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Chest tightness anxiety symptoms

Marilyn Folk BScN medical reviewer
Written by: Jim Folk.
Medically reviewed by: Marilyn Folk, BScN.
Last updated: April 27, 2019

chest tightness anxiety symptoms information

What anxiety chest tightness can feel like?

Anxiety chest tightness is often described as:

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?

Medical Advisory

We recommend all new, changing, persistent, and returning anxiety symptoms be discussed with your doctor as some medical conditions and medications can cause anxiety-like symptoms, including this anxiety symptom. If your doctor concludes your symptoms are solely anxiety-related, you can be confident there isn't a medical cause. Generally, doctors can easily determine the difference between anxiety symptoms and those caused by a medical condition.

Doctors aren't infallible, however. If you are uncertain about your doctor’s diagnosis, you can seek a second or more opinions. But if all opinions agree, you can be assured anxiety is the cause of this symptom.

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 flight response, 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 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 experience tightness, too.

anxiety chest tightness symptoms

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:

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.

Research has also shown that self-help information can also be beneficial.[12][13] For a more detailed explanation about anxiety symptoms including this one, why symptoms can persist long after the stress response has ended, common barriers to recovery and symptom elimination, and more recovery strategies and tips, we have many chapters that address this information in the Recovery Support area of our website.

For a more detailed explanation about anxiety chest tightness (and all of the other anxiety symptoms), why symptoms can persist long after the stress response has ended, common barriers to recovery and symptom elimination, and more recovery strategies and tips, we have many chapters that address this information in the Recovery Support area of our website.

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.


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:


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, www.ncbi.nlm.nih.gov/pmc/articles/PMC4373764/.

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, www.ncbi.nlm.nih.gov/pmc/articles/PMC5579396/.

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, www.ncbi.nlm.nih.gov/pmc/articles/PMC4263906/.

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, www.ncbi.nlm.nih.gov/pmc/articles/PMC3584580/.

9. Leichsenring, Falk. “Is Cognitive Behavioral Therapy the Gold Standard for Psychotherapy?” JAMA, American Medical Association, 10 Oct. 2017, jamanetwork.com/journals/jama/article-abstract/2654783.

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, www.psychologytoday.com/us/blog/the-pregnant-pause/201712/advantages-e-therapy-over-conventional-therapy.

12. C., Lewis, et al. "Efficacy, cost-effectiveness and acceptability of self-help interventions for anxiety disorders: systematic review." British Journal of Psychiatry, Jan. 2012, https://www.ncbi.nlm.nih.gov/pubmed/22215865

13. Kumar, Shefali, et al. "Mobile and traditional cognitive behavioral therapy programs for generalized anxiety disorder: A cost-effectiveness analysis." Journal PLOS, 4 Jan. 2018, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0190554


Return to our section that explains the hundreds of anxiety signs and symptoms, including trembling, numbness, tingling, shortness or breath, and racing heart, and so on.

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