Cervical-Origin Chest Pain – A Hidden Cause Often Overlooked

by Son Cheolho Rehabilitation Medicine & Chiropractic Clinic in Seoul

When people experience chest pain, the first concern is usually a heart or lung condition. And rightly so—serious issues like angina or myocardial infarction must always be ruled out first.
However, when diagnostic tests reveal no cardiac or pulmonary abnormalities, another possible cause may be found in an unexpected area: the cervical spine. This condition is known as cervicogenic chest pain or musculoskeletal-related chest pain.

What Is Cervicogenic Chest Pain?

Cervicogenic chest pain refers to discomfort in the chest region caused by dysfunction in the cervical spine (neck). This may result from cervical disc degeneration, joint instability, or soft tissue dysfunction, such as myofascial or neural tension.

The pain is often referred, meaning the source of the pain is in the neck, but the sensation is felt in the chest, upper back, or even around the heart area. It can mimic cardiac pain but has different underlying mechanisms.

Common Features

  • Chest pain persists despite normal heart and lung tests (ECG, echocardiogram, chest X-ray, etc.)

  • Symptoms may worsen with certain neck movements or posture changes (e.g., lying down, turning the head)

  • Pain often radiates to the shoulder, arm, or upper back

  • Tenderness or movement restriction may be noted in the cervical or upper thoracic spine

These signs may indicate that the chest discomfort is neuromuscular in origin rather than cardiopulmonary.

How Does It Happen?

The C4 to C8 cervical nerves and upper thoracic spinal nerves (T1 to T4) share sensory pathways that extend to the chest wall, shoulder, and arm. When a dysfunction in the cervical spine irritates these nerves, the brain may misinterpret the signal as coming from the chest—leading to referred pain.

This phenomenon can be explained by what’s known as convergent neural input at the spinal cord level, where sensory signals from multiple body regions merge and are processed together.

Clinical Approach

After ruling out internal organ causes, a functional evaluation of the musculoskeletal system may include:

  • Assessment of cervical and upper thoracic mobility

  • Palpation for trigger points in neck and shoulder muscles

  • Postural and biomechanical analysis

  • Manual therapies such as upper cervical correction, IMS (Intramuscular Stimulation), and myofascial release

As each patient presents differently, a personalized approach based on individual findings is essential.

Final Thoughts

Not all chest pain originates from the heart or lungs. In persistent, unexplained chest discomfort, cervical spine dysfunction should be considered—especially when symptoms vary with posture or movement.

At Son’s Rehabilitation Medicine & Chiropractic Clinic, we aim to assess such conditions through a comprehensive perspective, integrating neurological, muscular, and biomechanical understanding to offer individualized treatment options.

👍Consultation and Appointment Information

Son PMR & Chiropractic Clinic( 2nd floor, 229-1 Gucheonmyun-Ro, Gangdongu, Seoul, South Korea) 

by  Dr Son MD & DC 
Contact: 02-482-8875 in Seoul( +82-2-482-8875)

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