What is costochondritis?
Costochondritis, also known as Tietze’s syndrome, is an
inflammation of the cartilage in the rib cage. The condition usually affects
the cartilage where the upper ribs attach to the breastbone (sternum), an area known
as the costosternal joint.
Chest pain caused by costochondritis can range from mild
to severe. Mild cases may only cause your chest to feel tender to touch or some
pain when you push on the area of your chest cartilage. Severe cases may cause
shooting pains down your limbs or unbearable chest pain that interferes with
your life and doesn’t seem to go away. The condition often goes away within a
few weeks, but some cases may require treatment.
What are the symptoms of
People with costochondritis often experience chest pain
in the upper and middle rib area on either side of the breastbone. The pain may
radiate to the back or the abdomen. It may also get worse if you move, stretch,
or breathe deeply.
These symptoms can indicate other conditions, including
a heart attack. Seek immediate medical care if you experience persistent chest
What causes costochondritis?
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 and syphilis, that can cause joint inflammation
- certain types
- tumors in the
costosternal joint region
Who is at risk for
Women and people over age 40
are most commonly diagnosed with costochondritis. You may also be at a higher
risk for this condition if you:
- participate in
- perform manual
- have allergies
and are frequently exposed to irritants
Your risk increases if you have any of the following
- rheumatoid arthritis
syndrome, also known as reactive arthritis
Improperly handling heavy loads can stress chest muscles. For instance, younger people
should lift heavy bags and backpacks with care. Adults should perform manual labor with caution.
What are emergency
symptoms of costochondritis?
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, as 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
How is costochondritis
Your doctor will perform a physical exam before making a
diagnosis. They may also ask about your symptoms and your family’s medical
history. During the physical exam, your doctor assesses pain levels by
manipulating your rib cage. They may also look for signs of infection or
Your doctor might order tests, such as X-rays and blood
tests, to rule out other conditions that may be causing your symptoms. You
might need an electrocardiograph or chest radiograph to make sure that you
don’t have coronary artery disease or another heart condition.
How is 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 prescribe:
painkillers, such as narcotics
antidepressants, including amitriptyline
- oral steroids
or injection of a steroid into the area involved
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 running and weightlifting. Manual labor can
also have a negative effect.
Your doctor may also recommend:
- bed rest
- hot or cold
therapy using a heating pad and ice
Your doctor may use pain levels to evaluate your
response to treatment. Once you’ve finished treatment, you can gradually build
up to your previous activity levels. Daily stretching can help relieve some
pain. Your doctor can also perform a procedure called transcutaneous electrical
nerve stimulation (TENS), which uses small amounts of electricity to stop your
nerves from sending signals of pain or aching to your brain.
What are complications
Long-term pain caused by costochondritis can be
debilitating if untreated. Normally, treatment of the inflammation and pain
causes costochondritis to eventually go away on its own.
If you have chronic costochondritis, the pain may
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
Pains associated with costochondritis can indicate other
issues. Chest pains can often mean that you’re having heart 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 pneumonia.
The chest pain associated with costochondritis is a
common 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
- difficulty focusing or
- feelings of depression
If you experience chest pains along with these other
symptoms, talk to 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.
What is the long-term outlook for costochondritis?
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 chance of persistent and chronic
costochondritis, carry and lift heavy loads properly. Try doing fewer
high-impact exercises or manual labor. Call your doctor immediately if you
experience chest pain while performing any of these activities.