Chest pain with a cardiac cause ruled out is most commonly caused by the chest wall — the ribs, cartilage, muscles, or thoracic outlet. These are real, identifiable, and treatable conditions. They are often missed because the focus goes straight to the heart. Dr Lawrence Okiror, Consultant Thoracic and Robotic Surgeon (GMC 6150382), assesses and treats chest wall causes at London Bridge Hospital. Most patients leave the first appointment with a clear diagnosis. Private appointments within 2–3 days. No GP referral required.
Last reviewed: April 2026 · Dr Lawrence Okiror FRCS(CTh) FRCSEd(CTh) · GMC 6150382
When chest pain is assessed, the ribs, cartilage, muscles, and nerves of the chest wall are frequently overlooked. A thoracic surgeon examines these structures specifically and can usually identify the cause at the first consultation.
Slipped rib syndrome, costochondritis, rib fractures, and thoracic outlet syndrome are all manageable conditions. Many respond to non-surgical treatment. Where surgery is needed, results are consistently good.
If you have chest pain with breathlessness, sweating, or pain radiating to the arm or jaw, call 999 or go to A&E immediately. A thoracic surgeon assesses chest wall causes — cardiac assessment should be done by a cardiologist first.
These are the most common chest wall causes of persistent or unexplained chest pain. All are treatable and diagnosable at the first specialist consultation.
One of the lower ribs moves excessively, catching on surrounding structures and causing a sharp, catching pain in the lower chest or upper abdomen. Frequently missed and attributed to reflux or back pain. Diagnosis is usually clinical. Surgical treatment gives consistently good results. Slipped rib syndrome →
Inflammation where the ribs join the cartilage connecting them to the breastbone. Causes localised tenderness worsened by movement or pressure. Common and usually responds well to anti-inflammatory treatment. Surgery is rarely needed.
Compression of nerves or blood vessels between the collarbone and first rib. Causes arm, neck, shoulder, and sometimes chest pain. Often misdiagnosed as rotator cuff or cervical spine disease. Dr Okiror offers robotic keyhole decompression — one of very few surgeons in the UK to do so. TOS →
A rib fracture causes persistent pain worse with breathing and movement. Most heal with time. Pleurisy — inflammation of the lung lining — causes sharp, stabbing pain worse with breathing. CT scan identifies both. Pleural disease →
Questions most commonly asked by patients whose chest pain has not been explained after cardiac assessment.
Book an Assessment →Or call Jo Mitchelson:
020 7952 2882
No GP referral required. Private appointments at London Bridge Hospital within 2–3 days. Dr Okiror will examine the chest wall specifically and give you a clear answer and a clear plan.
Jo Mitchelson, Private PA · 020 7952 2882 · pa@lungsurgeon.co.uk
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