Costochondritis

This article contains self-care information for the selected condition. If you have questions or need more comprehensive treatment advice, please consult a medical professional.

Costochondritis is an inflammation of the cartilage between the rib and the breastbone. The exact cause of costochondritis is unknown.

Costochondritis tends to affect women more often than men, and it can affect people of all ages, but it's slightly more common in people over 40 years of age. 1

Costochondritis symptoms may typically include chest pain that could be worsened by some activities, such as taking a deep breath. The onset of costochondritis is often chronic.

Diagnosis is mainly based on a physical exam, medical imaging, and blood tests.

Physical therapy and painkillers may help. As the symptoms can be like a heart attack, it's important to consult with a healthcare professional. They can offer an assessment and advice.

Costochondritis is a self-limiting condition and often goes away on its own. However, it can recur.

The specific cause of costochondritis is still unknown. However, in some cases, costochondritis may occur due to the following:

• An injury or a blow to the chest 2
• Physical strain, This could be caused, for example, by strenuous exercise or lifting heavy objects
• Severe coughing is also linked to costochondritis 2 This could also be because of the increased strain on the chest area when coughing.
• An infection, including respiratory tract infections, wound infections, or through hematogenous spread. 2 3

Costochondritis occurs more often in females than in males, and it tends to affect people over 40 years of age. 1 People who have had trauma to the chest are at higher risk of developing costochondritis. This is also the case for people doing high-impact activities or sports using the chest muscles, like weightlifting. Some case reports have described costochondritis in vitamin D deficient patients that resolved with vitamin D supplementation 4, which could also be a risk factor.

The symptoms of costochondritis include:

• Pain in the area where the rib meets the breastbone, which is known as the costochondral joint (junction). The pain could shift to the back or upper belly. It may worsen during physical activity or when taking deep breaths or coughing. Costochondritis pain locations are most common in the 2nd to 5th ribs. 3 5
• Tenderness in the costochondral joint. This can be elicited by pressing on it. The tenderness can also extend to the sternoclavicular joint and the muscles around the area. 3

Other Less common symptoms include:

• fever
• sweating
• redness on the chest
• dizziness, and nausea.

The diagnosis of costochondritis is usually made during a physical exam. Before a diagnosis can be confirmed, your GP may ask to carry out some tests to exclude other possible causes of chest pain. These include a chest X-ray, an electrocardiogram (ECG or EKG), and blood tests. 2

Due to the similarities in symptoms, costochondritis is often confused with Tietze syndrome. They are similar in presentation, but there are a few differences between the two conditions:

Costochondritis is more common than Tietze syndrome. It occures mainly in people older than 40. It affects mostly the 2nd to 5th rib, and swelling is rarely present. On the other hand, Tietze syndrome is rarer than costochondritis. It tends to affect people younger than 40. The most common site affected is the 2nd and 3rd rib, and there is commonly a local swelling. 2 5

The main aim of the treatment is to relieve pain. Treatment of costochondritis often involves:

• Rest and physical therapy
• Avoiding activities that worsen the pain
• Doing stretching exercises
• Simple painkillers
• Sometimes, the condition is caused by a bacterial infection, and for these cases, treatment may include antibiotics
• In some cases with severe pain and if simple pain killers are unsuitable or ineffective, corticosteroid injections may be prescribed. A doctor should administer these. 2

The prognosis for costochondritis is generally very good. It tends to get better over time without any further problems. The condition may last from weeks up to a year. 3 In some cases, the condition may return or persist even with treatment. These cases are known as chronic costochondritis.