diagnosis. Because there are also causes that are less common but life-threatening - such as a pulmonary embolism, the occlusion of a large pulmonary artery, or especially with left-sided pain, a narrowing of the coronary arteries.

Secondly, this pain is intensified by breathing, which is associated with a pressure difference in the chest. Treatment is extremely different due to the variance in causes.

  • If there is tension, use Warmth, movement and if necessary physical therapy treated.
  • In the case of infections, the patient must save, his Keep hydration high and maybe Antibiotics to take in.
  • In the case of bruises and fractures, it is also important to close yourself saveto keep calm as far as possible and with Pain medications to contain the initially severe pain and thereby prevent easy breathing.

Find out more about: Painful breathing

The chest burns - what can be behind it?

The burning sensation in the chest is also a non-specific symptom, which can indicate various diseases. The most widespread assumption among the population that there is a strong burning sensation in the chest is an indication of a heart attack. This is caused by the radiation of pain to other parts of the body such as the poor and the jaw accompanied, which usually lasts several minutes and is accompanied by a feeling of pressure. The pain is particularly localized in the left half of the chest. If the symptoms mentioned occur, the person concerned must seek medical treatment immediately.

Also respiratory infections that bronchitis, can be the cause of a burning sensation in the chest. This burning sensation is particularly noticeable when coughing. The course of the disease usually begins with one rattling dry cough and then turns into the so-called productive cough. The productive cough means one Coughing up mucuswhich forms and loosens in the airways. This infection is usually accompanied by fatigue, sore throat and possibly fever.

Burning cough can also indicate pleurisy (pleurisy), a lung disease such as pneumonia, bronchial asthma or, in the worst case, even lung cancer.

Another cause of a burning sensation in the chest is heartburn. This describes one Reflux (Backflow) of stomach acid into the esophagus. The uncomfortable feeling can often spread to the throat area. Heartburn is mostly dependent on eating habits. It occurs especially with strongly sour, spicy or fatty food. But even with stress, eating too fast, hormone changes, such as during pregnancy, or medication, heartburn can be responsible.

Other causes of a burning sensation in the chest can be simple nerve irritation, sore muscles or tension, in which the symptoms should usually subside after a few days.

Chest pain during pregnancy

Many women suffer from recurring pain during pregnancy. These range from back pain and leg pain to stomach pain and headache and toothache. The hormonal balance changes significantly in pregnant women and makes the tissue more flexible. The core muscles are partially stretched and the legs and back are loaded with additional weight.

Heartburn is a common symptom that pregnant women face. As the baby continues to grow, the stomach is compressed and can no longer expand properly. The sphincter between the stomach and esophagus (Esophagus) often no longer seals tightly and this leads to a reflux of gastric acid. Strong kicks by the child can also trigger this reflux. On the other hand, it usually helps pregnant women to pay more attention to their diet and to remove fatty foods and highly carbonated drinks from the menu. Thorough and slow chewing, as well as taking smaller meals, can also prevent the symptoms. Moving and walking after eating also often helps digestion.

In addition to heartburn, the chest can be painful during pregnancy as the baby's growth takes up more and more space. In this way organs are displaced and the chest is shifted slightly upwards. The flexibility of the fabric over time make this possible. The chest and back muscles can be unnaturally tense as a result. Most of the pain during pregnancy is completely normal and usually unavoidable. However, the pain can be relieved somewhat with warmth and massage.

Spasm in the chest

A cramp is an involuntary, i.e. not consciously triggered, contraction of the muscle that occurs very suddenly and is extremely painful. There are three different types of muscle spasms.

  1. The first is idiopathic spasm. Here the cause is unexplained.
  2. The symptomatic spasm occurs due to other underlying diseases. These can be of neurological or internal origin.
  3. The most common type of spasm is paraphysiological. This spasm occurs in healthy people under certain conditions, for example when they are physically exhausted, after extreme sports or even more often during pregnancy.

If the chest muscles or the muscles around the chest are cramped, it can have serious consequences. For normal breathing, the muscles must be able to stretch. If it is tense, breathing can be severely restricted and the body will be under oxygen supply as a result. Cramps can also occur within the chest. Here is especially the Bronchospasm (a spasm of the muscles in the airways), which is a typical symptom of bronchial asthma.

Nerve pinched in the chest

The term pinched nerve is mostly used colloquially and often only describes the irritation of a nerve. This irritation can arise for a number of reasons. For example, when the muscles around the nerve tract are hardened and exert pressure. Inflammatory processes can also be the cause of nerve irritation and thus cause the corresponding symptoms. As well as acute injuries such as bruises or broken ribs and poor posture when sitting or sleeping for long periods of time.

When one speaks of having pinched a nerve, what is meant is a sudden, severe pain that can just as suddenly disappear again, but can also persist, for example due to muscle tension. In addition to the pain, numbness and tingling may also be felt in the surrounding area. Unnatural sweating can also occur.

If these symptoms accumulate, a doctor should be consulted, as a long-term irritated nerve can lead to a variety of consequential damage. Therapy can anti-inflammatory drugs, massages, heat therapy or in the worst case one surgical intervention include. Most of the time, the irritation of the nerve resolves itself with a correct relieving posture. And as long as there are no further complications in the healing process, you will be free of pain after a few days.

Learn more about: Chest pain from nerves

Blockage on the chest

The rib cage is important for the stability and upright posture of the human body. In return, the joints between the ribs, the spine and the sternum are kept fairly tight by ligaments and, in addition to the necessary space for breathing, offer little freedom of movement. If there is a blockage on the chest, it is usually the language of a rib joint, which is in an incorrect position and thus leads to restricted mobility and pain. The pain radiates from the blocked rib area to the chest and shoulder area. Breathing can be restricted and cause panic in the person concerned. This incorrect position can be due to various causes. On the one hand, injuries such as traffic accidents can be responsible. On the other hand, older people are already showing signs of wear and tear, like the arthrosis, concerned.

There are two therapeutic approaches that are pursued. On the one hand, it is important to alleviate the pain of the person affected in order to reduce incorrect postures and breathing difficulties. This is going through Pain medications and Heat treatment reached. Breathing exercises to specifically prevent shallow breathing are also often used. On the other hand, the blockage must be resolved with specific movements. This can happen with a doctor or with physiotherapy. Furthermore, it can be worthwhile to try to build muscle on the chest as a preventive measure, as stronger muscles protect against joint displacement.

Stinging in the chest - what's behind it?

Stinging in the chest is one of the symptoms that can stand for a serious illness or simple tension. Therefore, if this symptom occurs, a doctor should be consulted in any case, who can rule out circulatory disorders of the heart, a heart attack, lung diseases, broken ribs or vascular injuries. Tietze syndrome, which describes a thickening of the cartilage attachments of the ribs on the sternum, should also be considered. If all of these possibilities are ruled out, in most cases it can be assumed that tension is responsible for the stinging. The tense muscles can be on the chest as well as on the back of the chest. Psychosomatic causes can also cause stinging in the chest. Stress, as well as feelings of fear and panic, play an important role here, some of which can be expressed physically by pressure, tightness or stinging in the chest.

The stinging often occurs in many people lying down or during heavy physical exertion. For others, stressful situations in particular cause the symptom to appear. The stinging in the chest is treated therapeutically according to the cause. If the cause is tension or a psychosomatic nature, help Relaxation exercises, Aromatic baths and Breathing exercises. The tension should be released and if necessary with Osteopaths to be treated with regard to the whole body. If psychosomatic factors are causing the stinging, a psychotherapeutic treatment worth it. In any case, the cause should be clarified if it occurs frequently.

More information can be found here: Stinging in the chest when breathing

How can you stretch the chest?

Various exercises help to make the chest more flexible, to relieve tension in the muscles located there and to breathe more freely.

  1. In one of these stretches, you get on your knees and place both hands on a slight elevation, such as the seat of a chair. When your arms are roughly level with your spine, push your chest down towards the floor. Keep your head in line as an extension of the spine and look down with your face. Breathe out when your chest is pushed far down and in when you let it go. Repeat this exercise several times, each time holding the stretch for a few seconds.
  2. A second exercise is used to stretch one side of the trunk. To do this, stand your legs shoulder width apart and pull one arm straight over your head. The arm on the other side is supported on the hip, while the whole upper body leans sideways in this direction. Include some repetitions here as well.
  3. A third possible exercise takes place while sitting. To do this, sit on the front edge of the chair and look straight ahead. The arms are stretched out to the sides at about shoulder height, the palms facing the ceiling. The abdomen should be tensed and the chest should be pulled forward and upward like a thread. In this position, inhale and exhale a few times and then bring your arms forward, letting your palms touch each other and doing a hunched back.

The asymmetrical rib cage

In most cases, an asymmetrical chest is not a health hazard. Most people have minimal asymmetries, which are not noticeable and are only slightly pronounced. Some other deformities, which are usually associated with an asymmetrical chest, are the funnel chest or the keel chest. The funnel breast (Pectus excavatum) occurs much more frequently in men and describes the sinking of the chest inwards. The keel chest (Pectus carinatum), on the other hand, is a protrusion of the region around the sternum.

The causes of these deformations have not yet been clearly clarified, but they are common within a family. Physical complaints are rarely caused by the deformities. Usually it is a cosmetic problem and causes psychological complaints and insecurity in many young people. These chest variants can be partially corrected surgically, the best time for the intervention being between 11 and 15 years, if the person is still growing. A splint can be attached to the chest, which will push the chest outwards for about three years. Metal implants can also be inserted during open surgery. Often the results are satisfactory and reduce the psychological distress of the adolescents.

Function of the rib cage

The chest protects the lungs and heart.

The chest / thorax can be raised or lowered through the respiratory muscles. This changes the volume of the lungs. The change in volume can cause air to enter the lungs or be forced out of them. Breathing is easier when standing than when lying down, because the abdominal viscera do not touch the diaphragm when standing (Diaphragm) to press.

The number of inhalations and exhalations, the breathing rate is called the breathing rate, is

  • in adults around 12 per minute
  • in adolescents around 20 per minute
  • around 30 per minute for toddlers
  • around 40 per minute in babies

Since the infant's chest / thorax has a barrel-shaped appearance, it cannot yet be raised or lowered, which means that only abdominal breathing is available to the infant.
The tidal volume of an adult, which is the amount of air that is transported between inhalation and exhalation, is between 0.4 and 0.6 liters at rest. A person breathes an average of 5,000,000 m³ of air in his entire life.

A cut was made here parallel to the forehead (frontal cut), which even hits the intestines. Both lungs are cut, the heart, which was partially covered by the lungs, is now visible in all its glory. In addition, the multi-storey structure of the trunk becomes clear: under the thorax lies the abdominal cavity with liver and stomach, the border is the diaphragm.

Thoracic anatomy

The chest / thorax consists of three parts:

  • 12 thoracic vertebrae
  • 12 pairs of ribs
  • Breastbone / sternum with the sword extension.

The shape of the rib cage varies from person to person. It can be long and narrow or more barrel-shaped.

The rib cage contains:

  • lung
  • Mediastinum in which the following organs are located:
    • heart
    • Thymus
    • large blood vessels with the main artery (aorta), superior vena cava and pulmonary vessels

The breathing muscles change the size of the chest.

To Respiratory muscles counting:

  • The diaphragm (Diaphragm), separates the chest cavity from the abdominal cavity and is the largest respiratory muscle. The so-called Abdominal breathing completed (see breathing).
  • The intercostal muscles (External intercostal muscle)

To Auxiliary respiratory muscles counting:

  • Sternocleidomastoid muscle
  • Scalenus muscle
  • Seratus anterior muscle
  • Pectoralis major muscle et minor
  • Erector spinae muscle
  • Latissimus dorsi muscle