Many things: Although by far the most common cause is muscular in nature, other causes include heart disease (coronary artery disease), lung disease and spinal disorders, to name just a few. If the pain has been persistent, it is best to be evaluated by your personal family physician. Another option is to see a physical therapist who should be able to tell you if it is simply musculoskeletal in nature.
Answered 3/25/2019
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Muscle: Muscle strain or injury.
Answered 9/6/2013
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