Costochondritis

The exact cause of costochondritis is largely unknown but it can be in response to an infection or an injury to the chest wall. It can also occur from straining, over-exertion from exercise, severe coughing bouts or wear and tear over time (including some types of arthritis).

What are the symptoms of costochondritis?

This is typically a sharp, stabbing type of pain, felt at the front of the chest and is worse on moving, breathing deeply or exertion. It can be a severe pain but also sometimes a general constant ache. Pressing on the affected part of the chest makes the pain worse (if this doesn’t happen, it’s unlikely to be costochondritis), and is usually over a small area only. The pain can come and go, settling if you change position or practice shallow, quiet breathing. Although it can happen anywhere on the chest, the usual places it’s felt are close to the breastbone and at the level of the 4th-6th ribs. There are no visible lumps or swellings with costochondritis.

If you have chest pain, you should discuss it with your doctor. With chest pain it’s important to seek immediate medical attention to rule out the possibility of a heart attack: any symptoms of sweating, shortness of breath, pain radiating to the arm or jaw are more associated with a heart attack. Pain when pressing the area, moving, and feeling more like a muscle pain are more likely to be costochondritis, which is not an emergency, but your doctor or emergency department can distinguish between them.

Your doctor will take a history from you and examine your chest area, which is usually tender when pressed or with certain movements. They will consider your medical history and medication and although there is no specific test to diagnose costochondritis, your doctor may do some tests and investigations (like bloodwork, an ECG and a chest X-ray) to rule out more serious causes. If these are all normal or all the symptoms clearly point towards costochondritis, then the diagnosis is made.

It’s important to try and rest your chest area in order to speed up the recovery process and this may mean taking time away from exercise or from work if your job requires a lot of movement or strenuous lifting. 

You can do simple things at home like applying heat to soothe the area and take simple painkillers like ibuprofen or acetaminophen to manage the pain and inflammation.  If simple medication isn’t helping or your symptoms are persisting for several weeks, your doctor may recommend you see a physiotherapist for stretching exercises and even a specialist health professional who may consider steroid injections to reduce joint inflammation. 

TENS machines can also be purchased and may work on an individual basis for pain relief. This works by sending a mild electric current to the affected area in efforts to distract pain signals coming from the brain.