Chest pain or fainting while exercising: call 999
Call 999 if:
- You get sudden pain or discomfort in your chest that doesn't go away; it can feel like squeezing or pressure, burning or indigestion.
- The pain spreads to your left or right arm, or your neck, jaw, stomach or back.
- You have chest pain and feel sweaty, sick, light-headed or short of breath.
- Someone faints while exercising, can't be woken within 1 minute, or has chest pain or a pounding, fluttering or irregular heartbeat.
Sources 1, 2
Chest pain that could be the heart or a collapsed lung: call 999
Call 999: sudden pain or discomfort in your chest that does not go away (it can feel like squeezing or pressure, burning or indigestion); pain that spreads to your left or right arm, or your neck, jaw, shoulder, stomach or back; or chest pain and you feel sweaty, sick, light-headed or short of breath. It could be a heart attack. Don't drive yourself to A&E.
Call 999: sudden chest pain or discomfort, or chest pain with feeling sweaty, sick, light-headed or breathless. A collapsed lung (pneumothorax) causes a sudden, sharp, stabbing pain in the chest or shoulder that gets worse when you breathe in, with breathlessness; it is more common in people aged 15 to 34, people who smoke, and tall, thin people.
Sources 1, 54
A shoulder out of place, a stroke or pressure on the spinal cord: call 999
- Call 999 or go to A&E: after a fall or injury, your shoulder looks out of place or has changed shape, you cannot move your arm, or your shoulder is painful, bruised or swollen. Do not drive yourself, and do not try to put it back in yourself.
- Call 999: you suddenly can't fully lift both arms and keep them there, because of weakness or numbness in one arm, especially if one side of your face droops or you slur your words or sound confused. It could be a stroke. Call even if the signs have stopped.
- Call 999 or go to A&E: new problems walking, loss of bladder or bowel control, or a sudden loss of coordination, such as difficulty doing up buttons. These can be signs of pressure on the spinal cord.
Sources 54, 1, 55, 56, 57
Unusual breathlessness
Call 999 or go to A&E (accident and emergency) straight away for severe difficulty breathing (gasping, choking or not able to get words out), a chest that feels tight or heavy, pain that spreads to your arms, back, neck and jaw, lips or skin turning very pale, blue or grey, or sudden confusion. If you're more short of breath than usual, or your heart is racing, fluttering or skipping beats, contact NHS 111.
Source 58
Back pain with chest pain: call 999
Call 999 or go to A&E: back pain with chest pain, or back pain that started after a serious accident, such as a car crash.
Source 59
Get help from NHS 111
- Get help from NHS 111: you're suddenly more short of breath than usual; you have chest pain and you feel sick or are being sick; or you have chest pain and you feel like your heart is racing, going too slowly, skipping a beat or fluttering.
- Get help from NHS 111: pain or tightness in your chest, neck, shoulders, jaw or arms that comes and goes, often brought on by exercise, stress, emotion or cold and easing after a few minutes' rest. It can be angina, a sign of a heart problem. If you've been diagnosed with angina, get help from NHS 111 too if it feels worse than before, is happening more often, lasts longer or happens when you're resting.
- Get help from NHS 111 if you think you have costochondritis. Chest pain needs checking to rule out other, more serious conditions, and costochondritis is diagnosed only once the heart and lungs have been considered.
Sources 54, 1
See a GP
See a GP if you have chest pain that comes and goes, or that goes away quickly but still worries you.
Source 1
A pulled chest muscle
Same day (NHS 111 or an urgent treatment centre): a pop or tearing at the front of the armpit or chest during a lift, a dip or a tackle, followed by bruising into the chest or upper arm, a change in the shape of the chest or armpit (a thinner or lost armpit fold, or a chest or nipple that looks uneven), or weakness pushing. Don't wait for it to settle: it can be a torn pec tendon, and repairs done within about 6 weeks did better than later ones.
A dip or change in the chest's shape that you only notice once the bruising fades, or weakness pushing that isn't getting better: get it checked promptly through your GP or NHS 111, and ask about a shoulder specialist. A tendon tear found late can often still be repaired, though the results are better early.
The NHS lists chest pain that "Starts after chest injury or chest exercise, may get worse when you breathe in, feels better when resting the muscle" as a possible chest sprain or strain. If you're not sure, it still needs the checks above (our suggestion).
Source 1
The shoulder: the same day
- Same day (GP or NHS 111): sudden or very bad shoulder pain; you cannot move your arm; the arm or shoulder is badly swollen or has changed shape; pins and needles that do not go away; no feeling in the arm; the arm is hot or cold to the touch; pain that started after an injury such as a fall; or severe pain in both shoulders.
- Same day (GP or NHS 111): the shoulder or arm is hot, swollen or red, or you have a high temperature (although not everyone has one) or feel unwell. A joint infection needs same-day care.
- Same day (GP or NHS 111): sudden weakness lifting the arm after an injury or fall. A rotator cuff tear caused by an injury needs urgent referral to a shoulder specialist. After a dislocation in anyone over 40, the rotator cuff should be checked: about 40% have a tear.
Source 56
The neck and arm: the same day
- Same day (urgent GP appointment or NHS 111): severe neck pain that starts suddenly or gets worse quickly; heaviness or weakness in the arms or legs; pins and needles in an arm along with neck or arm pain; or pain between the shoulder blades.
- Same day: clumsiness in your hands, or numbness, pins and needles or weakness in one or both arms, that is getting worse; problems with balance or walking since the neck pain started; or neck pain with a severe headache.
- Arm weakness or numbness that keeps getting worse, severe pain that painkillers and rest do not touch, or an unexplained fever.
Source 57
See a GP or physiotherapist
- Your shoulder has partly or fully come out of joint, or you worry it might.
- Pain that is getting worse or has not improved after 2 weeks of looking after it yourself, or it is very hard to move your arm. In many areas you can refer yourself to physiotherapy.
- Pins and needles or a cold arm alongside neck pain, or a new loss of strength or feeling in the arm that you cannot explain (a possible nerve problem).
- Neck pain or stiffness that has not eased after a few weeks, or after 8 weeks of looking after it yourself; painkillers are not helping; or you are worried. In many areas you can refer yourself to NHS physiotherapy.
- See a GP if you have pain and stiffness for more than a week, especially if you're over 50, it's in both shoulders (often the neck and hips too) and the stiffness lasts longer than 45 minutes in the morning. It can be polymyalgia rheumatica.
Sources 56, 57, 60
The back
Back pain that is worse arching back and has lasted more than a couple of weeks can be a stress fracture of the spine (spondylolysis): get it checked.
Modify or avoid exercises that round your back deeply or repeatedly, especially with a weight: sit-ups, toe touches, Pilates roll-downs and curl-ups, and extreme yoga forward folds. Bend from the hips instead. You do not need to avoid bending, twisting or lifting altogether: move smoothly and keep your upper back straight.
Tingling during a pose
Burning, tingling, numbness or pins and needles down an arm or leg usually means a nerve is under tension, so ease off to a position without it. A pinch at the front of the hip or shoulder at the end of a pose is the joint, so work below it. See a GP or physiotherapist if either keeps happening (our suggestion).
Stop and get medical help
If you get chest pain or pressure, feel faint or dizzy, are unusually breathless, or your heart races or beats irregularly during exercise, as our plans advise.
During yoga
A joint pain that is sharp, gets worse during a session, lingers into the next day or changes how you move is a reason to use an easier version, and to see a GP or physiotherapist if it keeps happening (the rule in our plans). Muscle soreness for a day or two after something new is normal. In a hot class, stop if you feel dizzy, sick or unwell; our hot yoga guide lists the signs of heat illness.
You can say no to any hands-on adjustment, and a teacher registered with Yoga Alliance must get your explicit consent each time.
Sources 61, 62
Head-down poses, bones and pregnancy
With glaucoma, or high blood pressure that isn't under control, skip headstands, shoulder stands and long head-down holds. With osteoporosis, swap deep forward folds for a flat-back hinge from the hips, and twist smoothly. In pregnancy, our yoga in pregnancy guide covers the changes. NCCIH advises beginners to avoid headstands, shoulder stands, the lotus position and forceful breathing.
Sources 53, 61
Before you start
The NHS advises getting advice from a healthcare professional first if you have a health problem, an injury or symptoms, or have recently had a heart attack or an operation.
If you have a heart, lung or joint condition, are pregnant or have recently been unwell, start gently and read our guide for your condition. Muscle soreness for a day or two after a new exercise is common and fades as you repeat it.
If you have a heart condition, follow your cardiac team's advice on how hard to work, and stop for the warning signs above. People with long-term conditions may wish to ask their specialist before starting. With uncontrolled high blood pressure, avoid straining against a held breath; the high blood pressure guide has more.