What Is Costochondritis?

Written by WebMD Editorial Contributors

Medically Reviewed by Jennifer Robinson, MD on January 04, 2023

• What Is Costochondritis?
• Costochondritis Causes
• Costochondritis Symptoms
• Costochondritis Diagnosis
• Costochondritis Treatment
• How Long Does Costochondritis Last?
• More

Costochondritis is when the cartilage (connective tissue) that joins your ribs to your breastbone is inflamed. Doctors call this area of your body the costochondral joint.

If you press on your upper ribs and it feels tender, or if your chest hurts when you move around, you may have it. The pain can start suddenly or gradually. 

One study found that 30% of people complaining of chest pain had costochondritis. The condition affects both children and adults, but is more common in people 40 and over. It’s more likely to affect women and people of Hispanic origin.

Is costochondritis dangerous? This condition is mostly harmless. But if you have sudden chest pain, always have it checked out by a doctor to make sure your heart is healthy. Unlike costochondritis, a heart attack often causes widespread pain along with symptoms like sweating, nausea, and a hard time breathing.

Injury, physical strain, respiratory infection, rheumatoid arthritis or psoriatic arthritis, chest wall infections, tumors, or rare conditions like relapsing polychondritis may also cause chest pain.

There isn’t a single known cause of costochondritis. Doctors aren’t sure how your costochondral joint gets inflamed. But they do know that inflammation is one way your body responds to injury or infection. The condition has been linked to:

• Strain due to exercise or exertion 
• Chest injury
• Lots of coughing 
• Infection, such as respiratory infections 
• Intravenous (IV) drug use

When your costochondral joint becomes inflamed, it results in chest pain and tenderness. Most people describe the pain as sharp, achy, and pressure-like. When you press on your chest, it feels tender and painful. The pain usually gets worse when you move around, breathe deeply, or sneeze. Some people have pain when they wear a seatbelt, hug someone, or lie down. 

Costochondritis pain locations. You usually first feel pain on the front left side of your breastbone. It often affects more than one rib. It may spread to the rest of your chest, and even affect your arms and shoulders. 

Your doctor will do a physical exam, pressing on your chest to check for areas of tenderness. They will also take a look at your range of motion and listen to your breathing. 

If you’re over 35, at risk for coronary artery disease or a blood clot, or you recently had a respiratory infection, your doctor may order more tests, like a chest X-ray and EKG, to rule out more serious problems.

Since costochondritis isn’t dangerous, treatment focuses on pain relief. Most of the time, chest pain from costochondritis will go away on its own. In the meantime, you can try one or more of the following on your own:

• Taking over-the-counter (OTC) pain relievers like aspirin or ibuprofen 2-3 times a day (making sure to follow the directions on the label carefully)
• Using hot compresses or heating pads in the painful area
• Avoiding activities, like strenuous exercise or reaching up, that make the pain worse

Talk to your doctor before taking OTC pain medications if you have:

• High blood pressure
• Heart disease
• Kidney disease
• Liver disease
• Past stomach ulcers or internal bleeding.

If your chest pain won’t go away or gets worse, see your doctor. They can give you a shot of a powerful anti-inflammatory medicine called a corticosteroid to reduce pain and swelling. They’ll inject the corticosteroid into the area where you’re feeling pain. But because having too much of a corticosteroid can damage your costochondral joint, you can only have this treatment once every few months.  

Your doctor might also try a procedure called transcutaneous electrical nerve stimulation, or TENS. A doctor or nurse puts adhesive patches on your skin near where you’re feeling pain. They use a TENS device to send a weak electrical current into your skin through the patches. It’s thought to work by stopping pain signals from reaching your brain.

Your doctor can also give you information on how to improve your posture and fix any muscle imbalances.

If necessary, they can refer you to a specialist called a rheumatologist, who treats diseases of the joints, muscles, and bones. 

Costochondritis isn’t a permanent condition. Most of the time, your chest pain will go away within a couple of weeks.

But in some cases, symptoms can linger for months. And sometimes it comes back again after it heals. About a third of those with costochondritis will have it for about a year. 

Top Picks

What Is Costochondritis?

Written by WebMD Editorial Contributors

Medically Reviewed by Jennifer Robinson, MD on January 04, 2023

• What Is Costochondritis?
• Costochondritis Causes
• Costochondritis Symptoms
• Costochondritis Diagnosis
• Costochondritis Treatment
• How Long Does Costochondritis Last?
• More

Costochondritis is when the cartilage (connective tissue) that joins your ribs to your breastbone is inflamed. Doctors call this area of your body the costochondral joint.

If you press on your upper ribs and it feels tender, or if your chest hurts when you move around, you may have it. The pain can start suddenly or gradually. 

One study found that 30% of people complaining of chest pain had costochondritis. The condition affects both children and adults, but is more common in people 40 and over. It’s more likely to affect women and people of Hispanic origin.

Is costochondritis dangerous? This condition is mostly harmless. But if you have sudden chest pain, always have it checked out by a doctor to make sure your heart is healthy. Unlike costochondritis, a heart attack often causes widespread pain along with symptoms like sweating, nausea, and a hard time breathing.

Injury, physical strain, respiratory infection, rheumatoid arthritis or psoriatic arthritis, chest wall infections, tumors, or rare conditions like relapsing polychondritis may also cause chest pain.

There isn’t a single known cause of costochondritis. Doctors aren’t sure how your costochondral joint gets inflamed. But they do know that inflammation is one way your body responds to injury or infection. The condition has been linked to:

• Strain due to exercise or exertion 
• Chest injury
• Lots of coughing 
• Infection, such as respiratory infections 
• Intravenous (IV) drug use

When your costochondral joint becomes inflamed, it results in chest pain and tenderness. Most people describe the pain as sharp, achy, and pressure-like. When you press on your chest, it feels tender and painful. The pain usually gets worse when you move around, breathe deeply, or sneeze. Some people have pain when they wear a seatbelt, hug someone, or lie down. 

Costochondritis pain locations. You usually first feel pain on the front left side of your breastbone. It often affects more than one rib. It may spread to the rest of your chest, and even affect your arms and shoulders.  

Your doctor will do a physical exam, pressing on your chest to check for areas of tenderness. They will also take a look at your range of motion and listen to your breathing. 

If you’re over 35, at risk for coronary artery disease or a blood clot, or you recently had a respiratory infection, your doctor may order more tests, like a chest X-ray and EKG, to rule out more serious problems.

Since costochondritis isn’t dangerous, treatment focuses on pain relief. Most of the time, chest pain from costochondritis will go away on its own. In the meantime, you can try one or more of the following on your own:

• Taking over-the-counter (OTC) pain relievers like aspirin or ibuprofen 2-3 times a day (making sure to follow the directions on the label carefully)
• Using hot compresses or heating pads in the painful area
• Avoiding activities, like strenuous exercise or reaching up, that make the pain worse

Talk to your doctor before taking OTC pain medications if you have:

• High blood pressure
• Heart disease
• Kidney disease
• Liver disease
• Past stomach ulcers or internal bleeding.

If your chest pain won’t go away or gets worse, see your doctor. They can give you a shot of a powerful anti-inflammatory medicine called a corticosteroid to reduce pain and swelling. They’ll inject the corticosteroid into the area where you’re feeling pain. But because having too much of a corticosteroid can damage your costochondral joint, you can only have this treatment once every few months. 

Your doctor might also try a procedure called transcutaneous electrical nerve stimulation, or TENS. A doctor or nurse puts adhesive patches on your skin near where you’re feeling pain. They use a TENS device to send a weak electrical current into your skin through the patches. It’s thought to work by stopping pain signals from reaching your brain.

Your doctor can also give you information on how to improve your posture and fix any muscle imbalances.

If necessary, they can refer you to a specialist called a rheumatologist, who treats diseases of the joints, muscles, and bones.  

Costochondritis isn’t a permanent condition. Most of the time, your chest pain will go away within a couple of weeks.

But in some cases, symptoms can linger for months. And sometimes it comes back again after it heals. About a third of those with costochondritis will have it for about a year. 

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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 • 24 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

Mamaeva Lidia Semyonovna

Neurologist • Reflexologist • Physiotherapist • Hirudotherapist
experience 48 years

Konovalova Galina Nikolaevna

Neurologist
experience 44 years

Linkorov Yury Anatolyevich

Neurologist
experience 42 years

Kuznetsova Elena Nikolaevna

Neurologist
experience 32 years

Yan Anzhela Alexandrovna

Neurologist • Reflexologist
experience 23 years

Kareva Tatyana Nikolaevna

Neurologist
experience 22 years

Ismailova Elvira Tagirovna

Neurologist
experience 20 years

Agumava Nino Mazharaevna

Neurologist
experience 19 years

Lysikova Tatyana Gennadievna

Neurologist • Physiotherapist
experience 19 years

Bachina Natalya Iosifovna

Neurologist
experience 19 years

Repryntseva Svetlana Nikolaevna

Neurologist
experience 18 years

Lisin Valery Igorevich

Neurologist
experience 15 years

Shishkin Alexander Vyacheslavovich

Neurologist • Chiropractor
experience 13 years

Dorofeeva Maria Sergeevna

Neurologist
experience 11 years

Filippenko Anton Olegovich

Neurologist • Reflexologist
experience 11 years

Amagova Tamila Magomedovna

Neurologist
experience 9 years

Miropolsky Ilya Andreevich

Neurologist
experience 9 years

Suleymanov Kurban Abbas-Ogly

Neurologist
experience 9 years

Satieva Marina Garunovna

Neurologist
experience 7 years

Diagnosis

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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Pain in the thoracic spine from the back

Pain in the thoracic spine from the back – causes and methods of treatment

Gimranov Rinat Fazylzhanovich
Neurologist, neurophysiologist, experience – 33 years;
Professor of Neurology, MD;
Clinic for Rehabilitation Neurology. About the author

Publication date: September 28, 2022

Soreness in this area is familiar to many. Feeling discomfort in the area of ​​​​the shoulder blades, we think that we have been sitting in an uncomfortable position for too long or have become too cold. However, if the thoracic spine hurts, where each vertebra means a lot and the main body systems are located, one cannot be sure that what is happening is a consequence of fatigue.

Attacks of pain can indicate a serious curvature of the spinal column, diseases of the bones, muscles, heart, blood vessels, lungs, digestive system. Therefore, it is important to turn to professionals in time.

Contents of the article:

• 1 Types of pain
• 2 Causes of chest pain
• 3 What not to do with chest pain
• 4 When urgent medical attention is needed
• 5 Diagnosis
• 6 Treatment
  • 6.1 Medical
  • 6.2 Physiotherapy and exercise therapy
  • 6. 3 Surgery
• 7 Prevention
• 8 References:

90 194

Types of pain

They are:

• Radicular. Acute shooting due to compression of roots. Most often a symptom of the presence of degenerative pathologies, neoplasms.
• Reflected. Discomfort in the region of the ribs, but the source is the internal organs and negative processes occurring near the heart, in the lungs or in the digestive system.
• Non-specific. Occur due to acquired or congenital curvature. Sometimes accompanied by radicular seizures.
• Specific. Often occurs in the development of oncology or tuberculosis of the spinal column.

Back pain in the thoracic spine can be mild or severe, acute, appear when you lie down or move, radiate from behind or in front, and the cause and future diagnosis depend on how this symptom manifests itself.

Causes of pain in the thoracic region

There are about a hundred causes that can cause pain in the region of the thoracic spine, in the back from behind, affecting the chest. [1] Many are easy to fix by removing the causative factor or can be corrected at home. Often they provoke serious, and sometimes life-threatening pathologies.

From the original cause, pain in the thoracic spine in men and women, young and old, can be dull and radiate to the sternum, pressing and constant, occurring at the entrance, stabbing, throbbing, making it difficult to breathe.

We will talk about the most common problems:

1. Osteochondrosis develops more slowly in this part, as well as muscle spasm due to degenerative changes in the intervertebral cartilage. [2] Soreness can be at the site of the affected vertebrae or spread to the entire chest, then the sensations will be similar to pain in cardiac pathologies.
2. Herniation of the intervertebral disc in this area is extremely rarely formed after trauma, unsuccessful sudden movements or physical effort, training, hard work. The appearance of a neoplasm leads to compression of the nerve roots and spasm of the muscles around it. The only way to remove a hernia is by surgery.
3. Intercostal neuralgia occurs when nerve endings are pinched. The pain is strong, sharp, increasing with each breath, as the muscles often spasm. It occurs as a result of osteochondrosis, various inflammatory processes, prolonged and regular stay in an uncomfortable position.
4. Curvature congenital or acquired, more often it is scoliosis or kyphosis. Constant aching soreness, over time becomes shingles. The increasing load destroys the vertebrae and compresses the nerve roots.
5. Muscular pathologies. This includes muscle spasm of the chest and back. With prolonged stress, excessive overstrain, regular excess of habitual loads, myofascial syndrome can develop – a series of seals on the muscle. Also, due to hypothermia, inflammatory processes develop.
6. Injuries in this part are quite rare. But in the chest area, you can get both a fracture of the ribs and a crack. Then there will be constant pain, aggravated by movements, a deep breath. Seeing a doctor is a must. There is a high probability of developing muscle injuries, damage to internal organs. And improperly fused bones will remind of themselves throughout life.

From the internal organs:

1. Diseases of the mammary glands are typical for women. Sometimes soreness appears on both sides at the same time during menstruation, but then fades. However, if there is constant anxiety, it can easily be confused with a heart or stomach problem. Discomfort on an ongoing basis indicates the occurrence of a neoplasm that presses on the nerve endings. It is important to start testing right away.
2. Heart diseases. Stenosis of the coronary arteries leads to the gradual development of myocardial ischemia. During exertion, stressful situations, plaques block the arteries and the heart remains without the oxygen necessary for work, there is a sudden and sharp pain, then relief may come, or ischemia turns into a myocardial infarction – the tissues of the main organ of the human body begin to die. The intensity of pain is similar to osteochondrosis. But it is possible to distinguish an attack by using Nitroglycerin, it instantly relieves an attack.
3. Pathologies of the gastrointestinal tract. The signal about the appearance of inflammation in this system often goes to the spine in the chest area, even here the symptoms are felt when the esophagus is damaged. A distinctive feature is the pain that does not disappear from the position of the body.
4. Diseases of the bronchopulmonary are manifested by a sharp costal pain when inhaling. There is also fever and coughing. The pain appears with inflammation of the pleura – the lining of the lungs, immediate antibiotic therapy is needed.
5. Pathology of the pancreas. With severe right-sided soreness in the chest, radiating to the back, pancreatitis is likely. You need to seek emergency medical help, as there is a high probability of the onset of tissue necrosis, otherwise it can be fatal.

Precisely determine the cause and say the name of the disease that causes pain in the thoracic region to the right or left of the spine, worsening of symptoms at night in the supine position from the back right between the vertebrae, only a doctor who conducts an examination and has research results can.

What not to do with chest pain

If you feel a sharp or pulling pain along the spine in the thoracic or lower thoracic region of the back, then try to avoid:

• Sudden movements , otherwise, pain may increase.
• Being in an uncomfortable position for a long time.
• Weight lifting.
• Weight gain. Every extra kilogram is a load on the skeleton.
• High-heeled shoes keep the muscles in constant tension.
• Sleeping on an excessively soft surface or on a high pillow, when the back tenses up, the full blood flow to the brain is blocked.
• Exercise therapy in the event of pain, leading to its intensification.

Faced with situations when the muscles of the thoracic spine hurt, it is worth reducing physical activity as much as possible in order not to accidentally worsen your condition.

When urgent medical attention is needed

Pain in the thoracic spine can be a manifestation of a chronic disease, as well as life-threatening. Sometimes you need to get to the hospital as soon as possible in order to preserve further health and life.

Reasons for emergency care:

1. Back pain in the thoracic region from the back was immediately very intense. Then the infringement is suspected. Any movement will either be impossible or will cause incredible agony.
2. Violent shingles, worse when trying to move, take a deep breath. Perhaps this is acute pancreatitis, when a dangerous condition can develop a few hours after the onset of pain.
3. Strong and sharp usually begin on the left, give into the arm and shoulder blade. This can also lead to myocardial infarction.
4. Unpleasant sensations aggravated by inhalation, cough reflex. At the same time, the temperature rises, breathing becomes more difficult, and the likelihood of developing pleuropneumonia is high.
5. Right-sided paroxysmal pain in the back when trying to change the position of the body, move the right arm or lift a weight. Maybe it’s pinched roots.

Even if the pain in the vertebrae in the area of ​​the thoracic spine does not cause severe discomfort, does not look dangerous, it should not be ignored. You still need to undergo an examination to find out the cause and protect yourself.

Diagnosis

It is necessary to determine exactly why the thoracic vertebrae hurt. To do this, a thorough examination and questioning is carried out at the first appointment. It is important to explain in detail how the thoracic spine aches and where the pain radiates. The primary examination is carried out by an orthopedic traumatologist, and then additional consultations are scheduled.

Usually ordered:

• X-ray examination to detect curvature and degenerative changes in the bone structure of the spinal column. Thanks to this method, it is possible to determine the degree of congenital and acquired diseases, injuries. If a compression fracture or herniated discs is suspected, CT or MRI is performed. X-ray of OGK allows to detect pulmonary pathologies.
• EFGDS is done if the digestive system is suspected.
• Ultrasound angioscanning is performed to determine the presence of aneurysm or inflammation in large vessels.
• Laboratory tests for inflammation or infection. If Bechterew’s disease is suspected, special tests are performed.

Treatment

Having determined why the back in the area of ​​the thoracic spine constantly hurts and presses the chest, the doctor will be able to decide what to do. [3] To achieve the best effect, complex therapy is used, it is important to complete the entire course. Do not use any other treatment without consulting your doctor.

Medication

When it is clear why the chest and part of the spine hurts from behind, affecting both from the back and strongly radiating to the sternum, you can prescribe the necessary drugs so that the chest stops hurting. The choice of drugs is individual.

Several groups of drugs are often used:

1. Non-steroidal anti-inflammatory drugs relieve pain and reduce inflammation. There are several forms of release: for oral and external use. This allows you to combine several tools at once to achieve the effect faster.
2. Antibiotics. If the cause is an infection, antibiotics are started.
3. Muscle relaxants and antispasmodics are also used as pain relievers in cases of muscle and nerve root damage. They relieve swelling and inflammation, hypertonicity, improve blood circulation.
4. Antisecretory are used if there is damage to the digestive system. They allow you to reduce the damage to the esophagus by the contents of the stomach, remove the burning sensation.

The course and dosage is calculated individually. If the patient takes too many drugs or stops drinking them before the end of the course, then side effects may occur.

Physiotherapy and exercise therapy

Another effective method is physiotherapy. Used:

• Acupressure. Only as prescribed by a doctor, a properly conducted course will reduce pain, restore mobility and improve blood circulation.
• Electrophoresis with strong pain medications is one of the most commonly used methods due to the fact that the drug does not enter the bloodstream, reduces the likelihood of allergies and complications.
• Therapeutic exercise. A special course is begging, taking into account the identified problem. Classes are initially held with a trainer. Subsequently, the patient will be able to practice independently at home.

When women or men constantly have a very severe pain in the thoracic spine in front and behind in the middle of the back, so that it is difficult to breathe while lying down, and when inhaling, as if the ribs break, then the reasons why it hurts so much have not yet been identified, and it has not been carried out treatment with drugs, no physical activity or physiotherapy procedures should be carried out. Massages performed without a doctor’s prescription can be harmful, exacerbating poor health.

Surgical intervention

Specialists resort to surgical intervention when conservative treatment is not able to give a long-term positive result or is not effective at all. So an emergency operation is performed if necessary to remove the exfoliating aneurysm. The work of a vascular surgeon is the only way for a patient to survive.

Also getting into the operating room is inevitable in severe injuries, fractures. Surgical intervention is required in order to remove the resulting hernia and eliminate spiral compression in neglected curvatures.

After the operation, you will have to undergo a course of rehabilitation and conservative treatment in order to completely get rid of the symptoms, then you will have to comply with restrictions for many years.

Prevention

In order to avoid such a problem as discomfort in the thoracic spine, you need to monitor your health. Experts have developed several rules. [4] These tips also protect against relapses, so those who have already received treatment should also take them into account.

In order not to feel acute pain in the chest and back in the area of ​​the chest and spine, flashing from the side of the sternum, you need:

1. Use orthopedic mattress and not too high a pillow. Maximum comfort during sleep is essential for well-being throughout the day.
2. Check your posture. A straight back is not only beautiful, but also useful. This is one of the most important elements in the prevention of pathological curvature.
3. Properly distribute the weight of the weight being lifted. Most of the load should fall on the arms, and not on the lower back.
4. Watch your diet. Daily eat foods rich in vitamins and minerals, but refuse harmful, fatty and fried, canned foods.
5. Maintain normal weight.
6. Exercise only with an experienced coach. Excessive passion for the gym and the desire to increase the weight lifted often leads to injury.
7. In the presence of chronic diseases during exacerbations or when performing physical work use bondages and orthopedic corsets.
8. Provide daily exercise. Do exercises in the morning or after a long stay in an uncomfortable position, set aside time for walks.
9. Taking a contrast shower promotes healthy tone. Improving blood circulation and increasing the hardening of the body.

References:

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