What is costochondritis?

Costochondritis is an inflammation of the chest wall between the breastbone and ribs. Costochondritis usually goes away on its own although inflammation can last from weeks to months.
Costochondritis is an inflammation of the chest wall between the breastbone and ribs. Costochondritis usually goes away on its own although inflammation can last from weeks to months.

Chest pain can be scary. If you have chest pain, the first assumption made could be that you are having a heart attack.

Your chest has soft tissue that can be irritated due to infection, injury, or autoimmune disease. One cause of inflammation from that irritation is costochondritis.  The pain it triggers can seem like a heart attack, but the cause is unrelated.  

Costochondritis is an inflammation of the chest wall between the breastbone and ribs. Most of your ribs and your breastbone are connected by cartilage. This cartilage can become inflamed and cause pain in the chest. There is not one definite cause of costochondritis, but it is often caused by trauma and overuse, sports injuries, or arthritis.

Costochondritis is also known as costosternal syndrome, parasternal chondrodynia, and anterior chest wall syndrome.

What is costochondritis like?

The main symptom of costochondritis is pain. Yet, other symptoms do exist. They include:

  • Left-sided breastbone pain 
  • Sharp or dull pressure 
  • Numerous ribs affected 
  • Pain with deep breathing or cough 
  • Chest wall pain that may move to your back or stomach
  • Tender pain when pressing on rib/breastbone area
  • Cessation of pain when you are sitting still

Women and people older than forty experience costochondritis more often. If there is associated swelling, the condition is known as Tietze syndrome, and it affects young adults. 

How long does costochondritis pain last?

Costochondritis is a self-limiting, benign condition. It is non-cardiac-related, and other causes of pain should be ruled out because it is usually an exclusion diagnosis. 

Costochondritis usually goes away on its own, though it sometimes lasts longer. Inflammation can last from weeks to months and can limit your ability to work and participate in daily activities without accompanying pain. The pain is usually worsened by breathing deeply and moving the upper body. The longevity of symptoms varies depending on whether the condition was caused by a recent upper respiratory illness or recent strenuous activity.

How is costochondritis diagnosed?

Costochondritis is diagnosed by a medical provider. They will do a history and physical exam. The exam will include pressing on the area where your breastbone and ribs meet. A diagnosis of costochondritis will usually be made if that area is sore and painful.

A chest x-ray could be done for severe symptoms or if symptoms do not improve with treatment. They may also conduct tests to make sure you haven’t had a recent heart attack.

The pain experienced can resemble that of lung disease, GI problems, and arthritis. The differential diagnosis (i.e., other, similar medical conditions) include:

How is costochondritis treated?

Many times, costochondritis can resolve on its own. If not, there are several treatment approaches depending on the symptoms. Treatment focuses on pain relief. The most simple approaches to treatment include:

In some cases, if the pain is bad enough, your doctor may prescribe strong pain medications. Sometimes, physical therapy may be needed. Therapy that tends to help with symptoms includes stretching exercises and nerve stimulation. With transcutaneous electrical nerve stimulation, a weak electrical current is used to zap the area of pain — hopefully masking pain signals so that they do not reach your brain.

If none of these things work, injections of medication and steroids directly to the area of pain might be the last step. 

Atypical treatments include antidepressants. They are known to treat chronic pain that keeps you from sleeping at night. Anti-seizure drugs have also proved to be good at treating chronic pain

When should I see a doctor?

Sometimes, costochondritis will go away on its own. Since it is a medical issue with chest pain, it should be monitored closely. You should call your doctor or call 911 if you have extreme chest pain. It never hurts to be persistent in finding out what is wrong!

Also, whether you have already been diagnosed yet or not, you should call your doctor if you have:

  • Fever 
  • Signs of infection like swelling, redness, or pus near your ribs 
  • Pain that gets worse even with medication 
  • Extreme pain with each breath

Overall, costochondritis is a musculoskeletal disorder that mimics other conditions that cause chest pain. If you have chest pain, you should see a doctor soon. Early detection of the cause of your pain can help to prevent complications in the future.

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Medically Reviewed on 1/4/2022
References
SOURCES:

Cureus: "Atypical Costochondritis: Complete Resolution of Symptoms After Rib Manipulation and Soft Tissue Mobilization."

Harvard Health Publishing: "Other conditions may be causes of chest pain."

Mayo Clinic: "Costochondritis."

MountSinai.com: "Costochondritis."