Causes

• Muscle Overuse. Chest pain can follow hard sports (such as throwing a baseball). Lifting (such as weights) or upper body work (such as digging) can also cause it. This type of muscle soreness often increases with movement of the shoulders.
• Muscle Cramps. Most brief chest pain lasting minutes is from harmless muscle cramps. It can also be caused by a pinched nerve.
• Coughing. Chest pain commonly occurs with a hacking cough. Coughing can cause sore muscles in the chest wall, upper abdomen or diaphragm. Asthma can cause chest pain this way.
• Heartburn. Heartburn is due to reflux of stomach contents.  It usually causes a burning pain under the lower sternum (breastbone).
• Heart disease is hardly ever the cause of chest pain in children.

Pain Scale

• Mild: Your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
• Moderate: The pain keeps your child from doing some normal activities.  It may wake him or her up from sleep.
• Severe: The pain is very bad. It keeps your child from doing all normal activities.         

1. What You Should Know:
   • Chest pains in children lasting for a few minutes are usually harmless. The pain can be caused by muscle cramps. They need no treatment.
   • Chest pains can be from hard work or sports that use the upper body. Sore muscles can start soon after the event.
   • Here is some care advice that should help.
2. Pain Medicine:
   • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed. See Dose Table.
   • Continue this until 24 hours have passed without pain.
3. Cold Pack:
   • For the first 2 days, use a cold pack to help with the pain.
   • You can also use ice wrapped in a wet cloth.
   • Put it on the sore muscles for 20 minutes, then as needed.
   • Caution: Avoid frostbite. 
4. Heat Pack:
   • If pain lasts over 2 days, put heat on the sore muscle.
   • Use a heat pack, heating pad or warm wet washcloth.
   • Do this for 10 minutes, then as needed.
   • Caution: Avoid burns.
   • A hot shower may also help.
5. Stretching the Muscles:
   • Gentle stretching of the shoulders and chest wall may help.
   • Do sets of 10 twice daily.
   • This may prevent muscle cramps from coming back.
   • Stretching can be continued even during the chest pain. Do not do any that increase the pain.
6. What to Expect:
   • For sore muscles, the pain most often peaks on day 2.
   • It can last up to 6 or 7 days.
7. Call Your Doctor If:
   • Pain becomes severe
   • Pain lasts over 7 days on treatment
   • Your child becomes worse

1. What You Should Know:
   • Heartburn is common.
   • It's due to stomach acid going up into the esophagus. The esophagus is the tube from the mouth to the stomach.
   • Heartburn causes a burning pain behind the lower part of the breastbone. It also causes a sour (acid) taste in the mouth and belching.
   • Here is some care advice that should help.
2. Antacids:
   • Heartburn is usually easily treated. Give 1 to 2 tablespoons (15 - 30 ml) of liquid antacid by mouth. You can use Mylanta or the store brand. No prescription is needed.
   • If you don't have an antacid, use 2 to 3 ounces (60 - 90 ml) of milk.
   • For heartburn that keeps coming back, give an antacid 1 hour before meals. Also, give a dose at bedtime. Do this for a few days.
3. Heartburn Prevention:
   • Do not eat too much at meals. This overfills the stomach.
   • Do not eat foods that make heartburn worse. Examples are chocolate, fatty foods, spicy foods, carbonated soda, and caffeine.
   • Do not bend over during the 3 hours after meals.
   • Do not wear tight clothing or belts around the waist.
4. What to Expect:
   • Most often, heartburn goes away with treatment.
   • But, heartburn also tends to come back. So, preventive measures are important. 
5. Call Your Doctor If:
   • Heartburn doesn't go away after 2 days of treatment
   • Your child becomes worse