Authors : Dr. Pooja Gurudasani; Dr. Ashlesha Mankar; Dr. Sachin Tendulkar; Dr. Amit Jaiswal; Dr. Aastha Patel; Dr. Sudesh Waydande; Dr. Priyanka Ghumnani

Volume/Issue : Volume 11 - 2026, Issue 9 - September

Google Scholar : https://tinyurl.com/4jmfphud

DOI : https://doi.org/10.38124/ijisrt/26sep1378

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Background: Non-cardiac chest pain (NCCP) is a heterogeneous clinical presentation in which chest pain persists despite the absence of an identified cardiac cause after appropriate medical evaluation. The underlying contributors may be musculoskeletal, vascular, neurological, respiratory, gastrointestinal, psychological, or a combination of these mechanisms.  Objective: To synthesize the available evidence regarding physiotherapy and rehabilitation approaches used for NCCP and NCCP-like presentations across musculoskeletal, vascular, neurological, respiratory, and gastrointestinal/psychological contributors.  Methods: A narrative review was developed from the supplied NCCP evidence set comprising 18 articles published between 1993 and 2026. The evidence included randomized controlled trials, prospective studies, case reports, systematic reviews, a systematic review and meta-analysis, narrative reviews, and a trial protocol. Findings were organized thematically according to the major clinical contributors to NCCP.  Results: Musculoskeletal studies reported benefits from selected manual therapy, heat, stretching, trigger-point-oriented interventions, and functional restoration, although long-term comparative superiority over self-management was inconsistent. Thoracic outlet syndrome literature supported postural correction, stretching, scapular stabilization, neural mobilization, exercise, taping, and technology-assisted rehabilitation, although protocols were heterogeneous. Cervical angina literature emphasized recognition of cervical pathology and conservative management, but direct physiotherapy trials were limited. Respiratory rehabilitation, including aerobic and inspiratory muscle training, showed promising findings in NCCP accompanied by dyspnea. Diaphragmatic breathing, relaxation, and dynamic neuromuscular stabilization were also investigated in gastrointestinal and psychological NCCP.  Conclusion: The reviewed evidence supports a mechanism-oriented, individualized, and multidisciplinary approach to NCCP rather than a universal physiotherapy protocol. Better diagnostic phenotyping, standardized intervention reporting, adequately powered trials, clinically relevant outcomes, and longer follow-up are needed to strengthen the evidence base.

Keywords : Non-Cardiac Chest Pain; Physiotherapy; Physical Therapy; Musculoskeletal Chest Pain; Thoracic Outlet Syndrome; Cervical Angina; Respiratory Rehabilitation; Diaphragmatic Breathing; Rehabilitation.

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