The information in our articles is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. Costochondritis, a lesser-known cause of chest pain, is more common. In many cases, doctors do not know what causes costochondritis. The course of the condition is variable, lasting from weeks to months, but usually abating by one year. Taking cough suppressants to ease coughing and reduce pressure to the cartilage. Common recommendations include practicing costochondritis stretches, using heat or ice, considering anti-inflammatory foods, herbs or supplements, minimizing pain and trying transcutaneous electrical nerve stimulation (TENS). In severe cases or chronic costochondritis, numbing medicine or corticosteroids may be injected directly into the painful rib joints. The inflammation of the cartilage in the rib cage causes symptoms of costochondritis. The chest pain associated with costochondritis can be a symptom of fibromyalgia. Ni-Cheng Liang, MD. But costochondritis is not fatal. If those dont help with your pain and swelling, your healthcare provider may prescribe: If needed, your primary healthcare provider may refer you to a rheumatologist (a physician who specializes in diseases of the muscles, bones and joints) or a surgeon. For many people, symptoms disappear within a few days to several weeks. Use it to try out great new products and services nationwide without paying full pricewine, food delivery, clothing and more. With over 15 years of experience, Dr. Liang specializes in pulmonary and respiratory medical concerns, mindfulness teaching, physician wellness, and integrative medicine. Costochondritis, also called chest wall pain, costosternal syndrome, or costosternal chondrodynia, occurs when the cartilage between a rib and the breastbone (sternum) becomes inflamed and swollen. Trustworthy Source Children under age 18 should not take aspirin due to the increased risk for Reyes syndrome. Symptoms of costochondritis include: 2 Pain in the chest near the area where your ribs connect to your breastbone Chest pain when taking a deep breath Pain with changing positions, as when going from lying to sitting or sitting to standing Pain when bending forward If you have any of these symptoms, check in with your physician right away. Thus, cervical or shoulder problems may refer pain to the chest wall.2, Costochondritis can affect children as well as adults. Chest wall examination should include palpation with gentle pressure of the anterior, posterior, and lateral thoracic area, noting areas of tenderness. If someone has gone to a doctor for their symptoms and has been diagnosed with costochondritis, there are still some instances when a person should seek immediate medical attention again. Mild cases of costochondritis may disappear after a few days. Annually, doctors evaluate about 650,000 cases of chest pain in young people 10-21 years of age. Yes, the pain of costochondritis can sometimes spread (radiate) to your back. For TENS therapy, a small device sends weak electrical current to try to interrupt or mask the pain signals your body sends your brain. Other medical conditions that may closely resemble costochondritis include: A physical examination to detect tenderness of the cartilage to the touch may also be performed. The pain may span more than one rib joint and be aggravated by coughing or deep breathing. Costochondritis, also called chest wall pain, costosternal syndrome, or costosternal chondrodynia, occurs when the cartilage between a rib and the breastbone (sternum) becomes inflamed and swollen. Find out what's causing your shoulder blade pain and how to relieve your pain. In adults, costochondritis affects women more than men (70% vs. 30%). Pain in the chest and breastbone area is the chief symptom of costochondritis. A seizure that lasts longer than three to five minutes. Symptoms of costochondritis may mimic other conditions, including a heart attack . The pain may also spread to your stomach or back. It is present in 13 to 36 percent of these patients, depending on the study and the patient setting.1-3,6 In a prospective study of adult patients presenting to an emergency department with chest pain, 30 percent had costochondritis.1 A prospective study of episodes of care for chest pain in a primary care office network found musculoskeletal causes in 20 percent of episodes of care, with costochondritis responsible for 13 percent.14 These data are similar to a study of patients with noncardiac chest pain that found reproducible chest wall tenderness (although not specifically defined as costochondritis) in 16 percent of patients.3 A European study found a higher prevalence of musculoskeletal diagnoses in patients with chest pain presenting in primary care settings compared with hospital settings (20 versus 6 percent, respectively).15. With fibromyalgia, you may experience soreness in your chest in addition to: If you experience chest pains along with these other symptoms, talk with your doctor about getting tested for fibromyalgia. Severe burn, electric shock or lightning strike. Costochondritis most commonly affects adults over age 40. Tietzes syndrome causes visible chest swelling that continues after the pain is over. Copyright 2023 American Academy of Family Physicians. The effect of upper extremity movement on pain should also be noted, because moving the arm on the affected side will usually cause pain.2,11 Examination should also include auscultation of the heart and lungs, and examination of the skin for herpes zoster rash. It occurs in a single rib 70 percent of the time, usually within costal cartilages of ribs two through three, predominantly in rib two.1,2,6 Infectious, rheumatologic, and neoplastic processes may cause it. Repeat this three to four times daily. Costochondritis causes pain in the area where your sternum joins with your ribs. This article is based on scientific evidence, written by experts and fact checked by our trained editorial staff. Dominique Fontaine, BSN, RN, HNB-BC, HWNC-BC, pain that becomes worse when theres pressure on your chest, like when you wear a seatbelt, pain that intensifies with coughing or deep breaths, pain that increases with physical activity, 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, recently had a physical trauma or fall that affected the chest area, have allergies and are frequently exposed to irritants, oral steroids or injection of a steroid into the area involved, transcutaneous electrical nerve stimulation (TENS), which is a mild electric current that is delivered to the area via a small, battery-powered device, fatigue and inability to rest due to pain. 18 June 2021. Rarely is physical therapy or combined lidocaine (Xylocaine)/corticosteroid injections of the costochondral joints needed. Risk factors for costochondritis include: Once your pain has been confirmed as a costochondritis diagnosis, your physician will discuss medical treatment options. In adults, costochondritis affects women more than men (70% vs. 30%). People with costochondritis often experience chest pain in the upper and middle rib area on either side of the breastbone. Is ice or heat better for costochondritis? The pain may spread to your back, abdomen, or down your arm. An easy way to do this is to brace your forearm against a doorway and then slowly lean forward until you feel the muscles below and around your shoulders stretch. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. The following activities usually worsened the pain associated with costochondritis: The pain associated with costochondritis usually occurs on the left side of the body but can affect both sides. Most people will recover fully. You cant see the swelling caused by costochondritis. Costochondritis is a common condition seen in patients presenting to the physician's office and emergency department.1-4 It is also known as costosternal syndrome, parasternal chondrodynia, or anterior chest wall syndrome. You can tell the difference by the following: Tietze syndrome usually comes on all of a sudden, with chest pain spreading to your arms or shoulder and lasting several weeks. wikiHow marks an article as reader-approved once it receives enough positive feedback. More than one (in 90 percent of patients), Costochondral junctions most commonly affected, Arthritis of sternoclavicular, sternomanubrial, or shoulder joints, Tenderness to palpation of specific joints of the sternum; evidence of joint sclerosis can be seen on radiography, Analgesics, intra-articular corticosteroid injections, physiotherapy, Tenderness to palpation of costochondral junctions; reproduces patient's pain; usually multiple sites on same side of chest, Simple analgesics; heat or ice; rarely, local anesthetic injections or steroid injections, Destruction of costal cartilage by infections or neoplasm, Bacterial or fungal infections or metastatic neoplasms to costal cartilages; infections seen postsurgery or in intravenous drug users; chest computed tomography imaging useful to show alteration or destruction of cartilage and extension of masses to chest wall; gallium scanning may be helpful in patients with infection, Antibiotics or antifungal drugs; surgical resection of affected costal cartilage; treatment of neoplasm based on tissue type, Symmetric tender points at second costochondral junctions, along with characteristic tender points in the neck, back hip, and extremities, and widespread pain, Graded exercise is beneficial; cyclobenzaprine (Flexeril), antidepressants, and pregabalin (Lyrica) may be beneficial, Clusters of vesicles on red bases that follow one or two dermatomes and do not cross the midline; usually preceded by a prodrome of pain; postherpetic neuralgia is common, Oral antiviral agents (e.g., acyclovir [Zovirax], famciclovir [Famvir], valacyclovir [Valtrex]); analgesics as needed for pain; may require narcotics or topical lidocaine patches (Lidoderm) to control pain, Tenderness at sternoxiphoid joint or over xiphoid process with palpation, Usually self-limited unless associated with congenital deformity of xiphoid; analgesics; rarely, corticosteroid injections, Tenderness and hypermobility of anterior ends of lower costal cartilages causing pain at lower anterior chest wall or upper abdomen; diagnosis by hooking maneuver: curving fingers under costal margin and gently pulling anteriorlya click and movement is felt that reproduces patient's pain, Rest, physiotherapy, intercostal nerve blocks; or, if chronic and severe: surgical removal of hypermobile cartilage segment, A single tender and swollen, but nonsupportive costochondral junction; usually in costochondral junction of ribs two or three, Simple analgesics; usually self-limiting; rarely, corticosteroid injections, Traumatic muscle pain and overuse myalgia, History of trauma to chest or recent new onset of strenuous exercise to upper body (e.g., rowing); may be bilateral and affecting multiple costochondral areas; muscle groups may also be tender to palpation, Simple analgesics; refrain from doing or reduce intensity of strenuous activities that provoke pain. Our website services, content, and products are for informational purposes only. Over-the-counter pain relievers or analgesics might provide some temporary relief. While the pain associated with costochondritis may subside with time, some people with Tietze syndrome will still experience the swelling. It may spread to your back or belly. If your chest pain is severe, you should go to the emergency department. The painful areas of your chest look swollen, red, and feel warm to the touch. It usually gets better on its own over time. Your healthcare provider might first recommend over-the-counter medications that can help reduce the swelling and pain in your chest. Lie on your stomach while supporting yourself on your elbows. Learn what you can do and when you should see a doctor. The pain is often exacerbated by upper body movement, deep breathing, and exertional activities.3 History of an antecedent illness with coughing, recent strenuous exercise, or physical activities that stress the upper extremity is common. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, http://kidshealth.org/en/teens/costochondritis.html#, http://www.aafp.org/afp/2009/0915/p617.html, https://rarediseases.org/rare-diseases/tietze-syndrome/. It usually takes a few days to a few weeks for costochondritis to resolve, but some people have symptoms for up to a year. Costochondritis is caused by inflammation and typically presents as chest pain that gets worse with certain movements or pressure. Costochondritis often resolves without treatment. It may be painful to touch your chest. Although the pain is typically felt . Cartilage is the tough, bendable tissue that protects your bones. Exert yourself in a rare way, like moving furniture or reaching into a high cupboard. 2005 - 2023 WebMD LLC. Costochondritis only causes pain in your chest, which sometimes travels to your back and stomach. Noninfectious costochondritis will go away on its own, with or without anti-inflammatory treatment. ANNE M. PROULX, DO, AND TERESA W. ZRYD, MD, MSPH. Normally, treatment of the inflammation and pain causes costochondritis to eventually go away on its own. An estimated 13-36 percent of those who seek emergency medical attention for chest pain are experiencing costochondritis. This can also include breathing, which can cause an increase in pain with large breaths. Costochondritis exercises may be very helpful in managing sternum pain. Symptoms of Costochondritis The obvious leading symptom is chest pain, typically it is described as a sharp or stabbing pain, and sometimes it is described as more of a dull ache which often becomes worse when moving or exerting the chest muscles. One prospective study found that one third of patients had persistent chest wall tenderness at one year.17 Adolescents may also have a chronic course.4 Patients with costochondritis should be educated and reassured that this is a benign condition that will eventually resolve itself. MNT is the registered trade mark of Healthline Media. Discrete areas of tenderness can be better localized by palpation with a single digit. What are the complications of costochondritis? Treatments can help relieve your symptoms. Whats Causing Pain in the Right Side of My Chest? This article was co-authored by Ni-Cheng Liang, MD. The condition causes chest pain, but its typically harmless and usually goes away without any treatment. Last medically reviewed on November 19, 2021. Approved. Can diet help improve depression symptoms? Our team aims to be not only thorough with its research, but also objective and unbiased. When there is swelling present, the condition is called Tietze syndrome (also known as chondropathia tuberosa or costochondral junction syndrome). Costochondritis. There are 8 references cited in this article, which can be found at the bottom of the page. Suggestions include: Although you might be willing to try anything to reduce the pain or speed your recovery from costochondritis even make changes to your diet theres really nothing you eat or drink that affects how you heal from costochondritis. There are many possible causes of costochondritis pain. wikiHow is where trusted research and expert knowledge come together. High fever that doesnt get better with medicine. While it lasts, you may wish to try conventional treatments and natural remedies to help ease symptoms. The main symptoms of costochondritis are pain and soreness in the chest. This condition usually isnt persistent. Costochondritis is a common diagnosis in people with chest pain. When this cartilage becomes inflamed, the condition is known as costochondritis or chest wall pain. Costochondritis is a painful condition caused by inflammation in the cartilage that connects the ribs to the breastbone. Pain may ease a little when the child stops moving or takes shallower breaths. In general, the exercises focus on stretching the arms, thorax, back and chest muscles. These can move from joints and. Ribs eight through 10 attach in front to the cartilaginous portion of the rib above them and often have synovial-lined interchondral articulations. Your doctor may tell you to make permanent lifestyle changes if you have persistent or chronic costochondritis. Key sign is pain on palpation of costochondral joints (particularly the second to the fifth). If you have costochondritis, youll feel pain that may start on the left side of your chest and spread (radiate) out to the rest of your chest. It may get worse when you move, breathe deeply, or push or lift an object. After 1520 minutes, remove the ice pack and give your skin a chance to warm up. Trouble breathing/shortness of breath, or if you stopped breathing for any reason. Tietze syndrome is a rare inflammatory condition that causes chest pain and cartilage swelling near your upper ribs. Food delivery, clothing and more purposes only, lasting from weeks to months, but also and! For chest pain in the chest and breastbone area is the tough, bendable tissue that protects your bones with. As costochondritis or chest wall examination should include palpation with a single digit what 's causing your blade. Of age known as chondropathia tuberosa or costochondral junction syndrome ) in rare... A high cupboard a heart attack than men ( 70 % vs. costochondritis symptoms!, abdomen, or push or lift an object physician will discuss medical treatment options breathe! In this article was co-authored by Ni-Cheng Liang, MD try conventional treatments and natural remedies to ease. 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