What are the common symptoms of costochondritis. How is costochondritis diagnosed. What treatments are available for managing costochondritis pain. Can costochondritis be prevented. What is the outlook for people with costochondritis.

Understanding Costochondritis: A Common Cause of Chest Pain

Costochondritis is a condition characterized by inflammation of the costochondral junctions, where the upper ribs connect to the cartilage that attaches them to the breastbone (sternum). This inflammation can cause significant chest pain, often mimicking more serious conditions. Despite its alarming symptoms, costochondritis is typically benign and self-limiting.

Is costochondritis a serious condition? While the chest pain associated with costochondritis can be intense and concerning, the condition itself is generally not dangerous. However, because chest pain can be a symptom of more serious heart or lung problems, it’s crucial to seek medical evaluation to rule out other potential causes.

Recognizing the Symptoms of Costochondritis

The primary symptom of costochondritis is chest pain, which can vary in intensity and presentation. Common characteristics of costochondritis pain include:

• Sharp or aching pain in the front of the chest, typically on the left side
• Pain that may spread to the back or abdomen
• Increased pain with deep breathing, coughing, or physical activity
• Tenderness when pressing on the affected rib joints

How can you distinguish costochondritis pain from other types of chest pain? Costochondritis pain is often reproducible with pressure on the affected area and tends to worsen with movement or breathing. In contrast, cardiac chest pain is typically more diffuse, may radiate to the arm or jaw, and is often accompanied by other symptoms like shortness of breath or nausea.

Causes and Risk Factors for Costochondritis

While the exact cause of costochondritis is not always clear, several factors have been associated with its development:

• Repetitive minor trauma to the chest wall
• Overuse of the arms, particularly in certain sports or occupations
• Respiratory infections, especially those caused by viruses
• Certain types of arthritis, including osteoarthritis and rheumatoid arthritis
• Rare cases of bacterial or fungal infections

Are certain populations more susceptible to costochondritis? Yes, the condition appears to affect women more frequently than men, with a ratio of about 70% to 30%. In younger populations, costochondritis is a common cause of chest pain, accounting for 10% to 30% of all chest pain cases in children and adolescents.

Costochondritis in Children and Adolescents

Costochondritis is particularly prevalent among young people, with an estimated 650,000 cases of chest pain seen annually in individuals aged 10 to 21. The peak age for the condition is between 12 and 14 years old. One interesting risk factor in this age group is the frequent carrying of heavy backpacks over one shoulder, which may contribute to the development of costochondritis.

Diagnosing Costochondritis: Ruling Out Serious Conditions

Diagnosing costochondritis can be challenging, as there is no specific test for the condition. The process typically involves ruling out more serious causes of chest pain through a combination of physical examination and diagnostic tests.

1. Physical examination: The doctor will check for tenderness in the rib joints, particularly over the fourth to sixth ribs.
2. Electrocardiogram (ECG): To rule out heart-related issues.
3. Chest X-rays: To check for lung problems or other structural abnormalities.
4. Blood tests: To look for signs of heart damage or inflammation.

What additional tests might be necessary for certain patients? In cases where there’s a history of sternum surgery or increased risk of heart disease, doctors may recommend further testing to rule out infection. This could include a gallium scan, which can detect areas of inflammation, or blood tests to check for elevated white blood cell counts indicative of infection.

Treatment Options for Managing Costochondritis Pain

While costochondritis often resolves on its own, several treatment options can help manage pain and discomfort:

Home Remedies and Over-the-Counter Treatments

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen
• Application of heat or ice to the affected area
• Rest and avoiding activities that exacerbate the pain
• Gentle stretching exercises

Medical Interventions

In more severe or persistent cases, medical professionals may recommend:

• Prescription-strength pain relievers or anti-inflammatory medications
• Physical therapy to improve posture and strengthen chest muscles
• Corticosteroid injections to reduce inflammation in severe cases
• Transcutaneous electrical nerve stimulation (TENS) for pain relief

How long does it typically take for costochondritis to resolve? The duration can vary significantly between individuals. Some people may experience relief within a few weeks, while others may have symptoms that persist for several months. Consistent treatment and avoiding aggravating factors can help speed up recovery.

Preventing Costochondritis: Strategies for Reducing Risk

While it may not always be possible to prevent costochondritis, certain measures can help reduce the risk of developing the condition or experiencing recurrences:

• Practice good posture to reduce strain on the chest wall
• Use proper form when lifting heavy objects or during exercise
• Avoid repetitive motions that strain the chest area
• Manage underlying conditions like arthritis effectively
• Strengthen chest and upper body muscles through appropriate exercises

Can lifestyle modifications help prevent costochondritis? Absolutely. Maintaining a healthy weight, engaging in regular low-impact exercise, and avoiding smoking can all contribute to overall chest health and potentially reduce the risk of developing costochondritis.

Costochondritis vs. Tietze Syndrome: Understanding the Differences

While costochondritis and Tietze syndrome are often confused or used interchangeably, they are distinct conditions with some key differences:

Why is it important to distinguish between costochondritis and Tietze syndrome? While both conditions are generally benign, the distinction can help guide treatment approaches and provide more accurate prognosis information to patients.

When to Seek Medical Attention for Chest Pain

Although costochondritis is typically not serious, any chest pain should be evaluated by a healthcare professional to rule out more severe conditions. Seek immediate medical attention if you experience:

• Severe chest pain, especially if accompanied by shortness of breath
• Chest pain with nausea, sweating, or left arm pain (possible signs of a heart attack)
• High fever that doesn’t respond to fever-reducing medications
• Signs of infection at the site of pain, such as redness, swelling, or discharge
• Persistent chest pain that doesn’t improve with over-the-counter medications

How can you differentiate between costochondritis pain and a heart attack? While it can be challenging to distinguish between the two, heart attack pain is often described as a crushing or squeezing sensation, may radiate to the jaw or arm, and is frequently accompanied by shortness of breath, nausea, or sweating. Costochondritis pain, on the other hand, is typically sharp and localized, worsening with movement or touch.

The Importance of Prompt Evaluation

Given the potential seriousness of chest pain, it’s crucial to err on the side of caution. A thorough medical evaluation can provide peace of mind and ensure appropriate treatment, whether the cause is costochondritis or a more serious condition.

Living with Costochondritis: Managing Symptoms and Improving Quality of Life

For individuals diagnosed with costochondritis, several strategies can help manage symptoms and improve overall quality of life:

• Identify and avoid triggers that exacerbate pain
• Incorporate stress-reduction techniques like meditation or deep breathing exercises
• Maintain good posture throughout the day
• Use supportive pillows when sleeping to reduce strain on the chest wall
• Engage in gentle stretching and strengthening exercises as recommended by a healthcare provider

Can dietary changes help manage costochondritis symptoms? While there’s no specific diet for costochondritis, an anti-inflammatory diet rich in omega-3 fatty acids, fruits, vegetables, and whole grains may help reduce overall inflammation in the body. Additionally, maintaining a healthy weight can reduce stress on the chest wall.

Emotional Impact of Chronic Pain

Living with chronic chest pain can take an emotional toll. It’s important to address the psychological aspects of dealing with costochondritis:

• Seek support from friends, family, or support groups
• Consider talking to a mental health professional if pain is affecting your mood or quality of life
• Practice relaxation techniques to manage stress and anxiety related to pain
• Stay informed about your condition to feel more in control of your health

How can patients effectively communicate their costochondritis symptoms to healthcare providers? Keep a pain diary documenting the intensity, duration, and triggers of your symptoms. This information can help your doctor tailor treatment plans and monitor your progress over time.

Research and Future Directions in Costochondritis Management

While costochondritis is a well-recognized condition, ongoing research continues to explore new understanding and treatment options:

• Investigation into the underlying mechanisms of costochondritis pain
• Exploration of novel anti-inflammatory treatments
• Studies on the effectiveness of complementary therapies like acupuncture or chiropractic care
• Research into potential genetic factors that may predispose individuals to costochondritis

What promising developments are on the horizon for costochondritis treatment? Some researchers are exploring the use of regenerative medicine techniques, such as platelet-rich plasma injections, to promote healing in the affected cartilage. While still in early stages, these approaches may offer new options for patients with persistent symptoms.

The Role of Interdisciplinary Care

As our understanding of costochondritis evolves, there’s growing recognition of the benefits of an interdisciplinary approach to care. This may involve collaboration between primary care physicians, rheumatologists, pain specialists, and physical therapists to provide comprehensive management strategies tailored to each patient’s needs.

By combining traditional medical treatments with lifestyle modifications, stress management techniques, and emerging therapies, the outlook for individuals with costochondritis continues to improve. While the condition can be painful and disruptive, with proper care and management, most people can expect to find relief and return to their normal activities.

Costochondritis — Symptoms, Causes, Tests, and Treatment for Costochondritis — from WebMD

Written by WebMD Editorial Contributors

• What Is Costochondritis?
• Costochondritis Causes
• Costochondritis Symptoms
• Costochondritis Risk Factors
• Costochondritis Diagnosis
• Costochondritis Treatment and Home Remedies
• Costochondritis Prevention
• Costochondritis Outlook
• More

Costochondritis is inflammation of the areas where your upper ribs join with the cartilage that holds them to your breastbone. These areas are called costochondral junctions. The condition causes chest pain, but it’s typically harmless and usually goes away without any treatment. But any chest pain in adults should be taken seriously, so you should be examined and tested for heart disease.

A rare condition called Tietze syndrome is often referred to as costochondritis, but the two are distinct conditions. You can tell the difference by the following:

• Tietze syndrome usually comes on all of a sudden, with chest pain spreading to your arms or shoulder and lasting several weeks.

• Tietze syndrome causes swelling at the painful area (where your ribs and breastbone meet).​​​​​​​

Doctors don’t know exactly why costochondritis happens, but they do know that some things can lead to it: 

• Repeated minor trauma to your chest wall
• Overuse of your arms
• Arthritis. Costochondritis can sometimes be a sign of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, or other conditions that affect your cartilage.
• Tumors. These can move from joints and other parts of your body and settle in your chest.
• Respiratory infections caused by viruses 
• Bacterial infections, especially in people who use IV drugs or have had surgery near their upper chest 
• Fungal infections (in rare cases)

Chest pain linked to costochondritis usually comes on after exercise, minor trauma, or an upper respiratory infection.

• Sharp pain in the front of  your chest, near where your breastbone and ribs meet, typically on the left side. It may spread to your back or belly.
• Pain when you take a deep breath or cough. It gets better when you stop moving or your breathing is quieter.
• Tenderness when you press on your rib joints. If you don’t have this tenderness, you probably don’t have costochondritis.
•  If costochondritis happens because of an infection after surgery, you’ll have redness, swelling, or pus discharge at the site of the surgery.

Call your doctor if you have any of the following:

• Trouble breathing
• High fever
• Signs of infection such as redness, pus, and increased swelling at the rib joints
• Continuing or worsening pain despite medication
• Nausea
• Sweating
• Dizziness

Go to a hospital’s emergency room if you have a hard time breathing or any of the following. They’re not usually caused by costochondritis:

• High fever that doesn’t get better with fever reducers such as acetaminophen or ibuprofen
• Signs of infection at the tender spot, such as pus, redness, increased pain, and swelling
• Persistent chest pain of any type when you also have nausea, sweating, or pain in your left arm. These may be signs of a heart attack. If you’re not sure what’s causing your chest pain, go to the emergency room.

Costochondritis is a common cause of chest pain in children and adolescents. It accounts for 10% to 30% of all chest pain in children. Annually, doctors see about 650,000 cases of chest pain in people ages 10 to 21. The peak age for the condition is ages 12-14.

Kids who often carry heavy book bags over one shoulder can be more likely to develop costochondritis.

In adults, costochondritis affects women more than men (70% vs. 30%).  

There is no specific test for diagnosing costochondritis. To rule out a more serious cause of your chest pain related to your heart or lungs, your doctor will probably start with tests like an echocardiogram (ECG), chest X-rays, and blood test for heart damage, among others. 

If those tests come back normal, they’ll likely see if you have tenderness in any of your rib joints, usually over the fourth to sixth ribs.

If you’ve had sternum (breastbone) surgery or are at risk for heart disease, they may recommend getting a test to see if infection is the cause of your chest pain. Doctors will:

• Look for signs of infection such as redness, swelling, pus, and drainage at the site of surgery
• Recommend a more sophisticated imaging study of the chest called a gallium scan, which will show an increase in the radioactive material gallium 
• Check your white blood cell count to see if it is high, a sign of infection
• Recommend a chest X-ray if pneumonia might be a cause of your chest pain

Home Remedies for Costochondritis

These home remedies may provide relief from costochondritis:

• Over-the-counter  pain relievers such as nonsteroidal anti-inflammatory medications (NSAIDs) like ibuprofen or naproxen as needed
• Using local heat or ice to relieve pain
• Avoiding unnecessary exercise or activities that make the symptoms worse; avoiding contact sports until there is improvement in symptoms, and then returning to normal activities only as tolerated
• Doing stretching exercises

Medications for Costochondritis

Your doctor may suggest the following:

• Prescription-strength NSAIDs.
• A local anesthetic and steroid injection in the area that is tender if normal activities become very painful and the pain doesn’t get better with medicine.
• Narcotics like hydrocodone/acetaminophen (Norco, Vicodin) or oxycodone/acetaminophen (Percocet, Roxicet, Tylox) can help with extreme pain, but, as with any narcotics, there’s danger of becoming addicted to them.
• Steroids. Your doctor can give you a corticosteroid shot directly into a painful joint, but that’s considered something of a last resort.
• Tricyclic antidepressants or cyclic antidepressants like amitriptyline can help ease pain, but they also can have side effects, like weight gain and drowsiness. 
• Antiseizure drugs, usually gabapentin (Neurontin), are typically used to treat epilepsy, but they also may help with costochondritis.
• Infectious (bacterial or fungal) costochondritis should be treated with IV antibiotics. Afterward, antibiotics by mouth or by IV should be continued for another 2 to 3 weeks. You should see a doctor during recovery, and then once a year. 

Surgery for Costochondritis

You may need surgery to remove the sore cartilage if other treatments don’t help. Your doctor can refer you to a surgeon.

Because inflammatory costochondritis has no definite cause, there is no good way to prevent it.

Noninfectious costochondritis will go away on its own, with or without anti-inflammatory treatment. Most people will recover fully.

Infectious costochondritis responds well to IV antibiotics and surgery, but recovery may take a long time.

Top Picks

Costochondritis — Symptoms, Causes, Tests, and Treatment for Costochondritis — from WebMD

Written by WebMD Editorial Contributors

• What Is Costochondritis?
• Costochondritis Causes
• Costochondritis Symptoms
• Costochondritis Risk Factors
• Costochondritis Diagnosis
• Costochondritis Treatment and Home Remedies
• Costochondritis Prevention
• Costochondritis Outlook
• More

Costochondritis is inflammation of the areas where your upper ribs join with the cartilage that holds them to your breastbone. These areas are called costochondral junctions. The condition causes chest pain, but it’s typically harmless and usually goes away without any treatment. But any chest pain in adults should be taken seriously, so you should be examined and tested for heart disease.

A rare condition called Tietze syndrome is often referred to as costochondritis, but the two are distinct conditions. You can tell the difference by the following:

• Tietze syndrome usually comes on all of a sudden, with chest pain spreading to your arms or shoulder and lasting several weeks.

• Tietze syndrome causes swelling at the painful area (where your ribs and breastbone meet).​​​​​​​

Doctors don’t know exactly why costochondritis happens, but they do know that some things can lead to it: 

• Repeated minor trauma to your chest wall
• Overuse of your arms
• Arthritis. Costochondritis can sometimes be a sign of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, or other conditions that affect your cartilage.
• Tumors. These can move from joints and other parts of your body and settle in your chest.
• Respiratory infections caused by viruses 
• Bacterial infections, especially in people who use IV drugs or have had surgery near their upper chest 
• Fungal infections (in rare cases)

Chest pain linked to costochondritis usually comes on after exercise, minor trauma, or an upper respiratory infection.

• Sharp pain in the front of  your chest, near where your breastbone and ribs meet, typically on the left side. It may spread to your back or belly.
• Pain when you take a deep breath or cough. It gets better when you stop moving or your breathing is quieter.
• Tenderness when you press on your rib joints. If you don’t have this tenderness, you probably don’t have costochondritis.
•  If costochondritis happens because of an infection after surgery, you’ll have redness, swelling, or pus discharge at the site of the surgery.

Call your doctor if you have any of the following:

• Trouble breathing
• High fever
• Signs of infection such as redness, pus, and increased swelling at the rib joints
• Continuing or worsening pain despite medication
• Nausea
• Sweating
• Dizziness

Go to a hospital’s emergency room if you have a hard time breathing or any of the following. They’re not usually caused by costochondritis:

• High fever that doesn’t get better with fever reducers such as acetaminophen or ibuprofen
• Signs of infection at the tender spot, such as pus, redness, increased pain, and swelling
• Persistent chest pain of any type when you also have nausea, sweating, or pain in your left arm. These may be signs of a heart attack. If you’re not sure what’s causing your chest pain, go to the emergency room.

Costochondritis is a common cause of chest pain in children and adolescents. It accounts for 10% to 30% of all chest pain in children. Annually, doctors see about 650,000 cases of chest pain in people ages 10 to 21. The peak age for the condition is ages 12-14.

Kids who often carry heavy book bags over one shoulder can be more likely to develop costochondritis.

In adults, costochondritis affects women more than men (70% vs. 30%).  

There is no specific test for diagnosing costochondritis. To rule out a more serious cause of your chest pain related to your heart or lungs, your doctor will probably start with tests like an echocardiogram (ECG), chest X-rays, and blood test for heart damage, among others. 

If those tests come back normal, they’ll likely see if you have tenderness in any of your rib joints, usually over the fourth to sixth ribs.

If you’ve had sternum (breastbone) surgery or are at risk for heart disease, they may recommend getting a test to see if infection is the cause of your chest pain. Doctors will:

• Look for signs of infection such as redness, swelling, pus, and drainage at the site of surgery
• Recommend a more sophisticated imaging study of the chest called a gallium scan, which will show an increase in the radioactive material gallium 
• Check your white blood cell count to see if it is high, a sign of infection
• Recommend a chest X-ray if pneumonia might be a cause of your chest pain

Home Remedies for Costochondritis

These home remedies may provide relief from costochondritis:

• Over-the-counter  pain relievers such as nonsteroidal anti-inflammatory medications (NSAIDs) like ibuprofen or naproxen as needed
• Using local heat or ice to relieve pain
• Avoiding unnecessary exercise or activities that make the symptoms worse; avoiding contact sports until there is improvement in symptoms, and then returning to normal activities only as tolerated
• Doing stretching exercises

Medications for Costochondritis

Your doctor may suggest the following:

• Prescription-strength NSAIDs.
• A local anesthetic and steroid injection in the area that is tender if normal activities become very painful and the pain doesn’t get better with medicine.
• Narcotics like hydrocodone/acetaminophen (Norco, Vicodin) or oxycodone/acetaminophen (Percocet, Roxicet, Tylox) can help with extreme pain, but, as with any narcotics, there’s danger of becoming addicted to them.
• Steroids. Your doctor can give you a corticosteroid shot directly into a painful joint, but that’s considered something of a last resort.
• Tricyclic antidepressants or cyclic antidepressants like amitriptyline can help ease pain, but they also can have side effects, like weight gain and drowsiness. 
• Antiseizure drugs, usually gabapentin (Neurontin), are typically used to treat epilepsy, but they also may help with costochondritis.
• Infectious (bacterial or fungal) costochondritis should be treated with IV antibiotics. Afterward, antibiotics by mouth or by IV should be continued for another 2 to 3 weeks. You should see a doctor during recovery, and then once a year. 

Surgery for Costochondritis

You may need surgery to remove the sore cartilage if other treatments don’t help. Your doctor can refer you to a surgeon.

Because inflammatory costochondritis has no definite cause, there is no good way to prevent it.

Noninfectious costochondritis will go away on its own, with or without anti-inflammatory treatment. Most people will recover fully.

Infectious costochondritis responds well to IV antibiotics and surgery, but recovery may take a long time.

Top Picks

Pain in the thoracic spine

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Attending physician: Yarukhin I.N.

The doctor deals with my problem individually!

I had a series of osteopathic sessions with Dr. Yarukhin. I turned to the Palikha clinic, as I always had problems with my back. I was tormented by osteochondrosis, pain for a long time, 2 years ago there was a serious attack. After that, she began to do gymnastics and look for a solution to the problem. I came to the clinic with an MRI, I liked that the doctor got acquainted with the pictures, and during the sessions I noticed that the doctor deals individually with my problems of my spine. At the 1st session, I still felt severe stiffness and stiffness in the lumbosacral region on the right side, where my muscles and tendons have always been tightened. After 3-4 sessions, I felt that I could take the positions that the doctor recommended, the muscles became stretched. I received very valuable advice on maintaining health, which I follow at home. I plan to have several massage sessions and return to Dr. Yarukhin for another course of osteopathy and supplement it with electrophoresis. Now my condition and general mood is much better. I saw positive dynamics and hope to put my spine in order. I recommend everyone who has back problems to contact this clinic, which I have the best impression of.

Marina Vladimirovna

Attending physician: Yarukhin I.N.

causes, treatment – how to get rid of chest pain

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Symptoms

Pain in the thoracic spine

This symptom is treated by an Orthopedic Traumatologist.

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Pain in the thoracic spine can indicate not only the pathology of the spinal column, but also the development of other diseases of the internal organs. Pain of any intensity cannot be ignored as it can cause severe health consequences. Early diagnosis of the causes of pain maximizes the chances of recovery and rapid rehabilitation.

CMRT specialist tells

Kuchenkov A.V.

Orthopedist • Traumatologist • Surgeon • Phlebologist • Sports doctor • 25 years of experience

Publication date: September 22, 2021

Verification date: January 31, 2023

All facts have been verified by a doctor.

Contents of the article

Causes of pain in the thoracic spine

Types of pain

First aid

Which doctor to contact

Diagnostics

Treatment of pain in the thoracic spine

Rehabilitation

The duration and nature of rehabilitation directly depends on the root cause of back and chest pain.

In most cases, comprehensive rehabilitation includes physiotherapy, full back massage, physiotherapy, and measures to limit heavy lifting.

Comprehensive recovery can be done at the rehabilitation center “Laboratory of Movement”.

An individual approach is provided for each patient.

Consequences

Prevention

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