Physical Therapy Evaluation and Treatment for Noncardiac Chest Pain: A Case Report

Abstract

Background Most chest pain in athletes is categorized as musculoskeletal and not cardiovascular in nature; however, differential diagnosis is challenging for providers across all disciplines. The deleterious impact resulting from clinical error in either diagnosis or management could result in irreversible negative medical outcomes. Some patients' symptoms resolve with activity modification and/or medication, which is considered standard medical management. Other patients have pain and activity restrictions for protracted periods. However, physical therapy is often not prescribed. Case Presentation A 32-year-old man presented with a 4-month history of isolated anterior chest pain that did not resolve with rest or medication. He was treated with manual physical therapy and targeted exercises in a progressive manner over 4 clinical visits. Outcome and Follow-Up The patient demonstrated clinically meaningful improvement in pain on the numeric pain-rating scale and in function on the global rating of change scale, allowing him to return to unrestricted physical training. Discussion Sound clinical reasoning, paired with systematic manual clinical assessment and treatment, facilitated the return to prior level of function for this patient with noncardiac chest pain. JOSPT Cases 2021;1(2):101–106. doi:10.2519/josptcases.2021.10186