Costochondritis is an inflammation of the cartilage of the rib cage. It usually involves the upper ribs near the top of the breastbone. It is most common in women and in those over age 40. Tietze’s syndrome (after the German physician who identified it) is a similar condition that generally affects young adults and occurs in both sexes with equal frequency. The symptoms of chest pain and tenderness, which can come on gradually or suddenly, vary from mild to intense. The pain is often aggravated by body movement and may radiate to the shoulder or arm. Even though costochondritis is not a serious disorder, it may cause great anxiety, since the intense chest pain can be mistaken for that of a heart attack. The condition may last for a week, or up to several years. While some patients experience recurrent episodes, spontaneous and permanent remission is the norm.
What Causes Costochondritis?
- The cause of costochondritis is unknown in the majority of cases.
- Costochondritis may result from an injury or blow to the chest or even from an episode of especially vigorous coughing.
- Costochondritis may be one feature of polyarthritis (widespread inflammation of cartilage).
Symptoms of Costochondritis
- Chest pain, usually in the front of the rib cage. The pain is exacerbated by movements that change the position of the ribs or by the direct application of pressure on the affected region.
- Swelling of the tissues around the breastbone may occur.
- Anxiety and hyperventilation during acute episodes of pain occur rarely.
Prevention of Costochondritis
- Wear protective gear when playing sports.
- Physical examination and patient history are needed.
- A chest x-ray, an electrocardiogram (a test to monitor the heart’s electrical activity), and blood tests may be performed to rule out more serious underlying disorders, including heart and lung diseases.
- Bone scan may be performed to detect cancer in the bones
How to Treat Costochondritis
- Rest and avoid exercises or movements that aggravate the inflammation and cause pain; symptoms generally disappear on their own over time.
- Take acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to relieve pain.
- Applying heat (for example, with a heating pad) may provide relief.
- Corticosteroid injections may be used to reduce pain and swelling in more severe cases.
When to Call a Doctor
- The pain of costochondritis is not serious. However, any intense chest pain warrants immediate emergency medical evaluation, since it may be a sign of a more serious problem, such as a heart attack.
Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference
Simeon Margolis, M.D., Ph.D., Medical Editor
Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50
Updated by Remedy Health Media