Millions of people experience chest pain each year and it is natural to fear it is a heart attack. But not all pain in your chest is heart-related. The causes of chest pain are numerous from spasms of the esophagus to problems with nerves and muscles The pain can vary in intensity from sharp to dull and can spread from neck to arms and throughout the entire chest area, leaving sore muscles. Pain from heart attacks may begin in the chest and then spread to other parts of the body or there may be no chest pain at all. Instead, pain begins in one of the arms or both arms, or elbows and shoulders. Any area of the body from neck to the waist may experience pain and it may ebb and flow. Men complain most often of pain in the left arm, whereas women may feel it in either arm or the elbow. Chest pain can originate from the spine and is a very common cause of patient complaints. Prolonged sitting, problems with spinal discs and rib joints can all refer pain to the chest area. Disease of the arteries in which the blood and oxygen flow to the heart become blocked is called angina and can spread the pain across the chest and back area and up into the neck and jaw. Angina may be brought on my excitement, exercise, and stress and can be relieved by rest. Patients with Angina chest pain may complain of stiff neck and jaw muscles. Similar to the pain of Angina is an actual heart attack, which is the result of lack of blood flow through the vessels, damaging cells in the heart. This pain is often accompanied by trouble breathing and nausea and shortness of breath. These symptoms especially if sustained need immediately medical attention. Inflammation of the heart muscle or Myocarditis caused by lack of blood flow to the heart can bring on similar pain in the chest, back, neck and jaw, but usually is not as severe as an actual heart attack. Fleeting pain in the chest area may be caused by injury or inflammation such as a cracked rib or shingles. Whereas heart pain may radiate throughout the arms and chest and intensify with exercise, an injury to the ribs will cause momentary and localized sharp pain that dissipates after a few minutes. Localized pain caused by breathing may be caused by inflammation in the lungs from pneumonia or asthma Bouts of pain in joints of the arms, legs and around chest can be brought on by inflammation caused by rheumatoid arthritis. It can be very painful but it is not life threatening. It is important to know that when the cartilage that attaches ribs to the breastbone becomes inflamed it causes pain in the center of the chest and is accompanied by no other symptoms. Inflammation of the joints around the breastbone is called Costochondritis. This pain is exacerbated by deep breathing, twisting and turning, laughing and/or coughing. Costochondritis is painful but not life threatening and will fade over time and can be treated with pain relievers and anti-inflammatory medication. Fibromyalgia is another cause of widespread pain in the upper chest, shoulders, and back of the head, as well as the muscles and tendons around the bones. Characterized by long term and widespread pain it is relieved by pain medicines and may be lessoned with a healthy life style of proper diet and exercise. Recurrent chest pain caused by Fibromyalgia may be mistaken for heart related disease due to similar symptoms such as heart palpitations and chest pain. Chest pain should be taken seriously as it may be symptomatic of a dangerous health issue. Your doctor should be advised if you are experiencing severe and persistent pain in your joints and muscles especially if there is a history of heart disease in the family.