What is costochondritis. How is costochondritis diagnosed. What are the symptoms of costochondritis. How is costochondritis treated. What is the prognosis for costochondritis.

What is Costochondritis and How Does It Affect the Rib Cage?

Costochondritis is a common cause of chest pain that occurs when the cartilage connecting the ribs to the breastbone becomes inflamed. This condition affects the costal cartilage, which joins all but the lowest two ribs to the sternum. Understanding the anatomy of the rib cage is crucial to comprehending how costochondritis develops and impacts the body.

The rib cage serves as a protective structure for vital organs such as the lungs and heart. It consists of 12 pairs of ribs, with the upper seven pairs directly attached to the sternum via costal cartilage. The next three pairs, known as false ribs, connect indirectly to the sternum through the cartilage of the ribs above them. The lowest two pairs, called floating ribs, are not attached to the sternum at all.

During normal breathing, the ribs and associated muscles expand and contract, allowing for the inhalation and exhalation of air. When costochondritis occurs, this natural movement can become painful, affecting a person’s ability to breathe comfortably and perform everyday activities.

Unraveling the Causes of Costochondritis: From Injuries to Infections

While the exact cause of costochondritis often remains unknown, several factors have been identified as potential triggers for this condition. These include:

• Chest injuries
• Strenuous exercise or heavy lifting
• Viral infections, particularly those affecting the respiratory system
• Persistent coughing, which can strain the chest wall
• Infections following surgery or intravenous drug use
• Certain types of arthritis

Is costochondritis more common in certain populations. Research suggests that women, especially those aged 20-40, are more likely to develop costochondritis. Additionally, people with certain autoimmune disorders or those who engage in repetitive upper body movements may be at higher risk.

Recognizing the Symptoms: Key Indicators of Costochondritis

The hallmark symptoms of costochondritis are pain and tenderness in the chest area. Patients typically experience:

1. Sharp pain at the front of the chest wall, which may radiate to the back or stomach
2. Increased discomfort when taking deep breaths or coughing
3. Tenderness when pressure is applied to the area where the rib joins the breastbone
4. Relief from pain when movement stops and breathing becomes quieter

How can one differentiate costochondritis pain from other chest pains. Unlike the pain associated with heart attacks, costochondritis pain is typically sharp and localized. It often worsens with movement or pressure on the affected area. However, due to the similarity of symptoms, it’s crucial to seek medical attention to rule out more serious conditions.

Diagnostic Approaches: How Medical Professionals Identify Costochondritis

Diagnosing costochondritis involves a combination of medical history assessment and physical examination. Healthcare providers typically follow these steps:

1. Taking a detailed medical history to understand the nature and onset of symptoms
2. Performing a physical examination, focusing on the area where the ribs meet the breastbone
3. Checking for tenderness and soreness in the costal cartilage region
4. Potentially ordering a chest X-ray if symptoms are severe or persistent
5. Conducting additional tests to rule out other conditions, such as heart attacks

Are there any specific diagnostic tests for costochondritis. While there is no definitive test for costochondritis, the diagnosis is often made based on the characteristic tenderness of the costal cartilage and the exclusion of other potential causes of chest pain. In some cases, imaging studies like CT scans or MRIs may be used to rule out other conditions or to assess the extent of inflammation.

Treatment Strategies: Managing Costochondritis Pain and Inflammation

The treatment of costochondritis primarily focuses on pain relief and reducing inflammation. Most cases resolve on their own within a few days to weeks, although some may persist for several months. Common treatment approaches include:

• Applying hot or cold compresses to the affected area
• Avoiding activities that exacerbate the pain
• Using over-the-counter pain relievers such as ibuprofen or naproxen
• Taking acetaminophen as an alternative pain reliever, if recommended by a healthcare provider
• Prescription of stronger pain medications for severe cases
• Physical therapy in some instances

Can lifestyle modifications help manage costochondritis. Yes, certain lifestyle changes can aid in managing costochondritis symptoms. These may include improving posture, practicing relaxation techniques to reduce muscle tension, and modifying exercise routines to avoid strain on the chest wall. Some patients find relief through gentle stretching exercises or the use of supportive devices like chest braces.

Exploring Alternative and Complementary Therapies for Costochondritis Relief

While conventional treatments are the mainstay for costochondritis management, some patients explore alternative and complementary therapies to alleviate symptoms. These may include:

• Acupuncture: This traditional Chinese medicine technique may help reduce pain and inflammation.
• Massage therapy: Gentle massage of the affected area and surrounding muscles can help relieve tension and pain.
• Herbal remedies: Some herbs with anti-inflammatory properties, such as turmeric or ginger, may offer relief when used under professional guidance.
• Transcutaneous electrical nerve stimulation (TENS): This therapy uses low-voltage electrical currents to alleviate pain.
• Mind-body techniques: Practices like yoga, tai chi, or meditation may help manage pain and reduce stress associated with chronic conditions.

Do these alternative therapies have scientific backing for costochondritis treatment. While some patients report benefits from these therapies, scientific evidence supporting their efficacy for costochondritis is limited. It’s crucial to consult with a healthcare provider before trying any alternative treatments to ensure they are safe and appropriate for your specific condition.

Long-Term Outlook: Understanding the Prognosis of Costochondritis

The prognosis for costochondritis is generally favorable, with most cases resolving within a few days to weeks. However, some patients may experience symptoms for several months. Factors that can influence the prognosis include:

• The underlying cause of the condition
• The patient’s overall health and age
• Adherence to treatment recommendations
• The presence of any complicating factors or comorbidities

Is costochondritis a recurring condition. While many people experience costochondritis as a one-time occurrence, some individuals may have recurrent episodes. In such cases, identifying and addressing potential triggers, such as certain activities or postures, can help prevent future flare-ups. Long-term management strategies may be necessary for those with chronic or recurring costochondritis.

Preventive Measures: Reducing the Risk of Costochondritis

While it’s not always possible to prevent costochondritis, certain measures can help reduce the risk of developing this condition or experiencing recurrent episodes:

1. Practicing proper posture to reduce strain on the chest wall
2. Using appropriate techniques when lifting heavy objects
3. Gradually increasing the intensity of exercise routines to avoid overexertion
4. Managing underlying conditions that may contribute to inflammation, such as arthritis
5. Maintaining a healthy lifestyle, including regular exercise and a balanced diet
6. Avoiding activities that repeatedly strain the chest area
7. Seeking prompt treatment for respiratory infections to prevent prolonged coughing

Can stress management play a role in preventing costochondritis. Yes, stress reduction techniques may help prevent costochondritis by reducing muscle tension and promoting overall well-being. Practices such as deep breathing exercises, progressive muscle relaxation, and regular physical activity can contribute to stress management and potentially lower the risk of developing costochondritis.

Understanding the Link Between Costochondritis and Other Health Conditions

While costochondritis is often an isolated condition, it can sometimes be associated with or mistaken for other health issues. Some related conditions and considerations include:

• Tietze syndrome: A similar condition that involves swelling of the costal cartilage
• Fibromyalgia: A chronic pain disorder that can sometimes involve chest wall pain
• Rheumatoid arthritis: An autoimmune condition that can affect the costal cartilage
• Ankylosing spondylitis: A type of arthritis that can cause inflammation in the chest wall
• Chest wall injuries: Trauma to the chest area can mimic costochondritis symptoms

How does costochondritis differ from these related conditions. The primary distinction lies in the specific area affected and the presence or absence of swelling. For instance, Tietze syndrome involves visible swelling, while costochondritis typically does not. Additionally, conditions like fibromyalgia and rheumatoid arthritis often involve more widespread symptoms beyond the chest area.

The Impact of Costochondritis on Daily Life and Mental Health

Living with costochondritis can significantly affect a person’s quality of life, particularly during acute episodes. The condition may:

• Limit physical activities and exercise routines
• Interfere with sleep patterns due to discomfort
• Cause anxiety, especially when the pain mimics more serious conditions
• Lead to social isolation if chronic pain persists
• Affect work performance and daily responsibilities

How can individuals cope with the psychological effects of costochondritis. Developing a support system, practicing stress-reduction techniques, and working with healthcare providers to manage pain effectively are crucial steps. Some patients find benefit in joining support groups or seeking counseling to address the emotional aspects of living with chronic pain.

Advancements in Costochondritis Research and Future Treatment Prospects

While costochondritis is a well-recognized condition, ongoing research continues to explore its underlying mechanisms and potential new treatments. Some areas of current interest include:

• Investigating the role of inflammatory markers in costochondritis diagnosis
• Exploring the efficacy of regenerative medicine techniques, such as platelet-rich plasma therapy
• Studying the potential benefits of targeted physical therapy programs
• Developing more effective pain management strategies for chronic cases
• Investigating the relationship between costochondritis and other inflammatory conditions

What potential breakthroughs might we see in costochondritis treatment. Future advancements may include more precise diagnostic tools, personalized treatment approaches based on individual patient factors, and novel therapies that address both pain and inflammation more effectively. As research progresses, patients with costochondritis may have access to a broader range of treatment options tailored to their specific needs.

Costochondritis Information | Mount Sinai

Chest wall pain; Costosternal syndrome; Costosternal chondrodynia; Chest pain – costochondritis

All but your lowest 2 ribs are connected to your breastbone by cartilage. This cartilage can become inflamed and cause pain. This condition is called costochondritis. It is a common cause of chest pain.

The ribs are the skeletal protection for the lungs and the chest cavity. The ribs and rib muscles expand and contract with normal breathing.

Causes

There is often no known cause of costochondritis. But it may be caused by:

• Chest injury
• Hard exercise or heavy lifting
• Viral infections, such as respiratory infections
• Strain from coughing
• Infections after surgery or from IV drug use
• Some types of arthritis

Symptoms

The most common symptoms of costochondritis are pain and tenderness in the chest. You may feel:

• Sharp pain at the front of your chest wall, which may move to your back or stomach
• Increased pain when you take a deep breath or cough
• Tenderness when you press the area where the rib joins the breastbone
• Less pain when you stop moving and breathe quietly

Exams and Tests

Your health care provider will take your medical history and do a physical exam. The area where the ribs meet the breastbone is checked. If this area is tender and sore, costochondritis is the most likely cause of your chest pain.

A chest x-ray may be done if your symptoms are severe or do not improve with treatment.

Your provider may also order tests to rule out other conditions, such as a heart attack.

Treatment

Costochondritis most often goes away on its own in a few days or weeks. It can also take up to a few months. Treatment focuses on relieving the pain.

• Apply hot or cold compresses.
• Avoid activities that make the pain worse.

Pain medicines, such as ibuprofen (Advil, Motrin) or naproxen (Aleve), may help to ease pain and swelling. You can buy these without a prescription.

• Talk with your provider before using these medicines if you have heart disease, high blood pressure, kidney disease, liver disease, or have had stomach ulcers or internal bleeding in the past.
• Take the dose as advised by the provider. Do not take more than the amount recommended on the bottle. Carefully read the warnings on the label before taking any medicine.

You may also take acetaminophen (Tylenol) instead, if your provider tells you it is safe to do so. People with liver disease should not take this medicine.

If your pain is severe, your provider may prescribe stronger pain medicine.

In some cases, your provider may recommend physical therapy.

Outlook (Prognosis)

Costochondritis pain often goes away in a few days or weeks.

When to Contact a Medical Professional

Call 911 or the local emergency number, or go to your local emergency room right away if you have chest pain. The pain of costochondritis can be similar to the pain of a heart attack.

If you have already been diagnosed with costochondritis, contact your provider if you have any of the following symptoms:

• Trouble breathing
• A high fever
• Any signs of infection such as pus, redness, or swelling around your ribs
• Pain that continues or gets worse after taking pain medicine
• Sharp pain with every breath

Prevention

Because the cause is often unknown, there is no known way to prevent costochondritis.

Crasto JA, Vaswani RS, Pauyo T, Musahl V. Overview of sport-specific injuries. In: Miller MD, Thompson SR. eds. DeLee, Drez, & Miller’s Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 9.

Hanak JA. Tietze syndrome. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 117.

Kurz J. Costosternal syndrome. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 101.

Last reviewed on: 10/20/2022

Reviewed by: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Costochondritis | NHS inform

Costochondritis is the medical term for inflammation of the cartilage that joins your ribs to your breastbone (sternum). This area is known as the costochondral joint.

Cartilage is tough but flexible connective tissue found throughout the body, including in the joints between bones. It acts as a shock absorber, cushioning the joints.

Costochondritis may improve on its own after a few weeks, although it can last for several months or more. The condition doesn’t lead to any permanent problems, but may sometimes relapse.

Tietze’s syndrome

Costochondritis may be confused with a separate condition called Tietze’s syndrome. Both conditions involve inflammation of the costochondral joint and can cause very similar symptoms.

However, Tietze’s syndrome is much less common and often causes chest swelling, which may last after any pain and tenderness has gone.

Costochondritis also tends to affect adults aged 40 or over, whereas Tietze’s syndrome usually affects young adults under 40.

As the conditions are very similar, most of the information below also applies to Tietze’s syndrome.

Signs and symptoms

When the costochondral joint becomes inflamed it can result in sharp chest pain and tenderness, which may develop gradually or start suddenly.

The pain may be made worse by:

• a particular posture – such as lying down
• pressure on your chest – such as wearing a seatbelt or hugging someone
• deep breathing, coughing and sneezing
• physical activity

When to seek medical help

It can be difficult to tell the difference between the chest pain associated with costochondritis and pain caused by more serious conditions, such as a heart attack.

However, a heart attack usually causes more widespread pain and additional symptoms, such as breathlessness, nausea and sweating.

If you, or someone you’re with, experiences sudden chest pain and you think there’s a possibility it could be a heart attack, dial 999 immediately and ask for an ambulance.

If you’ve had chest pain for a while, don’t ignore it. Make an appointment to see your GP so they can investigate the cause.

Causes of costochondritis

Inflammation is the body’s natural response to infection, irritation or injury.

It’s not known exactly why the costochondral joint becomes inflamed, but in some cases it’s been linked to:

• severe coughing – which strains your chest area
• an injury to your chest
• physical strain from repeated exercise or sudden exertion that you’re not used to – such as moving furniture
• an infection – including respiratory tract infections (RTIs) and wound infections
• wear and tear – your chest moves in and out 20 to 30 times a minute, and over time this motion can lead to discomfort in these joints

Diagnosing costochondritis

If you have symptoms of costochondritis, your GP will examine and touch the upper chest area around your costochondral joint. They’ll ask you when and where your pain occurs and look at your recent medical history.

Before a diagnosis can be confirmed, some tests may need to be carried out to rule out other possible causes of your chest pain.

These may include:

• an electrocardiogram (ECG) – which records the rhythms and electrical activity of your heart
• a blood test to check for signs of underlying inflammation
• a chest X-ray

If no other condition is suspected or found, a diagnosis of costrochondritis may be made.

Treating costochondritis

Costochondritis often gets better after a few weeks, but self-help measures and medication can manage the symptoms.

Self-help

Costochondritis can be aggravated by any activity that places stress on your chest area, such as strenuous exercise or even simple movements like reaching up to a high cupboard.

Any activity that makes the pain in your chest area worse should be avoided until the inflammation in your ribs and cartilage has improved.

You may also find it soothing to regularly apply heat to the painful area – for example, using a cloth or flannel that’s been warmed with hot water.

Painkillers

Painkillers, such as paracetamol, can be used to ease mild to moderate pain.

Taking a type of medication called a non-steroidal anti-inflammatory drug (NSAID) – such as ibuprofen and naproxen – two or three times a day can also help control the pain and swelling. 

Aspirin is also a suitable alternative, but shouldn’t be given to children under 16 years old.

These medications are available from pharmacies without a prescription, but you should make sure you carefully read the instructions that come with them before use.

NSAIDs aren’t suitable for people with certain health conditions, including:

• asthma
• stomach ulcers
• high blood pressure
• kidney or heart problems

Contact your GP if your symptoms get worse despite resting and taking painkillers, as you may benefit from treatment with corticosteroids.  

Corticosteroid injections

Corticosteroids are powerful medicines that can help reduce pain and swelling. They can be injected into and around your costochondral joint to help relieve the symptoms of costochondritis.

Corticosteroid injections may be recommended if your pain is severe, or if NSAIDs are unsuitable or ineffective.

They may be given by your GP, or you may need to be referred to a specialist called a rheumatologist.

Having too many corticosteroid injections can damage your costochondral joint, so you may only be able to have this type of treatment once every few months if you continue to experience pain.

Transcutaneous electrical nerve stimulation (TENS)

TENS is a method of pain relief where a mild electric current is delivered to the affected area using a small, battery-operated device. 

The electrical impulses can reduce the pain signals going to the spinal cord and brain, which may help relieve pain and relax muscles.

They may also stimulate the production of endorphins, which are the body’s natural painkillers.

Although TENS may be used to help relieve pain in a wide range of conditions, it doesn’t work for everyone.

There isn’t enough good-quality scientific evidence to say for sure whether TENS is a reliable method of pain relief. Speak to your GP if you’re considering TENS.

Read more about transcutaneous electrical nerve stimulation (TENS).

Costochondritis – Medical center “Lіko-Med”

Publication date
October 3, 2018

Rubric
Diseases

What is costochondritis?

Costochondritis is an inflammation of the cartilage that connects the ribs and sternum. The inflammatory process causes pain in the chest on one or both sides. Certain diseases can lead to costochondritis, such as arthritis and fibromyalgia, trauma, and a viral or bacterial infection of the respiratory tract. However, the cause of the disease is usually unknown. Costochondritis is considered harmless. Very often it is mistaken for a heart attack. The disease is more common among women than among men. As a rule, the inflammation goes away on its own in a few days or weeks.

What to expect?

The pain of costochondritis can be severe, and the disease is often mistaken for a heart attack or lung disease. The inflammation usually goes away within a few days or weeks on its own. Pain relievers, ice packs, or heat can help relieve pain.

Distribution.

Costochondritis is diagnosed in 14% of adolescents and 30% of adults who complain of chest pain.

Risk factors .

– Belonging to the female sex.

– Over forty years of age.

Treatment.

Treatment of costochondritis includes:

– Applying heat or cold to the affected area.

– Use of anti-inflammatory drugs.

– Avoidance of activities that aggravate pain.

– Corticosteroid injections – for severe pain.

What can you do yourself?

Costochondritis is usually treated at home with anti-inflammatory drugs. It is useful to apply ice or heat to the area of ​​​​inflammation. If this does not help, see a doctor to assess the condition.

What makes it worse?

– Injuries.

– Twisting movements.

– With deep breaths.

– Sleeping on an uncomfortable bed with no pillow or mattress.

When to see a doctor?

See a doctor if:

– you wake up with pain;

– breathing problems;

– fever or signs of infection.

Chest pain that radiates to the left arm, along with sweating, nausea, or general chest pain that is not concentrated in one area, may be a sign of a heart attack and requires emergency care.

What to ask the doctor?

1. How often do I need to have a health check-up?

2. Do I need to have any tests or x-rays?

3. What symptoms should you seek medical attention for?

4. When will the condition improve?

5. What is the long-term prognosis of the disease?

Diagnosis.

Costochondritis is diagnosed based on the patient’s medical history and physical examination.

costochondritis: symptoms, causes, dangers and treatment

Introduction

Costochondritis is an inflammation of the costal cartilage that causes chest pain. In particular, the bone-sternal joints (where the ribs connect to the sternum) are susceptible to inflammation.

Also called osteosternal syndrome or costal chondritis, the main causes can be:

• chest trauma,
• excessive physical effort,
• infections,
• rheumatological diseases (ankylosing spondylitis, rheumatoid arthritis, …),
• certain cancers,
• fibromyalgia.

The most common symptoms of costochondritis are:

• chest pain, widespread or localized, aggravated by movement or pressure on the chest,
• pain radiating to the back or abdomen leading to pain in the back and abdomen,
• functional restriction of the chest in movements,
• constant feeling of tension.

If you experience chest pain, seek immediate medical attention to rule out the possibility of a heart attack; after ruling out heart problems or other serious pathologies (such as pulmonary embolism or pleurisy), using the history, physical examination, and some instrumental tests, the diagnosis of costochondritis can be made by exclusion.

Given that in most cases costochondritis resolves spontaneously within a few days, symptomatic treatment is based on rest and the use of anti-inflammatory and analgesic drugs.

The condition responds positively to physical therapy and some physical rehabilitation procedures (such as TENS and others).

Causes

This problem mainly affects women and adolescents, although anyone at any age can suffer from costochondritis; a large percentage of people suffer from costochondritis with no known cause (idiopathic), while known triggers include:

• Chest injury: any kind of injury to the ribs and sternum can be a precursor to costochondritis. The most common traumatic events are sports injuries (eg, football, rugby, American football, hockey, combat sports), physical assault, and car accidents.
• Excessive exercise: this refers to excessive sports activity in untrained subjects, lifting excessive weights, only in rare cases chronic and continuous cough.
• Infections: may be bacterial, viral or fungal, including:
  • syphilis,
  • tuberculosis,
  • aspergillosis,
  • candidiasis,
  • Staphylococcus aureus,
  • viral respiratory infections
• Rheumatological disorders, such as:
  • Ankylosing spondylitis,
  • Rheumatoid arthritis,
  • osteoarthritis
  • and various forms of arthritis (juvenile idiopathic arthritis, Reiter’s arthritis, psoriatic arthritis)
• Tumors: Several types of tumors can cause costochondritis, including:
  • lung cancer,
  • breast cancer,
  • bone metastases
• Fibromyalgia: A chronic disease of still unknown cause characterized by chronic muscle pain that is difficult to relieve, as well as stiffness and functional impotence. It often presents with pain at specific points, called trigger points, which are also present in the chest.

Symptoms

The main symptom of costochondritis is chest pain, which has several characteristics:

• It may be diffuse throughout the chest or localized to specific points at the level of the sternum or more laterally at the level of the ribs.
• Tends to be aggravated by chest movements (including coughing) or pressure on certain points.
• Tends to radiate to the back and abdomen, resulting in back and abdominal pain.
• May have a limited duration or remain fixed for some time.

May be associated with other symptoms such as

• constant feeling of muscle tension in the chest
• functional limitation of certain chest movements.

Diagnosis

If you experience chest pain, it is recommended that you seek immediate medical attention to rule out the possibility of a heart attack.

After ruling out more serious problems such as heart problems, the diagnosis can be made on the basis of

• history,
• physical examination,
• instrumental examination.

Anamnesis consists in the fact that the doctor formulates a series of questions in order to study and reconstruct the patient’s entire medical history. In this case, it is important to understand:

• when the pain occurred and what characteristics it has,
• if it may be due to injury or excessive exercise,
• whether it is aggravated by movement or pressure on certain trigger points.

At the end of this phase, the doctor is often already able to suspect possible costochondritis, but an objective examination allows to recognize all the symptoms reported by the patient and objective clinical signs, excluding, in particular, the presence of swelling at the level of the costal cartilage, characteristic of Tietze’s syndrome.

From an instrumental point of view, the following can be done:

These examinations are important to exclude

• heart or lung disease,
• rib fractures.

Costochondritis is not recognized on any instrumental examination, requiring a clinical (ie, symptom-based) diagnosis of exclusion.

Differential diagnosis

Costochondritis is included in the differential diagnosis with a number of other pathologies, the most important of which are:

• Rib fracture : in this case there is actual bone damage; in history – a serious injury to the chest, the pain is very intense and prolonged. In older people, due to osteoporosis, it can occur without noticeable chest trauma.
• Myocardial infarction : The pain is intense (less pronounced in diabetic neuropathy) and radiates to the shoulder and left arm. Before thinking about costochondritis, myocardial infarction must always be ruled out.
• Tietze’s Syndrome: This is a benign pain syndrome, manifested by chest pain localized in the region of the first 4-5 ribs. It is now recognized as a severe form of chronic costochondritis. A significant distinguishing factor from costochondritis is the presence of swelling and edema of the articular cartilage, which are absent in costochondritis, as well as the localization of pain:
  • Costochondritis usually affects the third, fourth and fifth costosternal joints,
  • Tietze’s syndrome usually affects the second or third costosternal joint.

In most cases, costochondritis resolves spontaneously within a few days.

Medical therapy is therefore symptomatic, i.e. associated with the elimination of symptoms, and is based on:

• absolute rest for several days,
• use of anti-inflammatory drugs (such as NSAIDs) and pain relievers (traditional such as paracetamol or opioid-derived for more severe pain),
• physical therapy and physical rehabilitation procedures such as TENS. The latter is a modern method used in pain therapy, which is especially effective in the treatment of chronic pain in the musculoskeletal system.