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- Pain or discomfort in the chest (front or back)
- Area includes the entire rib cage
- The older child complains of chest pain
- The younger child points to or holds the chest
- Mild: Your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
- Moderate: The pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
- Severe: The pain is very bad. It keeps your child from doing all normal activities.
- Muscle Overuse. Chest pain can follow hard sports (such as throwing a baseball). Lifting (such as weights) or upper body work (such as digging) can be causes. This type of muscle soreness often increases with movement of the shoulders.
- Muscle Cramps. Most brief chest pain lasting minutes is from harmless muscle cramps. It can also be caused by a pinched nerve.
- Coughing. Chest pain commonly occurs with a hacking cough. Coughing can cause sore muscles in the chest wall, upper abdomen or diaphragm. Asthma can cause chest pain this way.
- Heartburn. Heartburn is due to reflux of stomach contents. It usually causes a burning pain under the lower sternum (breastbone) or upper belly.
- Heart disease is hardly ever the cause of chest pain in children.
- Chest pains in children lasting for a few minutes are usually harmless. The pain can be caused by muscle cramps. They need no treatment.
- Chest pains that last longer can be from hard work or sports. Sore muscles can start soon after the event. The shoulders are usually involved.
- Here is some care advice that should help.
- To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.
- Continue this until 24 hours have passed without pain.
- For the first 2 days, use a cold pack to help with the pain.
- You can also use ice wrapped in a wet cloth.
- Put it on the sore muscles for 20 minutes, then as needed.
- Caution: Avoid frostbite.
- If pain lasts over 2 days, put heat on the sore muscle.
- Use a heat pack, heating pad or warm wet washcloth.
- Do this for 10 minutes, then as needed.
- Caution: Avoid burns.
- A hot shower may also help.
Stretching the Muscles:
- Gentle stretching of the shoulders and chest wall may help.
- Do sets of 10 twice daily.
- This may prevent muscle cramps from coming back.
- Stretching can be continued even during the chest pain. Do not do any exercises that increase the pain.
What to Expect:
- For sore muscles, the pain most often peaks on day 2.
- It can last up to 6 or 7 days.
Call Your Doctor If
- Pain becomes severe
- Pain lasts over 7 days on treatment
- You think your child needs to be seen
- Your child becomes worse
Author: Barton Schmitt MD, FAAP
Copyright 2000-2020 Schmitt Pediatric Guidelines LLC