Right-side chest pain can be frightening. Many people immediately worry about a heart attack — but right chest pain is far more often caused by non-cardiac conditions involving the lungs, ribs, muscles, nerves, digestive organs, or even stress.
Understanding where the pain is, what it feels like, and what worsens or relieves it is the key to identifying the real cause and choosing the right treatment.
Is Right Side Chest Pain a Heart Attack?
A heart attack most commonly causes left-sided or central chest pain, but this does not completely exclude the heart as a cause of right-sided chest pain.
Certain cardiac conditions can still present with right chest discomfort, including:
- Inflammation of the heart muscle (myocarditis)
- Inflammation of the heart lining (pericarditis)
- Rare right-sided coronary artery involvement
Any chest pain with breathlessness, sweating, nausea, dizziness, or radiation to the jaw or arm must be treated as a medical emergency, regardless of side.
Common Causes of Pain in the Right Chest
Right chest pain can originate from multiple systems, broadly classified into:
- Lung-related causes
- Musculoskeletal and nerve-related causes
- Digestive system causes
- Other medical and systemic causes
Lung-Related Causes of Right Side Chest Pain
Pneumonia
An infection of the lung tissue that may cause:
- Sharp or aching chest pain
- Fever and chills
- Cough with phlegm
- Pain that worsens with deep breathing
Pleurisy
Inflammation of the lung lining (pleura), causing:
- Sudden, sharp, stabbing pain
- Pain aggravated by breathing, coughing, or sneezing
- Temporary relief when holding the breath
Pulmonary Embolism
A life-threatening emergency due to a blood clot in the lungs:
- Sudden chest pain
- Severe shortness of breath
- Rapid heart rate
- Coughing up blood
Pneumothorax (Collapsed Lung)
Air leakage into the chest cavity causes:
- Sudden sharp pain on one side
- Breathlessness
- Often follows trauma or occurs in smokers
Pulmonary Hypertension
High blood pressure in lung arteries leading to:
- Chest tightness
- Fatigue
- Dizziness
- Progressive breathlessness
Chronic Obstructive Pulmonary Disease (COPD)
A chronic lung condition causing:
- Chest tightness
- Wheezing
- Reduced exercise tolerance
Asthma
Reversible airway inflammation presenting with:
- Tight or squeezing chest discomfort
- Wheezing
- Symptoms triggered by allergens, cold air, or exercise
Lung Cancer
May present with:
- Persistent chest pain
- Chronic cough
- Unexplained weight loss
- Breathlessness
Pain is often constant and progressively worsening.
Musculoskeletal & Nerve-Related Causes of Right Chest Pain
Muscle Strain
Caused by overuse, poor posture, coughing, or exercise:
- Localised pain
- Pain worsens with movement or lifting
- Tenderness on pressing the area
Costochondritis
Inflammation where ribs meet the breastbone:
- Sharp or aching pain
- Pain reproduced on touch
- Often mistaken for heart pain
Intercostal Neuralgia
A commonly missed but important cause of right chest pain.
Intercostal neuralgia occurs when the nerves between the ribs become irritated or inflamed.
Typical features:
- Sharp, burning, or electric-shock–like pain
- Band-like pain wrapping around the chest
- Pain worsens with twisting, coughing, sneezing, or deep breathing
- Tenderness along rib spaces
Common triggers include trauma, post-viral inflammation (including shingles), rib joint dysfunction, or spinal problems.
At Alleviate Pain Clinic, intercostal neuralgia is treated with image-guided nerve blocks, regenerative injections, and targeted rehabilitation, addressing the cause rather than masking symptoms.
Myofascial Trigger Points (Often Overlooked)
Myofascial trigger points are tight knots in muscles that can refer pain into the right chest, mimicking heart or lung disease.
Common characteristics:
- Deep aching or sharp pain
- Pain reproduced when a specific muscle spot is pressed
- Associated neck, shoulder, or upper back stiffness
- Pain worsens with poor posture or prolonged sitting
Muscles commonly involved:
- Pectoralis muscles
- Intercostal muscles
- Upper trapezius and shoulder stabilisers
Because scans often appear normal, trigger point pain is frequently misdiagnosed unless actively looked for.
Digestive System Causes of Right Chest Pain
Heartburn and Acid Reflux
Acid irritation causes:
- Burning chest pain
- Worse after meals or lying down
- Sour taste in the mouth
Gallstones and Cholecystitis
Gallbladder disease often causes:
- Right chest or upper abdominal pain
- Pain after fatty meals
- Radiation to the right shoulder or back
Gas and Bloating
Trapped gas may cause:
- Pressure-like or cramping pain
- Pain relieved by burping or bowel movements
Pancreatitis
Inflammation of the pancreas leads to:
- Severe upper abdominal pain radiating to the chest
- Nausea and vomiting
- Pain worsens after eating
Other Causes of Right Chest Pain
Shingles
A viral nerve infection causing:
- Burning or stabbing pain
- Rash appearing days after pain onset
- Pain following a nerve distribution
Stress and Anxiety
Can cause:
- Tightness or pressure in the chest
- Palpitations
- Normal ECG and imaging despite symptoms
Myocarditis and Pericarditis
Inflammation of heart muscle or lining:
- Sharp chest pain
- Pain relieved by leaning forward
- Often follows viral illness
Pain From Malignancy Involving the Chest
Although uncommon, malignancy-related chest pain must always be considered, especially when pain is persistent or unexplained.
Warning features include:
- Constant deep pain
- Pain worsening at night or at rest
- Poor response to painkillers
- Unexplained weight loss or fatigue
Sources may include lung tumors, chest wall tumors, or metastatic disease involving the ribs.
At Alleviate Pain Clinic, cancer-related pain is managed through advanced, image-guided pain interventions in coordination with oncology care.
Understanding Right Side Chest Pain by Location
Upper Right Chest Pain
Commonly linked to:
- Lung conditions
- Muscle strain
- Trigger points
- Anxiety
Lower Right Chest Pain
Often related to:
- Gallbladder
- Liver
- Digestive causes
Right Chest Pain Under the Ribs
Frequently due to:
- Intercostal muscle strain
- Rib Fractures
- Intercostal neuralgia
- Rib joint inflammation
- Gallbladder or liver conditions
How Is Right Side Chest Pain Diagnosed?
Medical History
Understanding pain pattern, triggers, and associated symptoms.
Physical Examination
Includes chest wall palpation, posture analysis, and breathing assessment.
Diagnostic Tests
Depending on suspicion:
- ECG and echocardiography
- Chest X-ray or CT scan
- Blood tests
- Ultrasound or MRI
Treatment for Right-Side Chest Pain
Treatment is cause-specific, not one-size-fits-all.
At Alleviate Pain Clinic, treatment may include:
- Image-guided diagnostic and therapeutic injections
- Nerve blocks for intercostal neuralgia
- Trigger point therapy
- Regenerative treatments (PRP, prolotherapy)
- Physiotherapy and posture correction
- Multidisciplinary coordination when needed
When to Seek Emergency Medical Care
Seek immediate help if you experience:
- Sudden, severe chest pain with crushing sensation
- Pain radiating to arms, jaw, neck, back, or stomach
- Chest pain with shortness of breath
- Cold sweats, extreme weakness, or dizziness
- Rapid or irregular heartbeat
- Loss of consciousness or near-fainting
- Chest pain after trauma
- Coughing up blood
Conclusion
Right-side chest pain has many possible causes, most of which are not heart-related – but some can be serious. The key is accurate diagnosis, not assumption.
If your chest pain is persistent, recurrent, or unexplained, a comprehensive evaluation at Alleviate Pain Clinic can help identify the true source and deliver precise, non-surgical, image-guided treatment for lasting relief.
Frequently Asked Questions (FAQs)
Right-side chest pain can originate from multiple body systems, including:
- Lung-related causes: pneumonia, pleurisy, asthma, pulmonary embolism
- Musculoskeletal causes: muscle strain, rib joint dysfunction, costochondritis
- Nerve-related causes: intercostal neuralgia, nerve irritation, post-herpetic pain
- Myofascial causes: trigger points in chest wall, shoulder, or upper back muscles
- Digestive causes: acid reflux, gallbladder disease, gas and bloating
- Psychological causes: stress and anxiety
- Serious causes (less common): inflammation around the heart, or pain from malignancy involving the lungs, ribs, or chest wall
Because the causes vary widely, accurate diagnosis is essential before treatment.
Yes, gas and bloating can cause right-side chest pain, especially when gas becomes trapped in the upper digestive tract.
Typical features include:
- Pressure-like or cramping pain
- Pain after meals
- Relief after burping or passing gas
However, gas-related pain should not cause breathlessness, sweating, or neurological symptoms. If these are present, other causes must be ruled out.
You should seek immediate medical care if right-side chest pain is associated with:
- Sudden onset and severe intensity
- Shortness of breath
- Pain radiating to the arm, jaw, neck, back, or abdomen
- Dizziness, fainting, or cold sweats
- Rapid or irregular heartbeat
- Coughing up blood
- Chest pain after trauma
- Persistent, unexplained pain with weight loss or night pain, which may suggest a serious underlying condition such as malignancy
Any chest pain that is progressively worsening or unexplained should not be ignored.
There is no single cure, because right-side chest pain is a symptom, not a diagnosis.
Treatment depends on the cause:
- Muscle strain, trigger points, and rib pain → physiotherapy, posture correction, image-guided injections
- Intercostal neuralgia → nerve-targeted treatments, nerve blocks, rehabilitation
- Inflammatory conditions → targeted medical management
- Malignancy-related pain → multidisciplinary pain management with precise interventions
