Costochondritis is inflammation of the cartilage connecting the ribs and breastbone. It can cause a stabbing, burning, or aching pain in the chest wall. Coughing and a blow to the chest are among the causes.

The ribs are connected to the breastbone by tough, protective tissue called cartilage. When this cartilage becomes inflamed, the condition is known as costochondritis or chest wall pain.

While this condition is usually temporary, it can be alarming, as the pain can become so significant it mimics a heart attack.

Doctors may also refer to costochondritis as costosternal syndrome or costosternal chondrodynia. The condition will usually resolve on its own with home treatments.

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Though causes are often unknown, in some instances, the condition can be the result of one or more of the following:

  • an injury to the chest
  • repetitive upper body movements, like lifting
  • coughing a lot
  • a problem with the joints in the back
  • an underlying condition like fibromyalgia or rheumatoid arthritis
  • a chest infection
  • radiation therapy

However, the condition is most commonly idiopathic – meaning no known cause exists.

Chest discomfort and pain may be stabbing, burning, or aching in nature. The ribs most affected are the second to fifth ones.

The condition most commonly affects people ages 40-50 years old.

According to an older study, an estimated 13-36% of those who seek emergency medical attention for chest pain are experiencing costochondritis.

Upper body movement and deep breathing usually worsen the pain associated with costochondritis.

The pain associated with costochondritis usually occurs on the left side of the body but can affect both sides.

Tietze syndrome

There is a variation of costochondritis called Tietze syndrome. This condition causes pain associated with costochondritis and swelling of the rib cartilage.

The swelling of Tietze syndrome affects at least one of the upper four ribs, usually the second or third ribs. While the pain associated with costochondritis may subside with time, some people with Tietze syndrome will still experience the swelling.

Although doctors have not defined how prevalent this condition is, they consider it a rare disorder. Besides pain and discomfort, it does not cause any long-term harmful effects.

Doctors usually treat costochondritis conservatively. Resting and avoiding strenuous exercise that affects the chest wall can help. So can over-the-counter pain relievers, such as acetaminophen or ibuprofen.

Children under age 18 should not take aspirin due to the increased risk for Reye’s syndrome.

In rare instances, a doctor may recommend injections of lidocaine or corticosteroids to reduce pain and inflammation. Other treatments that may help to relieve chest pain include:

  • Applying moist heat by way of warm compresses.
  • Taking cough suppressants to ease coughing and reduce pressure on the cartilage.
  • Physical therapy to ease tension in the chest wall.

If these treatments do not reduce a person’s incidence of costochondritis, they should seek a follow-up with their doctor.

If a person has chest pain, they should not try to determine whether it is a heart-related issue or costochondritis. Instead, they should seek immediate medical attention.

If a younger person who is not at risk of heart attack experiences these symptoms, they should seek emergency attention if their chest pain is sharp and does not improve with rest.

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. These include:

If chest pain radiates to the arms, neck, shoulder, jaw, or back, a person should seek immediate medical attention.

Doctors often diagnose costochondritis by ruling out other potential causes of the chest pain and discomfort connected with the condition. For example, if a person is older than 35, a doctor may first want to rule out coronary artery disease (CAD) as a potential cause.

Individuals who are at risk of CAD, such as those with a family history, those who are obese, or those with a history of smoking, should usually have an electrocardiogram (ECG or EKG) and chest X-ray to check for CAD.

Other medical conditions that may closely resemble costochondritis include:

  • arthritis of the shoulder or nearby joints
  • chest wall infections
  • fibromyalgia, a condition that causes nerve pain
  • slipping rib syndrome, when there is too much mobility in the cartilage supporting the ribs
  • injuries to the shoulder or neck that cause pain to refer or travel to the chest wall

A doctor will perform a physical examination to detect tenderness of the cartilage to the touch. If a person is having a heart attack or has another type of heart condition, the cartilage in the chest is not usually sensitive to the touch.

The doctor will also listen to the heart and lungs and examine the skin for signs of infection. An X-ray or other imaging studies will not show signs of costochondritis.

Doctors can usually diagnose a child, adolescent, or young adult by asking questions about their medical history and conducting a physical exam. As part of this, the doctor will often check for tenderness in the chest cartilage.

Costochondritis can last from a few weeks to months. It may also recur if it is caused by physical exercise or strain.

The condition does not usually last longer than one year. However, adolescents with costochondritis can sometimes experience a longer period of symptoms.

Below are some commonly asked questions about costochondritis.

What helps costochondritis go away?

Generally speaking, costochondritis will get better on its own over time. However, over-the-counter medication like acetaminophen or ibuprofen can help with pain and inflammation.

How does a person test for costochondritis?

There is no specific test to diagnose costochondritis.

However, a doctor will usually make a diagnosis based on a combination of a physical examination, medical history, and additional tests (to rule out other conditions). These other tests may include:

What not to eat when a person has costochondritis?

While no specific foods directly cause or exacerbate costochondritis, certain foods or ingredients may contribute to inflammation in the body. This, in turn, could potentially worsen symptoms for some individuals.

Some examples include:

Learn more about foods that cause inflammation.

Costochondritis, inflammation of the cartilage connecting the ribs and breastbone, leads to chest pain, which is often stabbing or burning in nature.

It usually has no known cause but can result from chest injuries, repetitive movements, or underlying conditions like fibromyalgia.

While mostly temporary, the pain can mimic a heart attack, necessitating medical evaluation to rule out other serious conditions.

Treatments range from rest and pain relievers to injections or physical therapy.

It’s crucial to seek medical attention if symptoms worsen or if chest pain is accompanied by certain symptoms, such as lightheadedness or an irregular heartbeat.