Chest pain can originate from the cervical spine or the thoracic spine.
The C4 nerve root distributes to the anterior chest wall down to the nipple. There is an ER condition called “cervical angina” where chest pain thought to be a heart attack really is compression of the C4 nerve root. The level that this nerve exits from is the C3-4 level. A good physical examination as well as an MRI can yield the diagnosis.
The thoracic spine can also cause symptoms in this region. Normally, like the C4 nerve root compression above, this pain would be unilateral (on one side only). This pain would start in the back and radiate around the chest wall to the front of the chest. There would be a numb band accompanying this pain. A thoracic spine MRI would identify this diagnosis and a selective nerve root block (see website) would confirm the diagnosis.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.