What is chest inflammation? How is costochondritis diagnosed and treated? Get expert insights on managing this condition, including symptoms, complications, and the role of specialists.

Understanding Costochondritis

Costochondritis, also known as chest wall pain, is a condition characterized by inflammation of the cartilage that connects the ribs to the breastbone (sternum). This can lead to a sharp, stabbing pain in the chest, often mistaken for a heart attack. While the exact cause is not always clear, costochondritis can be triggered by injury, overuse, or certain medical conditions.

Symptoms and Diagnosis of Costochondritis

The primary symptom of costochondritis is chest pain, which can be localized or spread across the chest. The pain is often worse with movement, deep breathing, or coughing. Some individuals may also experience tenderness or swelling in the affected area. To diagnose costochondritis, a healthcare provider will perform a physical examination, assess the patient’s medical history, and potentially order imaging tests to rule out other conditions.

Differentiating Costochondritis from Other Chest Conditions

It’s important to note that chest pain can be a symptom of a variety of conditions, including heart attack, pericarditis, and pleurisy. A healthcare provider will need to carefully evaluate the patient’s symptoms and medical history to determine the underlying cause of the chest pain and rule out more serious conditions.

Treatment Approaches for Costochondritis

The primary treatment for costochondritis involves managing the pain and inflammation. This may include over-the-counter or prescription anti-inflammatory medications, heat or cold therapy, and gentle stretching exercises. In some cases, corticosteroid injections or physical therapy may be recommended. It’s essential to follow the healthcare provider’s instructions and allow time for the condition to improve.

Complications and Chronic Costochondritis

While costochondritis is generally a self-limiting condition, in some cases, it can become chronic or lead to complications. Severe or persistent chest pain, difficulty breathing, or swelling in the affected area may require further medical evaluation and management.

The Role of Specialists in Costochondritis Treatment

Depending on the severity and underlying cause of the costochondritis, a healthcare provider may refer the patient to a specialist, such as a cardiologist, rheumatologist, or physical therapist, for additional evaluation and treatment.

Can costochondritis be mistaken for a heart attack?

Yes, the sharp, stabbing chest pain associated with costochondritis can be easily mistaken for a heart attack, especially in individuals who have not experienced the condition before. It is crucial to seek immediate medical attention if you experience chest pain, as it may be a sign of a more serious underlying condition.

How long does it take for costochondritis to go away?

The recovery time for costochondritis can vary, but most cases resolve within a few weeks to a few months with appropriate treatment and rest. In some instances, the condition may become chronic or recurrent, requiring ongoing management by a healthcare provider.

Can costochondritis cause shortness of breath?

Yes, severe or persistent costochondritis can sometimes lead to shortness of breath, especially if the inflammation affects the cartilage connecting the ribs to the sternum. This can make it difficult to take deep breaths and may exacerbate any existing respiratory issues.

What are the long-term effects of costochondritis?

In most cases, costochondritis does not have any long-term effects, and the condition resolves with proper treatment. However, in rare instances, chronic or recurrent costochondritis may lead to the development of scar tissue, which can cause ongoing chest pain and difficulty with physical activities.

Can costochondritis be prevented?

While there is no guaranteed way to prevent costochondritis, taking steps to maintain good posture, engage in moderate physical activity, and avoid sudden or strenuous movements that may strain the chest wall can help reduce the risk of developing this condition.

When should I see a doctor for costochondritis?

If you experience persistent or worsening chest pain, difficulty breathing, or any other concerning symptoms, it’s important to seek medical attention promptly. A healthcare provider can properly evaluate your condition, rule out more serious underlying causes, and provide appropriate treatment recommendations.

Symptoms and Diagnosis of Pericarditis

Signs and symptoms of pericarditis

A common symptom of acute pericarditis is a sharp, stabbing chest pain, usually coming on quickly. It’s often is in the middle or left side of the chest, and there may be pain in one or both shoulders.

Sitting up and leaning forward tends to ease the pain, while lying down and breathing deep worsens it. Some people describe the pain as a dull ache or pressure in their chest.

The chest pain may feel like a heart attack. If you experience chest pain, call 911 right away because you may be having a heart attack.

Fever is another common symptom of acute pericarditis. Other symptoms are weakness, trouble breathing and coughing. Palpitations, which are feelings that your heart is skipping a beat, fluttering or beating too hard or too fast, may occur and can be a sign of deeper heart tissue involvement.

Chronic pericarditis often causes tiredness, coughing and shortness of breath. Chest pain is sometimes absent with this type of pericarditis. Severe cases of chronic pericarditis can lead to swelling in the stomach, feet, ankles and legs and hypotension (low blood pressure).

Complications of pericarditis

Two serious complications of pericarditis are cardiac tamponade and chronic constrictive pericarditis.

• Cardiac tamponade happens if too much fluid collects in the sac, putting pressure on the heart. This prevents the heart from properly filling with blood, so less blood leaves the heart, causing a sharp drop in blood pressure. Untreated cardiac tamponade can be fatal.
• Chronic constrictive pericarditis is a rare disease that takes time to develop. It leads to scar-like tissue forming throughout the sac around the heart. As the sac becomes stiff and unable to move properly, the scarred tissue starts to compress the heart and prevent it from functioning well.

Diagnosing pericarditis

A doctor diagnoses pericarditis based on your medical history, a physical exam and test results.

Specialists involved

Primary care doctors, such as a family doctor, internist or pediatrician, often diagnose and treat pericarditis. A cardiologist, pediatric cardiologist or infectious disease specialist may be involved, depending on the patient’s age and medical conditions.

Medical history

Your doctor may ask whether you have had:

• A recent respiratory infection or flu-like illness
• A recent heart attack or injury to your chest
• Other medical conditions

If you have chest pain (angina), your doctor will ask you to describe how it feels, where it’s located and whether it’s worse when you lie down, breathe or cough.

Physical exam

When the pericardium is inflamed, the fluid between the sac’s two layers of tissue increases. So your doctor will look for signs of excess fluid in your chest. A common sign is the pericardial rub. This is the sound of the pericardium rubbing against the outer layer of your heart. Your doctor will listen for this using a stethoscope.

Your doctor may hear other chest sounds that are signs of fluid in the pericardium (pericardial effusion) or the lungs (pleural effusion). Both are more severe problems related to pericarditis.

Diagnostic tests

Your doctor may recommend tests to diagnose your condition and its severity. The most common tests are:

Learn more:

• View an animation of angina 

Written by American Heart Association editorial staff and reviewed by science and medicine advisors. See our editorial policies and staff.

Last Reviewed: Apr 8, 2021

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Costochondritis…a mysterious inflammation of the rib joints in your chest…or is it? – Sophie Cooke – Soft Tissue Therapy

• Post author:Sophie Cooke











• Post published:12th May 2020












• Post category:Uncategorised

From personal experience this condition is extremely painful, comes out of no where and stops you doing A LOT of things!! The month before the GP told me I had Costochondritis I was merrily running the Cardiff half marathon with not so much as a sniff of pain in my chest.

THEN all of a sudden, I had severe chest pain, breathlessness, fatigue and even chopping vegetables was an impossible task. Following an ambulance trip into A&E, full medical assessment and X-ray it was concluded I had Costochondritis. The advice ….. rest, take anti inflammatory medication, breath quietly and it will settle itself. Or will it?!

AFTER a month of this I began to get impatient, I spent hours on the internet researching what it actually is – in the hope for some sort of medical / logical explanation for the inflammation.

THEN I found Steve August, a physio based in New Zealand. For the first time an explanation as to the cause of this that made total sense. As a Soft Tissue therapist, we always look for the cause of pain and not just focus on treating the pain site itself. To have this explanation made all the difference.

FINALLY, A SIMPLE ANSWER! All hail Steve! The answer – the joints at the back of the rib cage (attached to the spine) are stiff and immobile and therefore the costochondral joints (the bits at the front) become overworked and more mobile to allow your body to breath ultimately causing them to strain. This inflammation creates pain and sensitivity and will continue until the immobile joints at the back are fixed!

FIXED! REALLY? YES!! Phew, I can hear your sigh of relief…this condition can be fixed.

Effective treatment includes the mobilisation of the stiff joints in your ribs that attach to your spine, deep tissue massage of your shoulders, neck and upper back combined with strengthening exercises and a focus on posture. I began my treatment journey with an Osteopath to free up my stiff rib joints and then maintained the release using the Backpod daily combined with a monthly deep tissue massage by a Soft Tissue therapist who knows how to treat costochondritis – it is very important they know what to do as some methods of treatment can make the inflammation worse. In between treatments I used various exercises to strengthen my shoulders and very quietly stretch my pectoral muscles. For more information on this please visit Costochondritis Explained

IMPORTANT If you have any chest pain, you MUST visit your GP for X-rays and tests to diagnose costochondritis and rule out any cardiac problems. Please ensure you do this before taking any of the above advice.

Mastitis (in women): symptoms, how to treat

Pain, redness of the skin in the area of ​​the mammary glands, bursting pains in the mammary glands – these symptoms may indicate the development of such a serious disease as mastitis. What is this pathology?

Pain, redness of the skin in the area of ​​the mammary glands, bursting pains in the mammary glands – these symptoms may indicate the development of such a serious disease as mastitis. What is this pathology? Who and why does it occur? How to prevent its development? The topic of mastitis is covered by the surgeon of the “Expert Clinic” Smolensk Efim Semyonovich Asnin.

– Efim Semyonovich, what is mastitis? Who usually develops it?

— Mastitis is an inflammation of the breast. It develops most often in women after pregnancy and the birth of a baby, as it is mainly associated with a violation of the normal outflow of breast milk (lactostasis). They constitute the risk group for the disease.

Mastitis of non-lactating (non-milk-producing) glands occurs, as a rule, in women under 30 and over 50 years of age.

How common is mastitis?

– 90% of all cases of mastitis occur during the period of breastfeeding, i.e., the inflammatory process develops in the lactating mammary gland. According to statistics, about 16% of breastfeeding women suffer from inflammation of the mammary glands. Among them, the vast majority of primiparas.

Mastitis in non-breastfeeding women occurs in 5-10% of cases.

“Breastfeeding is painful,” young mothers say. Is breastfeeding always painful for a woman? Quote from “Which of these is NOT true about breastfeeding?”

— What are the causes of mastitis?

– The main reason is the penetration of pathogenic microflora into the tissue of the mammary glands, in particular a bacterial infection (most often staphylococcal). If a woman does not properly attach her baby to her breast, if her nipples are not prepared, cracks may appear on them, forming an entrance gate for the penetration of microbes. Incomplete pumping of milk from the breast contributes to the development of lactostasis, and this is a favorable environment for the development of inflammation.

Mastitis can also be caused by a hormonal imbalance (namely, excessive production of the hormone prolactin, dysfunction of the thyroid gland), or abrupt weaning of the child from the breast.

Incorrect implantation, nipple piercings, and trauma to the mammary gland can also lead to the development of inflammation in it.

— Tell us about the types of mastitis

— Acute and chronic mastitis, unilateral and bilateral, are distinguished along the course. By the nature of the inflammatory process, they are serous, infiltrative, purulent, abscessing, gangrenous, phlegmonous. The first two forms are characterized by a limited focus of inflammation. When ensuring a good outflow of milk, they usually do not suppurate. All other forms of the inflammatory process require surgical intervention.

— What are the symptoms of mastitis?

— Painful sensations in the mammary gland when feeding a child, bursting pains in it, thickening of the gland tissue, reddening of the skin in this area, cracks and abrasions on the nipple and around it, enlargement of nearby lymph nodes, signs of intoxication — high fever, chills, headache. These symptoms should be a signal for a woman to see a doctor immediately.

In more advanced cases, discharge from the mammary glands mixed with pus and blood can be observed.

— What makes up the diagnosis of mastitis?

– First of all, from the collection of complaints and anamnesis, examination by a doctor. If necessary, it is recommended to conduct a series of blood tests, ultrasound of the mammary glands, bacteriological seeding of secretions from the mammary glands for microflora.

Read related materials:

What does breast ultrasound show?
Bacteria: find and identify. What will bakposev tell about?

— How and how is mastitis treated?

— Treatment tactics are selected by the doctor individually, depending on the form and severity of the inflammatory process. Of the conservative methods of treatment, antibacterial, anti-inflammatory, immunomodulatory therapy, some types of physiotherapy procedures are used.

If the inflammatory process progresses or there are cavities filled with pus in the gland, surgical intervention may be required.

Read related materials:

How to use antibiotics correctly? Instructions for use
Why don’t antibiotics help?

— How do you feel about traditional methods of treating mastitis?

– I can recommend proven folk remedies only after a personal examination of the patient, if I consider that they will be effective in this case.

— What should be done to avoid mastitis?

— First of all, observe the rules of personal hygiene when feeding and caring for the mammary glands, prevent congestion by regularly feeding the child with both glands in turn, followed by decanting milk residues. Contact obstetricians or lactation consultants for information on the technique and rules of feeding, pumping. It is important that a woman wears properly sized underwear made from natural fabrics.

A breastfeeding woman should not have chronic foci of infection in the body, so even during the planning of pregnancy, you should consult a doctor to eliminate them.

Relatives should provide a nursing woman with good nutrition, sleep, and protect her from stress and excessive physical exertion.

I urge women to immediately consult a doctor in case of any changes in the mammary glands. Do not forget that timely diagnosis and treatment will help to maintain lactation, not to resort to surgical intervention.

Interviewed by Sevilya Ibraimova

You can make an appointment with a surgeon here
ATTENTION: the service is not available in all cities

The editors recommend:

Is mastopathy dangerous? Don’t panic, but heal!
Breast fibroadenoma: how can a doctor help?
Breast cancer is not a sentence!
Do’s and Don’ts in the diet of a breastfeeding mother

For information:

Asnin Efim Semyonovich

In 1972 he graduated from the medical faculty of the Smolensk State Medical Institute.
In 1973 he completed his internship in the specialty “Surgery”.
Passed improvement in various areas of surgery, orthopedics.
Doctor of the highest category.
Currently – a surgeon at the “Expert Clinic” Smolensk. Accepts at: st. March 8, 20.

Mastitis – health articles

Mastitis is an inflammatory process in the tissues of the mammary gland. It is manifested by strong arching pains in the chest, swelling, induration, redness of the skin of the gland, a sharp rise in body temperature, chills. Mastitis is diagnosed during a visual examination by a mammologist; additionally, it is possible to conduct an ultrasound of the mammary gland. The disease can lead to the formation of an abscess, phlegmon, necrosis in the mammary gland, the development of sepsis and even death.

Causes

As the main reason for the development of mastitis, the entry of bacteria directly into the breast tissue is distinguished. This can happen through cracks in the nipples, which in this case act as an open gate for penetration into the specified infection environment, as well as through blood, which occurs in the presence of chronic infectious foci in the body. In the latter case, such foci include pyelonephritis, chronic tonsillitis and other diseases.

It should be noted that in a normal state of health, the entry of a certain amount of bacteria into the mammary gland leads to their corresponding destruction, carried out by the immune system. Meanwhile, the vast majority of cases indicate a weakening of the female body after childbirth, respectively, the immune system ceases to properly fight infections.

As an important point contributing to the development of the disease we are considering, lactostasis should be singled out, in which stagnation occurs in the ducts of the milk glands, which occurs due to insufficient decantation of milk, incomplete decantation, or due to rare feedings. Stagnation of milk in the ducts provides a favorable environment for the process of reproduction of bacteria, because milk as a whole has a mass of nutrients.

Symptoms

Usually mastitis is characterized by acute development – this indicates that the symptoms appear quickly (within a few hours – a couple of days)
There are such main signs and symptoms of mastitis:

– body temperature increases to 38 degrees, which evidence of an inflammatory process in the body. As a result of an increase in temperature, chills, pain in the head, weakness appear;
– constant pain in the chest of a aching nature, which intensifies during breastfeeding;
– an increase in the volume of the mammary gland, redness of the skin in the area of ​​​​inflammation, the skin becomes hot.

If mastitis is not treated in the early stages, it progresses to a purulent form.
The main signs and symptoms of purulent mastitis are as follows:

– body temperature rises to 39 degrees or more, sleep disturbance, severe pain in the head, poor appetite,
– severe pain in the mammary gland, pain is felt even from a light touch,
– in the axillary region, there is an increase in lymph nodes, which are presented to the touch as small, dense, painful formations.

Diagnostics

Diagnostic search for suspected mastitis includes the following tests:

wounds with determination of sensitivity to antibiotics of isolated microorganisms
3) Ultrasound examination of the mammary glands
4) X-ray examination of the mammary glands (mammography), which is especially indicated in case of suspected carcinomatous mastitis (however, the latter can only be excluded after a histological examination)
5) Testing for tuberculosis, actinomycosis, etc. is necessary to rule out specific infections.

In some cases, it is required to carry out a differential diagnosis of mastitis with other diseases that have similar clinical manifestations.

Treatment

The strategy for treating mastitis depends on the nature, duration of the disease and the volume of the affected area. Infectious forms are treated with targeted antibiotics. In order to achieve the desired result during bakposev, the type of pathogen and its concentration are determined. In the boundary conditions between mastitis and lactostasis, first of all, antiseptics are used and the dynamics are monitored. Only if the situation worsens, they switch to antibiotics.

Need to express milk every 3 hours, but if there is an abscess, the breast should not be touched. If purulent bags have formed, doctors open them surgically or pump out pus through a needle, wash the mammary gland and prescribe antibiotics. In the treatment of mastitis, local use of cold, immunomodulators and physiotherapy are prescribed. Acute non-purulent mastitis is not a hindrance to breastfeeding, but if the milk contains pus, it is forbidden to breastfeed!

Suppurative forms of mastitis usually require surgery. The developed abscess of the mammary gland is an indication for emergency surgical sanitation: opening of mastitis and drainage of the purulent focus.

Progressive mastitis, regardless of its stage, is a contraindication to further feeding (including healthy breasts), since breast milk is usually infected and contains toxic tissue breakdown products. For a child, pathologically altered breast milk can cause the development of dysbacteriosis and disorders of the functional state of the digestive system. Since mastitis therapy includes antibiotics, feeding during this period is also not safe for the baby. Antibiotics can markedly impair the normal development and growth of organs and tissues. During the treatment of mastitis, milk can be expressed, pasteurized, and only then given to the child.