What is costochondritis. How does it affect the rib cage. What are the main symptoms of costochondritis. What causes this condition. How is costochondritis diagnosed. What are the treatment options for costochondritis. When should you seek medical attention for chest pain.

Understanding Costochondritis: A Common Cause of Chest Pain

Costochondritis is a condition characterized by inflammation of the cartilage connecting the ribs to the breastbone (sternum). This inflammation can cause sharp, localized chest pain that may be mistaken for more serious conditions like heart attacks. Understanding the nature of costochondritis is crucial for proper diagnosis and management.

What exactly is costochondritis?

Costochondritis is an inflammation of the costal cartilages, which are the cartilage segments that connect the ribs to the sternum. This condition primarily affects the upper ribs and can occur on one or both sides of the chest. The pain associated with costochondritis can range from mild discomfort to severe, debilitating pain that may limit daily activities.

Recognizing the Symptoms of Costochondritis

Identifying the symptoms of costochondritis is crucial for early detection and appropriate treatment. While the primary symptom is chest pain, there are several other indicators that can help distinguish this condition from other health issues.

What are the main symptoms of costochondritis?

The most common symptoms of costochondritis include:

• Sharp, aching pain in the chest, typically on the left side
• Pain that worsens with movement, deep breathing, or coughing
• Tenderness when pressing on the affected area
• Pain that may radiate to the back or abdomen
• Difficulty taking deep breaths due to discomfort

It’s important to note that the intensity of pain can vary from person to person and may fluctuate throughout the day. Some individuals may experience mild discomfort, while others may have severe pain that mimics a heart attack.

Causes and Risk Factors for Costochondritis

Understanding the potential causes and risk factors associated with costochondritis can help in prevention and management of the condition. While the exact cause is often unknown, several factors have been identified as potential triggers.

What are the common causes of costochondritis?

Some of the known causes and risk factors for costochondritis include:

1. Physical trauma or injury to the chest area
2. Repetitive strain from activities like heavy lifting or intense exercise
3. Respiratory infections, such as viral or bacterial pneumonia
4. Certain medical conditions, including fibromyalgia and arthritis
5. Excessive coughing or sneezing
6. Poor posture or spinal misalignment

It’s worth noting that in many cases, the exact cause of costochondritis remains unknown, making it challenging to prevent its occurrence entirely.

Diagnosing Costochondritis: What to Expect

Diagnosing costochondritis can be challenging, as its symptoms can mimic those of other serious conditions. Healthcare providers typically rely on a combination of clinical examination and diagnostic tests to confirm the diagnosis and rule out other potential causes of chest pain.

How is costochondritis diagnosed?

The diagnostic process for costochondritis usually involves:

• Medical history review: Your doctor will ask about your symptoms, their duration, and any potential triggers.
• Physical examination: The healthcare provider will palpate your chest to identify areas of tenderness or swelling.
• Imaging tests: X-rays, CT scans, or MRI may be ordered to rule out other conditions.
• Electrocardiogram (ECG): This test helps rule out heart-related issues.
• Blood tests: These can help identify signs of inflammation or infection.

It’s important to note that there is no specific test to definitively diagnose costochondritis. The condition is often diagnosed based on the exclusion of other potential causes of chest pain.

Treatment Options for Costochondritis

While costochondritis often resolves on its own over time, various treatment options can help manage symptoms and promote faster recovery. The choice of treatment depends on the severity of symptoms and individual patient factors.

What are the most effective treatments for costochondritis?

Common treatment approaches for costochondritis include:

1. Over-the-counter pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce pain and inflammation.
2. Rest and activity modification: Avoiding activities that exacerbate symptoms can aid in recovery.
3. Heat or cold therapy: Applying heat or ice to the affected area may provide relief.
4. Gentle stretching exercises: Specific stretches can help improve flexibility and reduce pain.
5. Physical therapy: A therapist can teach techniques to improve posture and strengthen chest muscles.
6. Topical anti-inflammatory creams: These can be applied directly to the affected area for localized relief.
7. Corticosteroid injections: In severe cases, a doctor may recommend steroid injections to reduce inflammation.

It’s crucial to consult with a healthcare provider before starting any treatment regimen, especially if symptoms persist or worsen over time.

Preventing Costochondritis: Lifestyle Modifications and Precautions

While it may not always be possible to prevent costochondritis, certain lifestyle modifications and precautions can help reduce the risk of developing this condition or experiencing recurrent episodes.

How can you reduce the risk of developing costochondritis?

Consider implementing the following strategies to minimize the risk of costochondritis:

• Practice good posture: Maintain proper alignment of your spine and rib cage during daily activities.
• Use proper lifting techniques: Avoid straining your chest muscles when lifting heavy objects.
• Warm up before exercise: Gradually increase intensity to prevent sudden stress on chest muscles.
• Manage stress: Chronic stress can lead to muscle tension, potentially contributing to costochondritis.
• Stay hydrated: Proper hydration helps maintain the flexibility of cartilage and connective tissues.
• Maintain a healthy weight: Excess weight can put additional strain on the chest wall.
• Quit smoking: Smoking can irritate the respiratory system and increase the risk of inflammation.

By incorporating these preventive measures into your daily routine, you may be able to reduce the likelihood of developing costochondritis or experiencing recurrent episodes.

When to Seek Medical Attention for Chest Pain

While costochondritis is generally not life-threatening, it’s crucial to be able to distinguish between its symptoms and those of more serious conditions. Knowing when to seek medical attention can be life-saving in certain situations.

When should you seek immediate medical care for chest pain?

Seek emergency medical attention if you experience any of the following symptoms:

• Severe, crushing chest pain that radiates to the arm, jaw, or back
• Shortness of breath or difficulty breathing
• Rapid or irregular heartbeat
• Dizziness, lightheadedness, or fainting
• Nausea or vomiting accompanying chest pain
• Chest pain that doesn’t improve with rest or worsens over time

These symptoms may indicate a heart attack or other serious cardiac condition that requires immediate medical intervention. It’s always better to err on the side of caution when it comes to chest pain.

Living with Costochondritis: Coping Strategies and Long-Term Outlook

For individuals diagnosed with costochondritis, learning to manage the condition and understanding its long-term implications can significantly improve quality of life. While the condition can be uncomfortable and sometimes disruptive, there are various strategies to cope with symptoms and maintain overall well-being.

How can you effectively manage costochondritis in daily life?

Consider implementing the following coping strategies:

1. Practice stress-reduction techniques: Meditation, deep breathing exercises, or yoga can help manage pain and reduce muscle tension.
2. Use supportive devices: A rib belt or chest brace may provide support and alleviate discomfort during activities.
3. Modify your sleeping position: Experiment with different sleeping positions and pillows to find the most comfortable arrangement.
4. Attend support groups: Connecting with others who have similar experiences can provide emotional support and practical tips.
5. Maintain a healthy lifestyle: Regular exercise, a balanced diet, and adequate sleep can contribute to overall health and potentially reduce inflammation.
6. Keep a pain diary: Tracking your symptoms and potential triggers can help identify patterns and inform treatment decisions.
7. Communicate with your healthcare provider: Regular check-ups and open communication can ensure your treatment plan remains effective.

It’s important to remember that the long-term outlook for costochondritis is generally positive. Most cases resolve within weeks to months, although some individuals may experience recurring episodes. By working closely with your healthcare provider and implementing appropriate management strategies, you can minimize the impact of costochondritis on your daily life and maintain overall well-being.

Alternative and Complementary Therapies for Costochondritis

In addition to conventional medical treatments, some individuals with costochondritis may find relief through alternative and complementary therapies. While scientific evidence supporting these approaches may be limited, many people report benefits from incorporating them into their treatment regimen.

What alternative therapies might help manage costochondritis symptoms?

Some alternative and complementary therapies that may provide relief for costochondritis include:

• Acupuncture: This traditional Chinese medicine technique may help reduce pain and inflammation.
• Chiropractic care: Spinal adjustments and soft tissue therapies may alleviate chest wall discomfort.
• Massage therapy: Gentle massage techniques can help relax tense muscles and improve circulation.
• Herbal remedies: Certain herbs with anti-inflammatory properties, such as turmeric or ginger, may offer relief.
• Essential oils: Aromatherapy using oils like lavender or eucalyptus may help reduce pain and promote relaxation.
• Transcutaneous electrical nerve stimulation (TENS): This therapy uses low-voltage electrical currents to alleviate pain.

It’s crucial to consult with your healthcare provider before trying any alternative therapies, especially if you’re taking medications or have other health conditions. While these approaches may complement conventional treatments, they should not replace medical care for costochondritis.

In conclusion, costochondritis is a common but often misunderstood cause of chest pain. By recognizing its symptoms, understanding its causes, and exploring various treatment options, individuals can effectively manage this condition and maintain their quality of life. Remember to always seek medical attention for unexplained or severe chest pain to ensure proper diagnosis and appropriate care.

Costochondritis – NHS

Costochondritis is inflammation where your ribs join the bone in the middle of your chest (breastbone). It can cause sharp chest pain, especially when moving or breathing. It usually gets better on its own over time.

Check if you have costochondritis

Costochondritis may cause sharp pain in the front or side of your chest.

The pain may be worse when:

• moving your upper body
• lying down
• breathing deeply
• you press the middle of your chest

Urgent advice: Get help from NHS 111 if:

• you think you have costochondritis

It is important to get chest pain checked to rule out other more serious conditions.

You can call 111 or get help from 111 online.

Immediate action required: Call 999 if:

You have sudden chest pain that:

• spreads to your arms, back, neck, or jaw
• makes your chest feel tight or heavy
• started with a shortness of breath, sweating, feeling sick or being sick
• lasts more than 15 minutes

You could be having a heart attack. Call 999 immediately as you need immediate treatment in hospital.

Treatments for costochondritis

Costochondritis usually gets better on its own, over time. It can last for a few weeks to several months.

Painkillers that help with inflammation, like ibuprofen, may be recommended to help with the pain.

If you have very bad pain that does not get better over time, you may be offered a steroid injection to help reduce inflammation or local anaesthetic to ease the pain.

Causes of costochondritis

It is not always known what causes costochondritis, but it may be caused by:

• an injury to your chest
• repetitive upper body movements, like lifting
• coughing a lot

Sometimes it may be caused by a problem with the joints in the back, or another underlying condition like fibromyalgia or rheumatoid arthritis.

It can also be caused by an infection.

Page last reviewed: 26 July 2022
Next review due: 26 July 2025

Symptoms, Causes, Tests, and Treatment

Costochondritis is an inflammation of the cartilage in the rib cage. It can happen due to infection, injury, and other health conditions.

This condition usually affects the cartilage where the upper ribs attach to the breastbone, also known as the sternum, in an area known as the costosternal joint or costosternal junction.

Chest pain caused by costochondritis can range from mild to severe. Mild cases may only cause your chest to feel slightly tender or some pain when you push on the area.

More severe cases may get worse with certain movements as well as with deep breaths. The condition often goes away within a few weeks or months, but some cases may require treatment.

People with costochondritis often experience chest pain in the upper and middle rib area on either side of the breastbone. This pain can gradually increase over time, or come on suddenly.

Additional symptoms can include:

• pain that becomes worse when lying down
• pain that becomes worse when there’s pressure on your chest, like when you wear a seatbelt
• pain that intensifies with coughing or deep breaths
• pain that increases with physical activity

It’s important to note that symptoms like chest tightness and radiating pain can indicate other conditions, including a heart attack. Seek immediate medical care if you’re experiencing persistent, intense chest pain.

The exact cause of costochondritis in most people is unknown. But conditions that may cause it include:

• trauma to the chest, such as blunt impact from a car accident or fall
• physical strain from activities, such as heavy lifting and strenuous exercise
• certain viruses or respiratory conditions, such as tuberculosis, that can cause joint inflammation
• severe coughing

There’s some research that suggests costochondritis occurs more often in women, especially those who are athletes. You may also be at a higher risk for this condition if you:

• participate in high-impact activities
• recently had a physical trauma or fall that affected the chest area
• have allergies and are frequently exposed to irritants

While there’s no test to diagnose costochondritis, your doctor will most likely ask a series of questions and do a series of tests to determine the source of your chest pain.

Lab tests

Typically, lab tests aren’t needed to diagnose costochondritis, but depending on your personal health history, your doctor may do some tests to see if your chest pain could be due to other issues like pneumonia or coronary heart disease.

X-rays and ECGs

Your doctor may want you to get an X-ray to make sure there’s nothing abnormal going out with your lungs.

If you’re dealing with costochondritis, your X-ray should look normal. They may also recommend an electrocardiogram (ECG) to make sure your heart isn’t the cause of your chest pain.

Many times, diagnosing costochondritis is a matter of eliminating other possible, more serious causes.

See your doctor right away if you have trouble breathing or are feeling intense chest pain.

Always seek immediate emergency care when you have abnormal and debilitating pain in your chest. It can indicate something serious, such as a heart attack.

Getting care as soon as possible limits the possibility of complications, especially if an underlying issue is causing your costochondritis.

Costochondritis can be treated in several ways.

Most cases of costochondritis are treated with over-the-counter medications. If your pain is mild to moderate, your doctor will probably recommend nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) or naproxen (Aleve).

Your doctor may also recommend:

• prescription-strength NSAIDs
• oral steroids or injection of a steroid into the area involved
• transcutaneous electrical nerve stimulation (TENS), which is a mild electric current that is delivered to the area via a small, battery-powered device

Lifestyle changes

Your doctor may tell you to make permanent lifestyle changes if you have persistent or chronic costochondritis.

Some types of exercise can aggravate this condition, including rowing and weightlifting. Manual labor may also have a negative effect.

Your doctor may also recommend:

• rest
• physical therapy
• hot or cold therapy using a heating pad and ice

Normally, treatment of the inflammation and pain causes costochondritis to eventually go away on its own.

If you have chronic costochondritis, the pain may persist or return — even with treatment — when you exercise or engage in certain activities. In these cases, you may need to seek long-term care to make sure that costochondritis doesn’t affect your quality of life and ability to take part in daily activities.

Pains associated with costochondritis can indicate other issues. Chest pain can often mean that you’re having heart or lung issues, so see your doctor right away when you feel pain in your chest to make sure that you’re not having a heart attack or have pneumonia.

The chest pain associated with costochondritis can be a symptom of fibromyalgia. With fibromyalgia, you may experience soreness in your chest in addition to:

• pain throughout your body
• fatigue and inability to rest due to pain
• difficulty focusing or concentrating
• feelings of depression
• headaches

If you experience chest pains along with these other symptoms, talk with your doctor about getting tested for fibromyalgia. Understanding this condition can help you address the symptoms and ensure that it doesn’t interrupt your daily life.

Costochondritis is caused by inflammation and typically presents as chest pain that gets worse with certain movements or pressure. This condition usually isn’t persistent. In many cases, costochondritis goes away on its own.

Mild cases of costochondritis may disappear after a few days. Chronic cases can last for weeks or more, but most cases don’t last any longer than a year.

To lower your chances of developing persistent costochondritis, carry and lift heavy loads properly. Try doing fewer high-impact exercises or manual labor, when possible.

Seek medical attention immediately if you experience chest pain while performing any of these activities.

Middle chest pain: possible causes, treatment

Doctors call the phenomenon when a person has pain in the chest in the middle, thoracalgia. There can be a lot of reasons for the appearance of pain syndrome, from the most harmless to quite serious pathologies. In order not to miss an important “alarm bell” from your body, it is best to contact a neurologist , who will examine you and determine why your chest began to hurt.

Middle chest pain: causes

There can be many reasons why pain appeared in the middle of the chest, so it is worth considering the intensity of the pain syndrome, its frequency and the specific localization of pain. By doing this, it will be possible to narrow the search for pathology leading to unpleasant sensations.

Heart pathologies

Pain in the chest is often associated with diseases of the cardiovascular system, the heart. If you feel thoracic all the time, this may indicate an aortic aneurysm. In this case, the pain in the left or right side of the chest is felt for a long time, and it will become stronger every time the person moves from rest to physical activity. The condition is treated exclusively surgically, so hospitalization will be required to confirm this diagnosis. Pain in the center of the chest in front can also appear if a pulmonary embolism develops. The pain syndrome becomes stronger on inspiration, and taking analgesics allows you to suppress it. Compressive pain may indicate that a person has angina pectoris, and pain can also be a symptom of myocardial infarction.

Respiratory damage

If there is pain in the front in the center of the chest, and at the same time you feel interruptions in breathing, you cannot breathe deeply, cough and shortness of breath appear, the problem may be the occurrence of pulmonary diseases, which include tracheitis, pneumonia, bronchitis, pleurisy and some others. The same symptoms can occur with diseases of the diaphragm.

Injuries

Pain in front of the chest, in the middle, or between the ribs may occur in a person who has survived an accident, has been involved in a fight, or has damaged chest structures from a fall or blow. Such pains intensify when he tries to turn around, bend down, take a deep breath, and are explained by the fact that blood vessels rupture, the periosteum is damaged, cracks and fractures form. In such a situation, at rest, the pain syndrome can disappear almost completely, which gives a person a false confidence that there is no need to consult a doctor.

Diseases of the spine

The most common reason why the chest hurts in the middle is osteochondrosis, if we talk about the pathologies of the spinal column. Pain in osteochondrosis can be constant or manifest in the form of seizures. The pain will be the same in intensity and manifestation with radiculopathy in the thoracic spine. Also, pain syndrome can indicate an intervertebral hernia and congenital anomalies in the structure of the spinal column.

Neurological diseases

Causes of pain in the chest in the middle can be neuralgic in nature. The most common diagnosis in this case is intercostal neuralgia, in which it is very painful in the sternum, it radiates to the back under the shoulder blade, which makes it easy for a person to confuse pain with heart pain.

Esophageal problems

Pain in the shoulder blades and in the middle of the chest may be associated with pathologies of the esophagus. The reason in this case is, as a rule, a spasm, which manifests itself more often in the morning or after eating. Pain in the chest area is relieved by taking antispasmodic drugs. Often spasms of the esophagus are accompanied by spasm of the muscular walls of the stomach.

How to relieve pain. First Aid

Often a person who has pain in the middle of the chest does not know what to do in such a situation. Some people are in so much pain that they faint. At the same time, a strong fright is observed, the pulse rate increases, the skin turns pale. The first thing to do if suddenly a person has severe pain in the sternum, internal organs and spine:

Remove clothing that restricts the chest, prevents breathing, give a nitroglycerin tablet, which will dilate blood vessels and improve the victim’s condition.

Also, if a person has pain in the middle of the chest, it is best to ask everyone present to leave the room and ensure complete rest for the patient until the ambulance arrives.

Diagnostics

The first thing the doctor will do is to interview and examine the patient, which will narrow the search for pathology by concomitant signs. After that, various diagnostic procedures can be prescribed to determine the cause of the pain syndrome. 9 may be useful0003 magnetic resonance or computed tomography , x-ray , ultrasound , blood tests, etc. This will determine why there are pains in the middle of the chest that radiate to the back, upper limbs or ribs.

Which doctor to contact

If you are able to visit the clinic on your own, you can make an appointment with the general practitioner . He will determine the approximate cause of the pain syndrome and the direction of further search, as well as give you directions for diagnostic procedures and, if necessary, to specialized specialists. In the event that there is a sharp pain in the chest in the middle, it is difficult and difficult to move, it is impossible to get out of bed without pain, call an ambulance. After the examination at home, the specialist will provide first aid and determine whether you need to be taken to the hospital.

You can make an appointment with specialists online , as well as by phone 8 (812) 901-03-03.

Costal chondritis (Tietze’s syndrome) – treatment, symptoms, causes, diagnosis

Costal chondritis (often called Tietze’s syndrome) is an inflammation in the cartilaginous attachment of the ribs to the sternum. The disease is characterized by local pain in the chest, aggravated by palpation and pressure on these areas. Costal chondritis is a relatively harmless condition and usually goes away without treatment. The cause of occurrence is not known.

• Costochondritis is a common cause of chest pain in childhood and adolescence and accounts for 10-30% of all chest pain in this age group. It most often occurs between the ages of 12-14 years.
• Costal chondritis is also considered a possible diagnosis in adults who have chest pain. Chest pain in adults is considered a potentially serious symptom of the disease and, first of all, it is necessary to exclude the pathology of the heart (ECG, tests, examination, etc.). Only after a thorough examination and exclusion of the cardiac genesis of pain can we assume the presence of costal chondritis. Sometimes differential diagnosis is difficult. In adults, costal chondritis is more common in women.

Costal chondritis is often referred to as Tietze’s syndrome. Tietze’s syndrome is a rare inflammatory disorder characterized by chest pain and cartilage swelling at the attachment of the second or third rib to the sternum. The pain occurs acutely and radiates to the arm, shoulder. Both men and women get sick more often between the ages of 20 and 40. It occurs mainly in people whose work is associated with physical activity or athletes.

Causes

Costal chondritis is an inflammatory process in cartilage, usually without any specific cause. Repeated minor chest injuries and acute respiratory infections can cause soreness in the area of ​​attachment of the ribs (both the effects of the viruses themselves and frequent coughing on the areas of attachment of the ribs). Sometimes costal chondritis occurs in people who take parenteral drugs or after surgery on the chest. After surgery, damaged cartilage tissue is more susceptible to infection due to impaired blood supply.

Symptoms

Chest pain associated with costal chondritis is usually preceded by physical exertion, minor trauma, or acute upper respiratory infections.

• The pain usually appears acutely and is localized in the anterior region of the chest. The pain may radiate down or more often to the left side of the chest.
• The most common localization of pain is the region of the fourth, fifth and sixth ribs. Pain is aggravated by movement of the body or deep breathing. And, conversely, there is a decrease in pain at rest and with shallow breathing.
• Soreness, which is clearly detected on palpation (pressure in the area of ​​​​attachment of the ribs to the sternum). This is a characteristic feature of chondritis and the absence of this feature suggests that the diagnosis of costal chondritis is unlikely.

When costal chondritis is caused by a postoperative infection, swelling, redness and/or pus may be seen in the area of ​​the postoperative wound.

Considering that the symptoms of chondritis often resemble medical emergencies, urgent medical attention should be sought in the following cases:

• Breathing problems
• High temperature
• Signs of an infectious disease (swelling, redness in the area of ​​attachment of the ribs)
• Persistent chest pain with nausea, sweating
• Any chest pain without clear localization
• Increased pain during treatment

Diagnosis

Diagnosis is based on the medical history and physical examination.