Chest pain from rheumatoid arthritis? It's a possibility, and if you don't know what to expect, it can leave you wondering if you're having a heart attack.

When you have rheumatoid arthritis, you may be used to bouts of pain in the joints of your arms and legs. Chest pain is another matter, but it, too, can happen as a result of RA. The condition is called costochondritis, and people can easily mistake it for a heart attack.

"It's not as common as the peripheral joints involved, but it does occur," said Patience White, MD, a rheumatologist and the vice president of public policy and advocacy for the Arthritis Foundation. "There are many joints around your chest, and they can become inflamed just like the joints of your hand and feet."

Chest pain from rheumatoid arthritis hurts terribly, but it actually is harmless. You'll want to see a doctor to make sure you aren't experiencing a true heart condition, but costochondritis from RA usually will fade on its own without treatment.

What Is Costochondritis?

Rubbery cartilage at points called costosternal joints attach your ribs to your breastbone, the hard bone you can feel running down the center of your chest. Costochondritis occurs when the cartilage in these joints becomes inflamed. Rheumatoid arthritis is one cause of that inflammation, but you also can get it from an injury or physical strain.

The RA inflammation may cause a sharp, stabbing chest pain that can be mistaken for a heart attack. However, there are key differences between the two conditions, Dr. White said.

Heart attack pain is usually widespread and felt in other parts of the body. You might feel pain in your jaw, shoulder, arms, or neck. You also may become sweaty and lightheaded.

Costochondritis pain, on the other hand, is usually only felt in a small area near the center of your chest, around the breastbone, and that pain is the only symptom you will feel.

"Costochondritis tends to be around your chest, while pain from a heart attack tends to be around your heart or in your shoulder or up in your neck and jaw," White said.

The way the pain responds to movement is another way to distinguish RA chest pain from a heart attack. "Costochondritis hurts most when you take a deep breath because it involves the joints that flex when you breathe," White said. Anything that causes those joints to move — coughing, twisting, or pressure placed on the ribs — will cause your chest pain to increase. On the other hand, if you take a deep breath during a heart attack, you won't feel any increase in pain.

Diagnosing and Treating RA Chest Pain

Because this is chest pain, you probably will be given an electrocardiogram to rule out the possibility of a heart attack. Your doctor also might perform blood tests or give you a chest X-ray.

If you're diagnosed with costochondritis, you may have to put up with the chest pain for a few days or weeks. The condition is harmless to your health and will fade on its own over time.

Some treatment options for the pain are available. Hot or cold compresses placed on the affected joints should help — try ice packs, heating pads, or a hot water bottle. Experiment with both heat and cold to see which is most effective in reducing your pain.

Over-the-counter pain relievers like aspirin, acetaminophen, ibuprofen, or naproxen may also provide relief. If your rheumatoid arthritis chest pain is not responding to other treatments, your doctor might be able to give you a cortisone injection into the affected joints.

And, while waiting for the costochondritis to dissipate, it's important to get plenty of rest and avoid activities that exacerbate your pain.