Fibromyalgia Chest Pain

This symptom is known as costochondritis

Do you have areas of your chest that are painful to the touch? A condition called costochondritis, which causes pain around the breastbone and rib cage, could be to blame. It is caused by inflammation in the cartilage that connects your ribs and sternum (breastbone). It's believed to be common in people with fibromyalgia (FMS).

Costochondritis is also called noncardiac chest pain or musculoskeletal chest pain. It does not involve the heart, but it is sometimes confused with heart palpitations. Because any other sources of pain can make your FMS symptoms worse, it's crucial to treat costochondritis.

Fibromyalgia chest pain can make you think you're having heart problems, which is a scary thing. Even though costochondritis is common, you should get medical attention if you have unexplained chest pain. You don't want to assume that it's FMS-related and end up with permanent heart damage or worse.

Causes of Costochrondritis

Costochondritis is caused by inflammation of the cartilage that connects your ribs to your breastbone. Depending on how much inflammation there is, it can range from mildly annoying to intensely painful. People sometimes describe the pain as stabbing, aching, or burning.

The causes of costochondritis aren't clear, but they may include:

  • Chest trauma, such as from a car accident
  • Repetitive trauma or overuse
  • Viral infections, especially upper respiratory infections

Some experts believe costochondritis and fibromyalgia are related. Regardless, because FMS amplifies pain, it can make costochondritis much more painful.

Costochondritis and Fibromyalgia: The Connection

Many people with FMS have symptoms very similar to costochondritis. In one study, non-specific chest pain is listed as the most common additional symptom in people who were hospitalized with FMS. Another lists FMS as a frequent cause of musculoskeletal chest pain.

No one is exactly sure whether this is actually costochondritis or why it occurs with FMS. One hypothesis is that FMS involves inflammation of the fascia, which is a thin layer of connective tissue that runs all through your body. If that's true, it may explain the connection between costochondritis and fibromyalgia.

The fibromyalgia tender points just beneath the collarbone may play a role as well. (Tender points are 18 spots on the body that are used to diagnose fibromyalgia.) Myofascial pain syndrome, which is common in people with FMS, also could be a cause.

Costochondritis is typically a minor injury, but it can take several weeks or months to resolve. If symptoms don't clear up, it could be a sign that your chest pain is caused by fibromyalgia.

Costochondritis common symptoms
Illustration by Cindy Chung, Verywell

Costochrondritis Symptoms

Pain in the chest wall and rib cage is the chief symptom of costochondritis. Generally, the pain will flare up with activity or exercise. Taking a deep breath can also cause more pain because it stretches the inflamed cartilage. Sneezing and coughing can increase pain as well.

The pain can radiate to your shoulder and arms as well (another way the condition mimics a heart attack). Sometimes the pain is accompanied by redness and/or swelling in the most painful areas. When that's the case, it's called Tietze's syndrome.


Your healthcare provider can diagnose costochondritis by pressing on the area where the ribs and breastbone come together. If it's tender and sore there, costochondritis is the most likely cause of pain. Healthcare providers generally will perform other tests to rule out heart problems and other causes of pain before diagnosing costochondritis and fibromyalgia.

Fibromyalgia Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Woman


You can treat costochondritis the way you'd treat any inflammation—ice and anti-inflammatory drugs, including Aleve (naproxen) and ibuprofen-based drugs such as Advil and Motrin.

This treatment sometimes runs counter to FMS treatments, which can include other types of pain relievers and heat. If you have fibromyalgia chest pain, you might find yourself with an ice pack on your chest and a heating pad on your back at the same time. 

Be sure to check with your healthcare provider or pharmacist about any possible interactions between anti-inflammatories and your other medications.

Your healthcare provider may recommend other types of treatment as well, including physical therapy or acupuncture.

A Word From Verywell

It's bad enough to live with one source of chronic pain. The more you heap on, the more pain you'll have and the more it can impact your life. Fortunately, fibromyalgia chest pain is fairly easy and inexpensive to treat, and managing it will keep it from exacerbating your FMS symptoms.

Frequently Asked Questions

  • Does your chest hurt with fibromyalgia?

    Fibromyalgia chest pain is called costochondritis. It occurs along the fibromyalgia tender points in the chest, where the breastbone and ribs meet. It is unclear why costochondritis happens with FMS, but it likely has to do with inflammation of FMS tender points.

  • What does a costochondritis flare-up feel like?

    A costochondritis flare includes a sharp pain in the chest that is usually to the left of the breastbone. In addition, you might notice the pain gets worse with a deep breath, coughing, sneezing, movement, or pressing on the area.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Ayloo A, Cvengros T, Marella S. Evaluation and treatment of musculoskeletal chest pain. Prim Care. 2013;40(4):863-87,viii. doi:10.1016/j.pop.2013.08.007

  2. Bellato E, Marini E, Castoldi F, et al. Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatmentPain Res Treat. 2012;2012:426130. doi:10.1155/2012/426130

  3. Campbell KA, Madva EN, Villegas AC, et al. Non-cardiac chest pain: A review for the consultation-liaison psychiatristPsychosomatics. 2017;58(3):252-265. doi:10.1016/j.psym.2016.12.003

  4. Cubos J, Cubos A, Di Stefano F. Chronic costochondritis in an adolescent competitive swimmer: A case reportJ Can Chiropr Assoc. 2010;54(4):271-275.

  5. Haviland MG, Banta JE, Przekop P. Fibromyalgia: Prevalence, course, and co-morbidities in hospitalized patients in the United States, 1999-2007. Clin Exp Rheumatol. 2011;29(6 Suppl 69):S79-87.

  6. Sturm C, Witte T. [Musculoskeletal-related chest pain]. Internist (Berl). 2017;58(1):39-46. doi:10.1007/s00108-016-0166-z

  7. Liptan GL. Fascia: A missing link in our understanding of the pathology of fibromyalgia. J Bodyw Mov Ther. 2010;14(1):3-12. doi:10.1016/j.jbmt.2009.08.003

  8. Zaruba RA, Wilson E. Impairment based examination and treatment of costochondritis: A case seriesInt J Sports Phys Ther. 2017;12(3):458-467.

  9. Sawada K, Ihoriya H, Yamada T, et al. A patient presenting painful chest wall swelling: Tietze syndromeWorld J Emerg Med. 2019;10(2):122-124. doi:10.5847/wjem.j.1920-8642.2019.02.011

  10. Hudes K. Low-tech rehabilitation and management of a 64 year old male patient with acute idiopathic onset of costochondritisJ Can Chiropr Assoc. 2008;52(4):224-228.

  11. Nemours. Costochondritis.

Additional Reading
  • Flowers, LK. Costochondritis. eMedicine.

  • Haviland MG, Banta JE, Przekop P. Fibromyalgia: prevalence, course, and co-morbidities in hospitalized patients in the United States, 1999-2007. Clinical and Experimental Rheumatology. 2011;(6 Suppl 69):S79-87.

By Adrienne Dellwo
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.