Costochondritis: Symptoms, Causes & Treatment
Costochondritis is inflammation of the cartilage between one or more ribs and the breastbone (sternum). It is also known as anterior chest wall syndrome, costosternal syndrome or parasternal chondrodynia. It can affect people of all ages and will go away on its own over time. Although the symptoms may be uncomfortable, costochondritis is not dangerous.
Costochondritis usually gets better on its own, but the time it takes varies. Normally, the pain takes a few weeks to recover, while in some cases, it may exceed a month or more.
Symptoms of Costochondritis
The main symptoms of costochondritis are pain and tenderness at the joint of the ribs and sternum due to inflammation of the cartilage tissue between the bones. The pain increases with movement and deep breathing and decreases with rest and even breathing. Pressure applied directly to the affected area also causes significant pain.
The pain may vary in frequency but is often severe. It can be described as pressure pain, or stabbing pain. It is usually in the chest but can also spread to the back, abdomen, arms or shoulders.
The pain is usually only on one side of the chest, most often the left side, but it can affect both sides of the chest at the same time.
Causes of Costochondritis
Often, there is no clear cause for costochondritis. It may be associated with a chest injury or with unusual or stressful physical activity (for example heavy lifting or profuse coughing). Costochondritis can occur in people undergoing respiratory illness such as a cold or flu and underlying conditions, such as fibromyalgia, systemic lupus erythematosus and ankylosing spondylitis.
Costochondritis affects women more often than men and is more common in adolescents and young adults.
Risk Factors of Costochondritis
Those at higher risk of developing costochondritis include-
- Women (70% of cases are women).
- Those engaged in hard manual work.
- People who do strenuous sports or high-impact activities.
- People who tend to cough or sneeze frequently.
Medical conditions related to Costochondritis
Tietze syndrome has similar symptoms like costochondritis. However, Tietze syndrome involves swelling of the joints while costochondritis does not. Tietze syndrome occurs in people under the age of 40, while costochondritis can affect all age groups.
Chest wall pain can also occur with other conditions, such as-
Fibromyalgia-Fibromyalgia is a disease that causes widespread musculoskeletal pain and fatigue. Chest wall pain is more common in patients with fibromyalgia.
Arthritis-Inflammation of the chest wall may also be seen in rheumatoid arthritis or other inflammatory joint conditions such as ankylosing spondylitis, psoriatic arthritis or lupus.
Infection-Infection can cause pain and swelling in the joints, among other symptoms.
Tumors-Rarely, both cancerous and noncancerous tumors can develop on the chest wall.
How to diagnose Costochondritis?
To diagnose costochondritis, your doctor will first perform a complete medical examination by asking about your symptoms, recent activities or medical conditions that may be contributing to the cause. He or she then performs a physical examination by listening to heart and lungs, and palpating the ribs and chest wall.
If your doctor is concerned about something other than costochondritis that is causing chest pain then, he or she may recommend blood tests, electrocardiography, or a chest X-ray to gather more information.
Treatment for Costochondritis
Your doctor may prescribe the following medications-
Nonsteroidal anti-inflammatory drugs (NSAIDs)- NSAIDs prescribed by your doctor can help reduce inflammation and pain. These medications have potential side effects when used in excess or by someone with another health condition, so use them with caution. Side effects include damage to the kidneys, liver, and stomach or worsening of heart failure. You may also be prescribed a topical form that has fewer side effects.
Physical Therapy-Physical therapy, also known as physiotherapy can help relieve chest pain.
Muscle relaxants-Muscle relaxants, such as cyclobenzaprine (Flexeril) are sometimes used for pain relief.
Antidepressants-There are several prescribed antidepressants that help relieve pain from persistent costochondritis. If costochondritis is causing you constant pain, tricyclic antidepressants (such as amitriptyline) can help.
Anti-seizure drugs -Gabapentin, an epilepsy medication, can also help relieve persistent pain.
Injections-Topical injections of pain relievers/steroids into the joint are rarely used but can be helpful in very persistent and severe cases.
Home Remedies for Costochondritis
Heat-Try using a warm pad or hot compress on a low setting for short periods of time several times a day.
Rest-Avoid activities that cause pain, take more rest as possible if you can.
Over-the-counter (OTC) pain relievers-Over-the-counter pain relievers such as naproxen sodium (Aleve), ibuprofen (Advil), or acetaminophen (Tylenol) can help control pain. OTC pain relieving creams for topical use can also provide relief.
Avoid coughing-If coughing is causing your symptoms, over-the-counter cough suppressants can help prevent attacks.
Stretches-Simple stretches that help open your chest muscles a little can help you feel better.
When to see a doctor?
Whenever you experience chest pain, you should see a doctor immediately to rule out something more serious. For example, if you experience chest pain along with other symptoms such as shortness of breath, nausea, sweating, dizziness, or left arm pain, this may be a sign of a severe health disease and you should see a doctor immediately.
If you have been diagnosed with costochondritis, you should see a doctor if you experience any of the following symptoms-
- Difficulty breathing.
- Signs of infection such as pus or redness.