| Objective: To qualitatively review the health literature regarding chest pain, particularly to what extent and how neuromusculoskeletal (NMS) chest pain is discussed concerning prevalence based on clinical settings, as well as evidence-based diagnostic protocols and management. Method: Literature search of MEDLINE, CINAHL, MANTIS and Index to Chiropractic Literature databases using a variety of search terms. Three hundred fifty citations were captured with a final yield of 108 journal articles and 4 book chapters for this study. Results: The prevalence of chest pain and types of diagnoses varies with the clinical setting. NMS chest pain prevalence might be as high as 50% in ambulatory care settings. The prevalence in emergency settings is much lower, and the diagnoses rendered vary greatly. The importance of NMS aetiologies for chest pain appears under-appreciated in the literature. Conclusion: Chest pain is a prevalent complaint in primary and portal-of-entry health provider offices, ambulatory care facilities, and urgent/emergent care facilities. The resulting diagnoses appear to be categorised mainly into cardiac, gastroesophageal, and psychiatric problems Attention to (NMS) diagnoses seems limited, although a small number of studies indicate NMS chest pain may be more prevalent in private office settings than previously realised. In addition, it is unknown to what degree chiropractors encounter chest pain as a primary or concurrent complaint. Chiropractors may provide a diagnosis and care for patients that have previously been overlooked. They may also make a substantial contribution to building much needed scientific and clinical evidence in the diagnosis and care of NMS chest pain. This abstract is reproduced with the permission of the publisher; full text (print only) by subscription.
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