Thoracalgia: diagnostic and treatment algorithms

Treatment of patients with chest pain (thoracalgia) is a current medical issue. The most common cause of thoracalgia is a benign musculoskeletal pain such as intercostal myofascial pain, facet syndrome and osteoarthritis of the sternocostal joints. However, chest pain can also be caused by life-threatening conditions that require emergent medical care. The article presents the clinical symptoms and treatment approaches for various chest pain syndromes and the principles of differential diagnosis of cardiac pain. The basis of effective treatment is a comprehensive approach that includes patient education about the benign nature of the condition, kinesiotherapy and cognitive behavioral therapy for chronic pain. Among the drug methods, the prescription of non-steroidal anti-inflammatory drugs (NSAIDs) is the most important. Nimesulide is an NSAID with an optimal profile of efficacy and safety. The example of a clinical case shows the heterogeneity of pain syndromes in patients with chest pain, whose timely diagnosis and complex treatment can prevent pain chronification and improve patients' quality of life.