Costochondritis

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Costochondritis
Illustration of the rib cage
Synonyms	Chest wall pain, costosternal syndrome, costosternal chondrodynia
Pronounce	N/A
Specialty	N/A
Symptoms	Chest pain, tenderness in the costosternal, costochondral, or costovertebral joints
Complications	N/A
Onset	Any age, but more common in adults
Duration	Can be acute or chronic
Types	N/A
Causes	Often unknown, but can be due to trauma, physical strain, or infection
Risks	Physical activity, coughing, respiratory infections
Diagnosis	Based on physical examination and medical history
Differential diagnosis	Tietze syndrome, myocardial infarction, angina, pleurisy
Prevention	N/A
Treatment	Rest, analgesics, anti-inflammatory medication
Medication	N/A
Prognosis	N/A
Frequency	Common
Deaths	N/A

Diagram of the human rib cage showing the costal cartilages

Illustration of costal cartilage

Anatomy of the thorax

Costochondritis is an inflammatory condition affecting the cartilage that connects the ribs to the breastbone (sternum). It causes chest pain and tenderness in the affected area and is a common cause of chest pain that is not related to the heart. The exact cause of costochondritis is often unknown, but it can be related to physical strain, injury, infection, or autoimmune conditions. Treatment is primarily focused on managing pain and inflammation.

Symptoms

The main symptom of costochondritis is chest pain that is usually located on the front of the chest, particularly on the left side. The pain may be sharp, aching, or pressure-like and can vary in intensity. It often worsens with physical activity, deep breathing, coughing, or sneezing. Other symptoms can include:

• Tenderness when pressing on the affected area
• Pain that radiates to the back or abdomen
• Swelling or redness in the affected area (less common)

Causes

The exact cause of costochondritis is often unknown (idiopathic), but several factors can contribute to its development:

• Physical strain: Heavy lifting, strenuous exercise, or repetitive movements can strain the chest muscles and lead to inflammation.
• Injury: A direct blow to the chest, such as from a fall or car accident, can cause costochondritis.
• Infection: Bacterial, viral, or fungal infections can spread to the costochondral junction and cause inflammation.
• Autoimmune conditions: Inflammatory disorders such as rheumatoid arthritis or lupus can affect the costochondral junction.
• Surgery: Costochondritis can develop after chest surgery, such as open-heart surgery or thoracic surgery.

Diagnosis

Costochondritis is typically diagnosed through a physical examination, which involves pressing on the chest wall to identify areas of tenderness. The diagnosis is mainly one of exclusion, as other conditions with similar symptoms, such as heart attack, pleurisy, or rib fractures, need to be ruled out. Additional tests, such as chest X-rays, electrocardiograms, or blood tests, may be performed to exclude other causes of chest pain.

Treatment

Treatment for costochondritis focuses on managing pain and inflammation:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter medications such as ibuprofen, naproxen, or aspirin can help reduce inflammation and relieve pain.
• Heat or cold therapy: Applying a heating pad or cold pack to the affected area can provide relief.
• Physical therapy: Gentle stretching exercises and strengthening exercises can help improve posture and reduce pain.
• Rest: Avoiding activities that worsen pain, such as heavy lifting or strenuous exercise, is important during recovery.
• In most cases, costochondritis is self-limiting and resolves within weeks to months. In some cases, however, symptoms may persist for a longer period or recur intermittently.

Prognosis

Costochondritis is generally a benign condition and typically resolves on its own within weeks to months. The prognosis for most individuals is favorable, and serious complications are rare. However, some people may experience persistent or recurring symptoms, which can impact their quality of life.

Prevention

While there is no guaranteed way to prevent costochondritis, certain measures can help reduce the risk of developing the condition:

• Practicing good posture: Maintaining proper alignment of the spine and chest can help minimize strain on the costochondral junction.
• Avoiding heavy lifting or strenuous activities: Reducing the frequency of activities that can strain the chest muscles may help prevent inflammation.
• Treating infections promptly: Seeking medical care for respiratory infections and other illnesses can reduce the risk of costochondritis caused by infections.
• Managing autoimmune conditions: If you have an autoimmune condition, working with your healthcare provider to manage the underlying disease may help prevent costochondritis.

See also

• Tietze syndrome: A similar condition that involves swelling of the costochondral junction.
• Intercostal neuralgia: A condition characterized by pain in the nerves between the ribs.
• Pleurisy: Inflammation of the lining of the lungs and chest cavity, which can cause chest pain similar to costochondritis.

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