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Prim Care. 2013 Dec;40(4):863-87, viii. doi: 10.1016/j.pop.2013.08.007.

Evaluation and treatment of musculoskeletal chest pain.

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Family Medicine Residency Program, Department of Family Medicine, Mount Sinai Hospital, California Avenue at 15th Street, Chicago, IL 60608, USA. Electronic address:


This article summarizes the evaluation and treatment of musculoskeletal causes of chest pain. Conditions such as costochondritis, rib pain caused by stress fractures, slipping rib syndrome, chest wall muscle injuries, fibromyalgia, and herpes zoster are discussed, with emphasis on evaluation and treatment of these and other disorders. Many of these conditions can be diagnosed by the primary care clinician in the office by history and physical examination. Treatment is also discussed, including description of manual therapy and exercises as needed for some of the conditions.


Costochondritis; Evaluation; Fibromyalgia; Musculoskeletal chest pain; Myofascial pain; Pectoralis muscle pain; Stretching exercises; Treatment

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