What is costochondritis. How is costochondritis diagnosed. What are the common symptoms of costochondritis. How is costochondritis treated. Can costochondritis be prevented. What is the outlook for people with costochondritis. When should you seek medical attention for chest pain.

What is Costochondritis and How Does It Occur?

Costochondritis is a common condition characterized by inflammation of the cartilage connecting the ribs to the breastbone (sternum). This inflammation can cause significant chest pain and discomfort. To understand costochondritis better, it’s essential to know the anatomy of the chest wall.

The rib cage plays a crucial role in protecting vital organs such as the lungs and heart. Most ribs are connected to the sternum by cartilage, which allows for flexibility during breathing and movement. When this cartilage becomes inflamed, it results in costochondritis.

Anatomy of the Rib Cage

• The rib cage consists of 12 pairs of ribs
• The upper 7 pairs are directly connected to the sternum via cartilage
• The next 3 pairs are indirectly connected to the sternum
• The lowest 2 pairs, known as floating ribs, are not connected to the sternum

During normal breathing, the rib cage expands and contracts, facilitating lung function. This constant movement can sometimes lead to stress on the costal cartilage, potentially contributing to costochondritis.

Common Causes and Risk Factors of Costochondritis

While the exact cause of costochondritis is often unknown, several factors can contribute to its development. Understanding these potential triggers can help in prevention and management of the condition.

Possible Causes of Costochondritis

• Physical trauma to the chest
• Strenuous exercise or heavy lifting
• Viral respiratory infections
• Severe coughing spells
• Post-surgical infections
• Certain types of arthritis

Are certain individuals more prone to developing costochondritis? While it can affect anyone, some groups may be at higher risk. These include people who engage in repetitive upper body movements, those with chronic respiratory conditions, and individuals with certain autoimmune disorders.

Recognizing the Symptoms of Costochondritis

Identifying the symptoms of costochondritis is crucial for timely diagnosis and treatment. The primary symptom is chest pain, but its characteristics can help distinguish it from other serious conditions like heart attacks.

Key Symptoms of Costochondritis

1. Sharp, localized pain in the front chest wall
2. Pain that may radiate to the back or abdomen
3. Increased pain with deep breathing or coughing
4. Tenderness when pressing on the affected area
5. Pain relief when resting or breathing shallowly

How does costochondritis pain differ from heart-related chest pain? Unlike heart attack pain, costochondritis pain is typically sharp and localized, often worsening with movement or pressure on the chest. It doesn’t usually cause shortness of breath, sweating, or nausea that often accompany heart issues.

Diagnostic Approaches for Costochondritis

Diagnosing costochondritis involves a combination of clinical evaluation and, in some cases, diagnostic tests to rule out other conditions. The process typically begins with a thorough medical history and physical examination.

Steps in Diagnosing Costochondritis

1. Medical history review
2. Physical examination, focusing on chest wall tenderness
3. Chest X-ray (in severe or persistent cases)
4. Additional tests to exclude other conditions (e.g., ECG, blood tests)

During the physical exam, the healthcare provider will gently press on the costal cartilage to check for tenderness. If this area is painful to touch, it strongly suggests costochondritis. However, since chest pain can have various causes, additional tests may be necessary to ensure an accurate diagnosis.

Effective Treatment Strategies for Costochondritis

While costochondritis often resolves on its own within a few weeks to months, various treatment options can help manage pain and discomfort. The primary goal of treatment is to reduce inflammation and alleviate symptoms.

Non-Pharmacological Treatments

• Rest and activity modification
• Application of hot or cold compresses
• Gentle stretching exercises
• Physical therapy techniques

Pharmacological Interventions

• Over-the-counter NSAIDs (e.g., ibuprofen, naproxen)
• Acetaminophen for pain relief
• Prescription pain medications in severe cases
• Topical anti-inflammatory creams

How long does it typically take for costochondritis to improve with treatment? While individual cases vary, many people experience significant relief within a few days to weeks of starting treatment. However, some cases may persist for several months.

Prevention and Long-Term Management of Costochondritis

While not all cases of costochondritis can be prevented, certain strategies can help reduce the risk of recurrence or manage chronic symptoms. Understanding these approaches is crucial for long-term well-being.

Preventive Measures

• Proper warm-up before physical activities
• Maintaining good posture
• Avoiding repetitive strain on the chest wall
• Managing underlying conditions like arthritis
• Practicing stress-reduction techniques

For individuals prone to recurrent costochondritis, working with a physical therapist can be beneficial. They can provide exercises to strengthen the chest wall muscles and improve flexibility, potentially reducing the likelihood of future episodes.

When to Seek Medical Attention for Chest Pain

While costochondritis is generally not life-threatening, chest pain should always be taken seriously. It’s crucial to know when to seek immediate medical attention to rule out more severe conditions.

Warning Signs Requiring Urgent Care

• Severe, crushing chest pain
• Difficulty breathing or shortness of breath
• Pain radiating to the jaw, left arm, or back
• Chest pain accompanied by nausea, sweating, or dizziness
• Fever or signs of infection

If you experience any of these symptoms, it’s essential to seek emergency medical care immediately. While they may not be related to costochondritis, they could indicate a more serious condition such as a heart attack or pulmonary embolism.

Living with Costochondritis: Coping Strategies and Lifestyle Adjustments

For those dealing with chronic or recurrent costochondritis, adopting certain lifestyle changes and coping strategies can significantly improve quality of life. Understanding how to manage the condition on a day-to-day basis is crucial for overall well-being.

Practical Tips for Daily Living

1. Use proper lifting techniques to avoid chest strain
2. Practice good posture, especially when sitting for long periods
3. Modify sleeping positions to reduce pressure on the chest wall
4. Incorporate gentle stretching exercises into your daily routine
5. Manage stress through relaxation techniques or mindfulness practices

How can you modify your work environment to accommodate costochondritis? Consider ergonomic adjustments such as using a standing desk, ensuring your computer screen is at eye level, and taking regular breaks to stretch and move around. These changes can help reduce strain on your chest and upper body.

Emotional and Psychological Support

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

• Join support groups for individuals with chronic pain
• Practice mindfulness meditation to manage pain perception
• Seek counseling or therapy if pain is affecting your mental health
• Engage in hobbies and activities that bring joy and distraction

By addressing both the physical and emotional aspects of costochondritis, individuals can better manage their symptoms and maintain a good quality of life.

Alternative and Complementary Therapies for Costochondritis

While conventional medical treatments are the primary approach for managing costochondritis, some people find relief through alternative and complementary therapies. These methods can be used alongside traditional treatments but should always be discussed with a healthcare provider.

Potential Alternative Therapies

• Acupuncture
• Chiropractic care
• Massage therapy
• Herbal supplements with anti-inflammatory properties
• Yoga and gentle stretching routines

Are there any risks associated with alternative therapies for costochondritis? While many alternative treatments are generally safe, they may not be suitable for everyone. Some therapies, like chiropractic adjustments, could potentially exacerbate symptoms if not performed correctly. It’s crucial to consult with a qualified practitioner and inform your primary healthcare provider before starting any new treatment.

The Role of Diet in Managing Inflammation

Some evidence suggests that dietary choices can influence inflammation in the body. While not specific to costochondritis, an anti-inflammatory diet may help in overall management of the condition. Consider incorporating the following into your diet:

• Omega-3 rich foods like fatty fish, flaxseeds, and walnuts
• Fruits and vegetables high in antioxidants
• Whole grains and legumes
• Turmeric and ginger, known for their anti-inflammatory properties

It’s important to note that while dietary changes may support overall health, they should not replace medical treatment for costochondritis. Always consult with a healthcare provider or registered dietitian before making significant changes to your diet.

Research and Future Directions in Costochondritis Management

As medical knowledge advances, researchers continue to explore new ways to understand and treat costochondritis. Staying informed about the latest developments can provide hope and potential new treatment options for those affected by this condition.

Current Areas of Research

• Improved diagnostic techniques to differentiate costochondritis from other conditions
• Development of targeted anti-inflammatory medications
• Exploration of regenerative medicine approaches for cartilage repair
• Studies on the long-term effects of costochondritis and potential complications

What promising treatments are on the horizon for costochondritis? While research is ongoing, some areas of interest include the use of platelet-rich plasma (PRP) injections to promote healing, advanced imaging techniques for more accurate diagnosis, and the development of personalized treatment plans based on genetic factors.

Participating in Clinical Trials

For individuals interested in contributing to the advancement of costochondritis research, participating in clinical trials can be an option. These studies help researchers evaluate new treatments and interventions. To learn about ongoing clinical trials:

• Consult with your healthcare provider about suitable trials
• Check reputable clinical trial databases like ClinicalTrials.gov
• Contact local research hospitals or universities conducting relevant studies

Participation in clinical trials can offer access to cutting-edge treatments and contribute to the broader understanding of costochondritis. However, it’s important to thoroughly understand the risks and benefits before enrolling in any study.

As research progresses, the hope is that new insights will lead to more effective treatments and improved quality of life for those affected by costochondritis. Staying informed and working closely with healthcare providers remains the best approach for managing this condition in the meantime.

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.

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.

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, risk factors and treatment

Photo: pixabay com

Costochondritis is also known as costosternal chondrodynia, costosternal syndrome, or chest wall pain syndrome. This is a condition associated with inflammation/swelling of the cartilage that connects the rib to the sternum or sternum. However, the inflammation is accompanied by a sharp pain in the left half of the sternum, which radiates to the shoulder and arm.

Because the pain of costochondritis is in the chest area, you may mistake it for a heart attack.

The condition is harmless and usually resolves without any treatment. But for severe pain, the treatment strategy is symptomatic and based on pain relief.

Symptoms of costochondritis

• Chest pain associated with costochondritis usually occurs after exercise, injury or respiratory infections.
• Sharp pain in the chest, usually on the left, at the junction of the ribs with the sternum.
• Pain when coughing or taking a deep breath.
• Pain on pressure on costal joints.
• If costochondritis is due to a postoperative infection, there will be redness, swelling, and purulent discharge at the surgical site.
• Your doctor will examine you for tenderness or swelling along your breastbone. He/she may ask you to move your arms or chest in a certain way to cause costochondritic pain.

There are no specific or confirmatory laboratory or imaging tests for costochondritis. But to rule out other serious chest, lung, and airway conditions, your doctor may order certain tests, such as a chest x-ray and an echocardiogram (ECG).

If you have had a history of chest surgery or are at risk for heart disease, your doctor may recommend testing to determine if an infection at the surgery site is causing the pain. They will look for:

• Redness, swelling and purulent discharge at the site of the operation.
• Check white blood cells (white blood cell count) to confirm infection.
• Recommend chest scan with gallium.
• Recommend a chest x-ray to rule out pneumonia.

Causes of costochondritis

Although the exact causes of costochondritis are unknown, the following conditions can cause costochondritis pain:

• Vigorous arm exercise
• Repeated or multiple minor chest injuries
• Arthritis. Costochondritis may be the initial sign of arthritis, rheumatoid arthritis, or ankylosing spondylitis.
• A tumor that has moved from the joints and settled in the chest.
• Virus-mediated respiratory infections.
• Upper chest wall surgery

Risk factors for costochondritis

Chest pain associated with costochondritis is commonly seen in children and adolescents. About 10-30% of chest pain in children is caused by costochondritis. It can be seen that 12-14 years is the peak age for this condition.

Women over 40 are also more prone to costochondritis.

Treatment of costochondritis

It is important to see a doctor if you experience chest pain. In order to find the optimal treatment, it is necessary to make the correct diagnosis.

Your doctor may first prescribe over-the-counter (OTC) medicines to relieve chest pain and swelling. These medications include NSAIDs such as ibuprofen, naproxen, and acetaminophen.

If NSAIDs are not sufficient to relieve pain, local anesthesia and injection of steroids at the site of pain may be given.
For extremely unbearable pain, drugs such as hydrocodone or oxycodone can help.

If these medicines do not help with pain, your doctor may give you an injection of corticosteroids at the site of pain.
Other drugs such as the tricyclic antidepressants amitriptyline and antiepileptic drugs such as gabapentin may also help treat costochondritis pain. However, they also have other side effects.

Infectious costochondritis is treated with intravenous antibiotics.

Home remedies for costochondritis

Once you have been diagnosed with costochondritis by your doctor, you can also manage costochondritis-related chest pain at home:

• Taking over-the-counter pain relievers.
• Get enough sleep and rest your arms and ribs.
• Avoid excessive exercise and heavy lifting.
• Apply an ice pack to your chest at the site of pain.