A patient comes to me with complaints of low back pain that have been going on for three weeks. On examination I see that there is tension of several core muscles that seem to be the cause of his back pain. I assure him that we are going to help him and instruct him on how to prepare for the session .It then occurs to me that the patient is unable to lie facing down as it gives him chest pain.

I give him a pillow and he manages to adopt a comfortable position after which we commence the session.

On finishing the patient seems tired out of lying down and I assure him that he will be fine after some rest.

The next session he reports quite some improvement and after review I allow him to prepare for the treatment. He experiences the same chest pain and I begin probing.

The Cause Of The Pain

According to the patient the doctor said that an x-ray did not show anything significant so he takes painkillers whenever he has the pain. The pain comes only when he strains or after a physical exertion like lying on his tummy with outstretched arms. This rang a bell and I decided to examine the patients’ chest muscular state. He exercised regularly so he was well built with a ‘six’ pack. Beyond the built musculature, he had a lot of muscle tension with shoulder movement limitation.

The pain was produced by stretching the muscle beyond the ‘normal’. After explaining to him, I  relaxed the muscles and stretched the muscles which was very painful. On finishing I treated his back, showed him some arm stretches to do at home which he promised to do religiously.

Three days later when he was due for his appointment, he walked in with a smile unlike the other days. He then reported to feeling much better and that the pain had subsided greatly. This time he was able to lie down without struggling and only felt some pain after lying for an hour.
After six sessions he was ready for discharge with zero pain and he was all smiles!!!!!!!

Likewise at some point or another, most people experience a muscle tension somewhere in their body. Often, muscle tension happens in the leg muscles especially the calf though it can happen in any other muscle.

Several factors can lead to a muscle tension, including:

  • Long periods of exercise or physical labor, without stretching
  • Overuse of a muscle
  • Dehydration
  • Holding a physical position for a prolonged period of time

Tension of the intercostal muscles and the pectoralis muscles can cause severe chest pain. This is because they attach on and run from rib to rib, and enable a person to breathe by expanding and contracting the chest wall.

Symptoms of (chest) intercostal muscle spasms include:

  • Severe stabbing pain in the lower left or right chest, that persists and usually worsens with an attempt to move or straighten the upper body
  • The pain is localized at one single point, usually around the ribs or in the middle lower area of the chest
  • If the person is not anxious, the heart beat is usually steady.
  • Pain increases with heavy breathing
  • Pain may last from five minutes to an hour or even more

Solution:

  • Lie flat with arms straightened out above the head to stretch the muscle.
  • Learn to stretch your muscles often especially after a workout.
  • If persistent see your physiotherapist who will help to relax and stretch your chest muscles.

By Naomi Wausi
Physical Therapist

It Is Not A Heart Attack
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