Ischemia, heart attack, death comes to mind every time we feel pain or heaviness on the left side of the chest.   A frightening associative triad that is imprinted on our subconsciousness and that is understandable. Careless and inattentive approach to these symptoms or needless bravery can cost a life. In most cases, true cardiac pain comes with nausea, a cold sweat and the fear of death. Radiation to the left arm or to the neck is not as important as an overall feeling of sickness and impending doom. In cases like this do not think twice. Call 911 and take an aspirin. If this has happened to you before, take whatever it is your doctor had prescribed to you in the past.

An EKG and specific blood tests that will be drawn at the hospital will show any damage to the cardiac muscle. A team of cardiac specialists will inspect your heart vessels and restore the supply of the blood to the heart if necessary. If the blood test results do not show any damage to the cardiac muscle, you will have a stress test that shows how your heart is working under increased demand. The stress test makes the heart work harder and reveals any abnormalities on the EKG as you are doing the test.

What if after you go through all this and the hospital does not find anything wrong. But when you arrive home to relax, the pain comes back and stabs you in the chest. Sure, you now might not have a cold sweat but all other symptoms are still there. The pain might even be radiating to the left hand and to the neck.

So what can you do about it?

A few years ago my friend came me for a referral to  a good cardiologist. He has been complaining about periodic chest pains, poor sleep and dizziness. The EKG was normal yet he had a feeling something must be wrong with his heart.  My assessment revealed exactly what I suspected– his anterior chest muscles were tight and spastic, as if he was wearing an invisible corset. Turned out, a few years ago he has been in a bad cad accident and could not move his neck for almost two months. Later on everything seemed to heel normally and the patient has completely forgotten about his condition.

I used manual therapy and MAX-D to rel ease decompressed joints of her anterior thoracic region. He could breathe effortlessly for the first time in a long time. His chest tightness was gone and he did not feel dizzy at all.

Traumatized muscles do not forget about us even when we forget about them. Any trauma leads to the so-called “protective spasm.” This spasm initially helps immobilize the affected joint, lessens the pain and inflammation. However later on this same spasm takes on a different role, this time of a rigid corset as I described in this patient’s case.

In childhood when we are busy running around and jumping up and down, this “corset” dissolves on its own, if it even gets a chance to form in the first place. But with age when our activity level goes down, this corset not only clings to us but it grows bigger and stronger with time. We now need to make an effort in order to free ourselves from this corset that immobilizes our joints and squeezes our blood vessels.

A precise manipulation of the affected joint, often times followed by a clicking sound and a feeling of liberation is called “musculoskeletal manual therapy”. A doctor that specializes in manual therapy – a manual therapist –can heal chest pain of non-cardiac origin. His goal - my goal - is to draw the map of your musculoskeletal blocks of the anterior thoracic region and to determine their relationship with your neck and low back. Then I decide in what order to begin manual manipulations in the most effective, painless and safest way. There are complementary medications to aid with this process. These medications lower the pain and inflammation. I also find physical therapy to be very effective. If your therapist knows what he is doing, you should feel better after only a few treatment sessions: you will see the increase in the range of motion, improved breathing, blood pressure and sleep patterns.

If your doctor does not have an available appointment until the end of the week you can help yourself.

• Find a comfortable position for your back.
• Turn carefully; stretch your muscles of the shoulders and those between the shoulder-blades.
• Take Ibuprofen 800 mg (4 tabs of 200mg) is a normal dose for an adult.
• Because the cause of your pain is in the spasm (or a block) you could use dry heat, apply some Icy-Hot or peppered Capsaicin.

After the pain is gone, it is essential to learn a set of exercises to stretch and mobilize the muscles of the chest that run along the spine. It is better to begin these exercises at home when you are alone in order to listen carefully to the voice of your muscles and common sense.

It is safest to begin these exercises slowly and lying down. Try to deep breathe and raise your arms up and then slowly stretch them in the opposite direction. When you stretch your muscles, try to pay attention to the way your blood moves and reaches those deprived areas. Turns out, the lack of blood flow that ensures the relaxation of the spastic muscles is the main cause of pseudo-cardiac pain.