Question: For the past two weeks or so, I have had on and off again tightness in my chest. It's not a really tight feeling, but I can notice it for sure. I figured it had something to do with allergies, but i'm not so sure now. Tightness in the chest is a concerning issue “especially if it is associated with exertion or stress,” says Dr. Davidson, a cardiologist with SignatureMD. Exertional chest pressure is called angina pectoris. It is the most common symptom of coronary artery disease, and may be associated with shortness of breath, but not necessarily.”.

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2. Occasional Chest Pain Left Side
3. Chest Tightness Definition

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by Vivian Okirie, M.D. and Micah Abraham, BSc

Last updated January 29, 2021

Chest tightness is arguably one of the most frightening anxiety symptoms. While anxiety has a variety of physical manifestations, chest tightness is the one that is associated with the most alarming health conditions, including heart attacks and stroke.

It is highly possible for chest tightness to be a symptom of many cardiac conditions, and experiencing it can often lead to further anxiety. Yet, in some cases, it is a result of anxiety, especially if one suffers from anxiety attacks frequently.

Frightening Symptoms of Anxiety

Chest tightness is an anxiety symptom that often causes a severe amount of distress. That is because chest tightness has a negative connotation that links it to severe health conditions. This can be very daunting for individuals who do not know much about the physical effects of stress and anxiety in their lives.

What Causes Chest Tightness

There is no exact explanation of what causes chest tightness in anxiety sufferers. Nevertheless, it is advised to seek a primary care provider immediately for any sudden or worsening chest pain in order to rule out possible cardiac disease.

Do not by any means feel as if you are bothering anyone when you seek help for chest pain. Once serious health conditions are ruled out, you can begin to tackle your anxiety-induced chest pain.

Rest assured that anxiety can commonly cause chest tightness and chest pain for a variety of reasons. These include:

• Hyperventilation: This is one of the most common causes of chest tightness in anxiety sufferers. Hyperventilation is a secondary condition to anxiety and is due to rapid breathing in response to a stressful situation. It results in your body taking shorter, shallower breaths that do not allow you to maintain the levels of carbon dioxide in your blood that are needed for proper ventilation. As a result, hyperventilation can cause a squeezing sensation around or near the heart as your breathing worsens.
• Bloating/Gas/Heartburn: Anxiety and stress have a profound effect on digestion because stress from anxiety puts undue pressure on your gut that can alter your normal digestive pattern. That pressure can lead to bloating; in some people, bloating tends to present with chest pressure that can often be misinterpreted as chest pain and/or tightness. Your chest is not tighter in any way, but the experience may subjectively feel like tightness. Heartburn is often classified as chest tightness when it actually is irritation of your lower esophagus by stomach acid. It also does not cause true chest tightness.
• Muscle strain: In some cases, people experience muscle strain or chest wall pain that can give the sensation of chest tightness but is actually musculoskeletal. Anxiety can exacerbate this discomfort and cause it to feel like chest tightness.

Chest tightness most often occurs right before or during an anxiety attack. It may also present spontaneously with no anxiety at all in what is known as a limited-symptom panic attack.

Rest assured that chest discomfort caused by anxiety is usually harmless.

How You Can Tell if You Are Suffering from Anxiety-Related Chest Tightness

The easiest way to determine if you are suffering from anxiety-induced chest tightness is by ruling out any cardiac or lung-related disease. Only a physician can rule these out completely.

A few signs can be helpful in determining if your chest tightness is cardiac-related. This is by no means an all-inclusive list. So, when in doubt, please visit your primary care physician. Generally, the following is more likely to be true of anxiety-related chest tightness and/or pressure:

• It is less likely to radiate towards the back, arms, or shoulders.
• It is more likely to occur with other anxiety symptoms.
• It tends to last for less than 10 minutes.

Again, having chest pain that abides by these suggestions does not rule out any cardiac or pulmonary causes. Also, women, diabetics, and the elderly often present with chest pain that is atypical of traditional cardiac chest tightness. So, if you belong to one of these groups and have new-onset chest pressure and/or tightness, it is best to see a physician first.

Anxiety attacks have a “peak” time, and that tends to be when the chest pressure is at its worst. Cardiac chest pressure, on the other hand, is more likely to last longer than 15 minutes, radiate, not be relieved with the resolution of anxiety, and be associated with shortness of breath etc.

Ways to Reduce Chest Pressure

When you are experiencing chest pressure and/or tightness, the key is to try to figure out the potential causes. Once you deem anxiety to be the cause of the symptom(s), the next goal is to stop it. See the following examples:

• Hyperventilation: Try to get your breathing under control by taking slower, deeper breaths and not trying to “over-breathe” or breathe too fast. When you’re experiencing hyperventilation, you may feel as though you’re not getting enough air, but hyperventilation occurs when you have expelled more CO2 than you make. So breathing more slowly helps to rebuild those CO2 levels.
• Bloating/Heartburn: If you can potentially reduce/prevent any gas, do so. You may also want to consider taking an antacid or drinking water, which may help with bloating or heartburn. Heartburn can be improved by eating more slowly, decreasing the amounts of spicy foods you consume, and staying upright for at least 30 minutes after eating. Also, avoid heartburn-inducing foods like peppermint, chocolate, coffee or caffeinated beverages, tomatoes, alcohol, and citrus fruits
• Muscle Strain: Be mindful of lifting or carrying items that are too heavy. Make sure to stretch and warm up your muscles before doing any strenuous activities.

These are only temporary fixes. Remember that your chest pressure and/or tightness is often related to some type of anxiety issue or anxiety disorder. That means that the only way to prevent the chest pressure from returning is to learn to manage your anxiety.

Yet, before you can do that, you need to make sure that you know what type of anxiety you are suffering from and what symptoms may result from it.

SUMMARY:

Hyperventilation is the most common cause of chest tightness with anxiety, caused by breathing too quickly when you feel anxious. Other causes need to be addressed using means specific to each one. Anxiety reduction, using CBT, medication, or self-help treatment is the only way to effectively control chest tightness overall, but there are strategies that can be used to decrease its severity in the interim.

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Anxiety chest tightness, including chest pressure, tension, fullness, pain, and shooting pains are often symptoms of anxiety disorder, including generalized anxiety disorder, social anxiety disorder, panic disorder, and others.

To see if anxiety might be playing a role in your anxiety symptoms, rate your level of anxiety using our free one-minute instant results Anxiety Test or Anxiety Disorder Test.

Occasional Chest Pain Left Side Sharp

The higher the rating, the more likely it could be contributing to your anxiety symptoms, including chest tightness.

This article explains the relationship between anxiety and chest tightness.

What anxiety chest tightness can feel like?

Anxiety chest tightness is often described as:

• An unusual tightness or pressure in your chest.
• An unusual pain or shooting pains in your chest.
• Sharp stabbing pains in your chest.
• Feels like your chest muscles are unusually tight or tense.
• Feels like a chest muscle or muscles are twitching, trembling, or stabbing.
• Feels like a burning, numbness, an uneasiness, or fullness in the chest area.
• Feels like a “heaviness” in your chest.
• A gripping feeling.
• A stabbing pain that comes out of nowhere.
• A tension, pressure, gripping feeling, stabbing pain, muscle tension, burning, numbness, an uneasiness, or a fullness in the chest and diaphragm areas—a sheet of internal muscle that extends across the bottom of the rib cage.

This chest tightness may be located in one, a few, or many spots in the chest area, or may move all over the chest area. The chest tightness may radiate to one or both shoulders; into the breasts; into the rib cage; into the sides of the abdomen; into the neck, throat, jaw, and head; and/or can be felt in the back and stomach areas.

This chest tightness feeling can also feel worse after eating, and cause a shortness of breath feeling.

This chest tightness can occur rarely, frequently, or persistently. It can be experienced as a dull, sharp, stabbing, piercing tightness or pain, and/or as persistent tightness, pressure, fullness, or numbness.

This chest tightness can precede, accompany, or follow an escalation of other anxiety sensations and symptoms, or occur by itself.

This chest tightness can precede, accompany, or follow an episode of nervousness, anxiety, fear, and elevated stress, or occur 'out of the blue' and for no apparent reason.

This chest tightness can range in intensity from slight, to moderate, to severe. It can also come in waves where it’s strong one moment and eases off the next.

This chest tightness can change from day to day, and/or from moment to moment.

All of the above combinations and variations are common.

This type of chest tightness is commonly misconstrued as heart problems or the signs of a heart attack.

This symptom is often referred to as Non-cardiac Chest Pain (NCCP).

What causes anxiety chest tightness?

1. The effects of the stress response

Behaving anxiously activates the body’s stress response. The stress response secretes stress hormones into the bloodstream where they travel to targeted spots to bring about specific physiological, psychological, and emotional changes that enhance the body’s ability to deal with a threat—to either fight with or flee from it. This survival reaction is the reason why it’s often referred to as the fight or flightresponse, the emergency response, or the fight, flight, or freeze response (some people freeze when they are afraid like a “deer caught in headlights”).[1][2][3][4]

A part of the stress response changes causes muscles in the body to contract and tighten in an attempt to protect the body from harm. Because there are many muscles in the chest, stomach, rib cage, neck, and throat areas, these muscles can tighten, too.

As our anxiety increases, so can these changes and their degrees. The more anxious you are, the tighter these muscles become. Muscle tension can lead to tightness and pain, including the muscles in the chest and nearby areas.

To make matters worse, many anxious people believe this muscle tightness may be caused by a heart problem or heart attack, which can cause more stress responses and a further increase in chest tightness and pain, as well as other stress and anxiety related symptoms similar to those of a heart attack, such as profuse sweating, light-headedness, and numbness in the arms, feet or face. These increased symptoms may reinforce your belief that you are having a heart attack causing even more fear, symptoms, and even panic.

2. Tightness and pain radiating from the stomach and digestive system

Stomach and digestive system upset can present pain, shooting pain, radiating pain, pressure, fullness, tightness, and discomfort that can be felt in the chest area and may be perceived as heart-related, as well. Stomach and digestive symptoms are also common for stress and anxiety, and can emulate chest tightness, pressure, and pain.

3. The effects of hyperstimulation (chronic stress)

When stress responses occur infrequently, the body can recover relatively quickly from the physiological, psychological, and emotional changes the stress response brings about. When stress responses occur too frequently and/or dramatically, however, such as from overly apprehensive behavior, the body has a more difficult time recovering, which can cause it to remain in a state of semi stress response readiness. We call this state “stress-response hyperstimulation” since stress hormones are stimulants (also often referred to as 'hyperarousal').[5][6][7]

Chronic stress (hyperstimulation) can overwork the body’s systems, organs, and glands, which can then present symptoms of being overly stressed. Experiencing 'chest tightness and pain' is a common symptom of chronic stress.

When you combine the above factors, it’s plain to see why so many anxious people end up in the emergency room each year due to chest tightness symptoms fearing they are coming from the heart (NCCP).

According to a 2017 review article published in the journal Psychosomatics, one in three people experiences NCCP at some point in their lives. Many experience high levels of anxiety as a result.

For more information about how to “tell the difference between an anxiety attack and a heart attack.”

How can I eliminate anxiety chest tightness?

1. End the stress response

When chest tightness is caused by an active stress response (triggered by being anxious, nervous, apprehensive), calming yourself down will bring an end to the stress response. This, in turn, will bring an end to the stress response changes. As your body recovers from the stress response changes, this chest tightness symptom should subside. Keep in mind that it can take up to 20 minutes or more for the body to recover from a major stress response. But this is normal and shouldn’t be a cause for concern.

2. Eliminate hyperstimulation

When this symptom is caused by hyperstimulation (chronic stress), it may take a lot more time for the body to recover and to the point where this symptom subsides. We explain this scenario in more detail in the Recovery Support area of our website.

Nevertheless, when the body has fully recovered from being anxious and chronically stressed, this chest tightness symptom completely disappears. Therefore, the anxiety chest tightness symptom needn’t be a cause for concern.

You can speed up the recovery process by reducing your stress, practicing relaxed breathing, increasing your relaxation, and not worrying about this symptom. Again, when your body has recovered from the stress response or chronic stress, this symptom will subside.

3. Short-term strategies:

While the overall goal is to eliminate hyperstimulation so that the body stops producing chest tightness and pain symptoms, some people have found some relief by adopting some of the following strategies:

• Reduce stress – reducing stress can reduce stress-caused muscle tension.
• Regular mild to moderate exercise – can help loosen tight chest and abdomen muscles. As fitness level increases, issues with tight muscles diminish.
• Have a massage – massages are relaxing, which can help loosen tight muscles.
• Relaxed breathing – can relax tight chest muscles.
• Stretching – can relax tight chest muscles.
• Deep relaxation – deeply relaxing the body can help unclench tight stomach and chest muscles.
• Warm to hot bath – soaking in the tub can be relaxing, which can help relax tight muscles.
• Steam bath or sauna – moderately warm steam baths or saunas can also relax tight muscles, including those in the stomach and chest areas.
• Take a leisure walk – leisure walking can reduce stress and tight chest muscles.
• Increase rest – resting helps the body to relax, which can also relax tight muscles.
• Relax chest and stomach muscles – some people tense their stomach and chest muscles, which becomes a habit. Learning to keep them relaxed can help loosen tight stomach and chest muscles.
• Avoid foods that irritate the stomach and digestive system – if certain foods upset your digestive system, avoid them until your body has recovered.
• Be sure you are well hydrated – dehydration can cause muscle tension and pain. Drinking enough fluids so that your urine is almost clear is a way to tell if your body is well hydrated.
• Avoid stimulants – Hyperstimulation means your body is overly stimulated. Ingesting stimulants will just aggravate hyperstimulation and its symptoms, including muscle tension and pain.

4. Therapy

The number one reason why anxiety disorder and its symptoms persist is because of unidentified and unaddressed underlying factors that cause issues with anxiety. This is why dealing with your anxiety issues is the most important overall.

Since the majority of stress comes from behavior (the ways we think and act), addressing the core reasons for anxiety disorder can reduce and eliminate the unhealthy stress that often leads to hyperstimulation and symptoms, including this one.

Keep in mind that eliminating anxiety symptoms doesn’t necessarily mean you’ve overcome issues with anxiety. Anxiety symptoms are symptoms of stress. Eliminating anxiety symptoms means you’ve eliminated the unhealthy stress that is causing your symptoms. But if the underlying factors that cause issues with anxiety aren’t addressed, it’s just a matter of time until the body is overly stressed and symptomatic again.

Rebounds of symptoms and a return to a struggle with anxiety are caused for this very reason: the core issues that cause problematic anxiety haven’t been successfully addressed.

To eliminate issues with anxiety and symptoms once and for all, we need to eliminate the cause of problematic anxiety – the underlying factors that cause issues with anxiety. When you eliminate the cause of the problem, you eliminate the problem and the problem's symptoms.

If you have been struggling with anxiety and symptoms, we recommend connecting with an experienced anxiety disorder therapist to help you overcome your anxiety issues. Research has shown that working with an experienced therapist is an effective treatment for anxiety disorder.[8][9]

All of our recommended anxiety disorder therapists have personally experienced anxiety disorder and have overcome it. Their personal experience with anxiety disorder combined with their Masters Degree and above professional training makes them a good choice when desiring to overcome anxiety disorder and its symptoms.

Moreover, getting therapy via teletherapy, distanced therapy, or e-therapy (telephone or online therapy) is as effective, if not more so, than in-person therapy.[10][11]

All of our recommended anxiety therapists are experienced at working with clients via distanced therapy and new technologies. We’ve found distanced therapy to be especially effective when working with anxious clients.

NOTE: If you are experiencing chest tightness or pain and aren’t sure of the cause, definitely seek immediate medical attention. It’s far better to be certain about the cause than wonder and be experiencing a true heart-related symptom.

Occasional Chest Pain Left Side

The combination of good self-help information and working with an experienced anxiety disorder therapist is the most effective way to address anxiety disorder and its many symptoms. Until the core causes of anxiety are addressed - the underlying factors that motivate apprehensive behavior - a struggle with anxiety disorder can return again and again. Identifying and successfully addressing anxiety's underlying factors is the best way to overcome problematic anxiety.

Additional Resources:

• For a comprehensive list of Anxiety Disorders Symptoms Signs, Types, Causes, Diagnosis, and Treatment.
• Anxiety and panic attacks symptoms can be powerful experiences. Find out what they are and how to stop them.
• Free online anxiety tests to screen for anxiety. Two minute tests with instant results. Such as:
• Anxiety 101 is a summarized description of anxiety, anxiety disorder, and how to overcome it.

Return to Anxiety Disorders Signs and Symptoms section.

anxietycentre.com: Information, support, and coaching/counseling/therapy for problematic anxiety and its sensations and symptoms, including the anxiety symptom chest tightness.

REFERENCES:

1. Selye H. Endocrine reactions during stress. Anesthesia & Analgesia. 1956;35:182–193. [PubMed]

2. 'Understanding the Stress Response - Harvard Health.' Harvard Health. N.p., n.d. Web. 23 May 2016.

3. 'The Physiology of Stress: Cortisol and the Hypothalamic-Pituitary-Adrenal Axis.' DUJS Online. N.p., 03 Feb. 2011. Web. 19 May 2016.

4. 'Stress.' University of Maryland Medical Center. N.p., n.d. Web. 16 May 2016.

5. Teixeira, Renata Roland, et al. “Chronic Stress Induces a Hyporeactivity of the Autonomic Nervous System in Response to Acute Mental Stressor and Impairs Cognitive Performance in Business Executives.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 2015.

6. Yaribeygi, Habib, et al. “The Impact of Stress on Body Function: A Review.” EXCLI Journal, Leibniz Research Centre for Working Environment and Human Factors, 2017.

7. Hannibal, Kara E., and Mark D. Bishop. “Chronic Stress, Cortisol Dysfunction, and Pain: A Psychoneuroendocrine Rationale for Stress Management in Pain Rehabilitation.” Advances in Pediatrics., U.S. National Library of Medicine, Dec. 2014.

8. Hofmann, Stefan G., et al. “The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-Analyses.” Cognitive Therapy and Research, U.S. National Library of Medicine, 1 Oct. 2012.

9. Leichsenring, Falk. “Is Cognitive Behavioral Therapy the Gold Standard for Psychotherapy?” JAMA, American Medical Association, 10 Oct. 2017.

10. Thompson, Ryan Baird, 'Psychology at a Distance: Examining the Efficacy of Online Therapy' (2016). University Honors Theses. Paper 285.

11. Kingston, Dawn.“Advantages of E-Therapy Over Conventional Therapy.” Psychology Today, Sussex Publishers, 11 Dec. 2017.

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Chest Tightness Definition