Massive Chest pain

Whenever I lay flat on my back with my head at any incline over, lets say 25 degrees, I experience horrendous pain after about 5 mins. in that position. It is felt in my lower and mid left chest area. It feels like my ribs are on fire. It is possible that I bruised my ribs (pain started after) about 12 years ago, but I doubt that the pain from that is lingering now. I had x-rays done at a local clinic about 11 years ago, but the doctor there could see no hairline cracks or any other abnormality. Anyone else ever get this type of pain? I figure that a musculature problem would not last this long.  Dunno, but it sure does hurt. I can't lay in bed and watch a movie or use my laptop. And I am jobless with no insurance, so I can't visit a physical therapist.

[J T Junig, MD PhD]

Read the posts about 'costochondritis', as that is the most likely scenario, but the one thing to 'rule out' is aortic dissection, as that can kill a person in a span of seconds. Work-up to rule that in or out would include checking the blood pressure in both arms, right vs left;  they should be almost the same.  A chest x-ray would be a cheap test to look for widening of the 'mediastinum', the space in the center of the chest where the aorta passes through.  If the BP or x rays were suggestive, you would want an MRI or angiogram to take a good luck at the aorta, to make sure there are no leaks or tears in the wall of the aorta.  Not common, but in general, 'severe' pains in the chest should be taken seriously until ruled out for the 'bad things'.