Chest tightness but lungs are clear

Chest tightness with normal lung testing is commonly associated with breathing pattern dysfunction, muscle tension, or heightened nervous system activity rather than structural lung disease.

When breathing becomes more upper chest–dominant or rapid, the muscles around the rib cage can become overworked and tight, creating a sensation of restriction or pressure in the chest.

This is often reversible with breathing pattern retraining, rib mobility work, and nervous system down-regulation strategies.