Chest Pain

Common Questions about Costochondritis And The Answers

costochondritis

What is costochondritis and how is it defined? 

According to the Mayo Clinic, costochondritis occurs when the patient has inflammation of the cartilage that connects the breastbone to a particular rib.

The pain from this inflammation is similar to the pain a person would feel when having a heart attack or other heart issues.

A variety of terms are used to identify costochondritis, which includes costosternal syndrome, chest wall pain, and costosternal chondrodynia. If the swelling is present, the issue is typically Tietze Syndrome and not costochondritis.

Costochondritis can disappear on its own. However, it can last for weeks or longer. If more information is needed about the definition of costochondritis, physical therapists, Bob Schrupp and Brad Heineck, have created a six-minute YouTube video called “Pain in Chest? Is it Costochondritis?”.

In this video, these experts provide a breakdown of costochondritis. This article will expand on the discussion seen in the video.

What are some interesting facts about costochondritis? 

According to this eMedicine Health article, some facts associated with costochondritis include:

  • It affects females more than males at a ratio of 70% to 30%.
  • This disease accounts for 10% to 30% of all chest pain issues in children.
  • The peak age for costochondritis is people over 40 years old.
  • Physicians exam around 650,000 cases of costochondritis every year.
  • Costochondritis is the leading cause of musculoskeletal chest pain.
  • Costochondritis does not cause swelling.

What are some of the common causes of costochondritis? 

Costochondritis comes from an inflammation process, but the definite cause has yet to be determined. According to WebMD, three items can contribute to chest pain caused by costochondritis.

These three items are minor trauma to the chest area, viral respiratory infections, and the overuse of the arms.

Bacterial infections associated with costochondritis can happen in IV drug users and those patients who have had surgery in the upper chest area.

This fact is true because, after surgery, the blood flow in the area of the operation is reduced. This reduction causes the cartilage to become more prone to infections.

WebMD also states that some of the most common infectious diseases that can cause costochondritis are:

  • Viral- Viral diseases cause costochondritis because of straining from coughing and the inflammation from the actual infection.
  • Bacterial- After surgery, bacterial infections can cause costochondritis.
  • Fungal- While fungal infections can cause costochondritis, it is scarce.

What are some common symptoms of costochondritis? 

The most predominant symptom of costochondritis is a pain in the area of the upper ribs. This pain is caused by inflammation, which is the primary trigger of costochondritis.

Typically, this inflammation is located where the upper portion of the ribs meets the breastbone or sternum. This area is referred to as the sternocostal joint or costosternal articulation.

The symptom of pain is localized but can vary in intensity. Some individuals have experienced very mild pain while others experience intensely debilitating pain.

In mild cases, the chest may be tender to the touch. In more severe cases, shooting pains may travel to your limbs, back, and abdomen.

When should a person seek medical care for costochondritis? 

If an individual is experiencing any of the following symptoms, he or she should seek medical care:

  • Breathing trouble
  • Redness, pus, swelling, or other signs of infection
  • Pain worsens with medication
  • High fever
  • Dizziness when sitting or standing
  • Nausea or excessive sweating

However, WebMD reminds patients that the following symptoms are not typically associated with costochondritis and may indicate a more pressing issue:

  • Fevers about 100° that do not respond to fever-reducers
  • Pus, redness, extreme pain, swelling, and other signs of infection at the tender spot
  • Chest pain that is not localized (This type of chest pain can be persistent and may be accompanied by sweating, nausea, and left arm pain. If a person is experiencing this type of chest pain, it may be signs of a heart attack.)

WebMD encourages a person to go directly to an emergency room or urgent care center if he or she is having any of these conditions or any breathing trouble.

How does a physician diagnose costochondritis? 

A physician will evaluate the patient’s health history first and then complete a physical exam. During the physical exam, the doctor will feel along the breastbone where it connects to the ribs.

He or she will apply pressure to this area looking for tenderness or swelling. The doctor may also move the arms and rib cage in different formations. He or she does this to trigger the patient’s symptoms.

The pain a patient feels with costochondritis mimics the pain a person feels with other medical issues. These conditions include osteoarthritis, gastrin intestinal problems, heart disease, and lung disease.

Since there is not a particular test to diagnose costochondritis, the physician will perform tests and exams to rule out the other conditions with similar symptoms as costochondritis.

What exams and tests can be performed to diagnose costochondritis? 

Because there isn’t a specific test to diagnose costochondritis, a physician will typically explore the patient’s medical history or perform a physical exam to diagnose the condition.

It is important to note that a physician may utilize a variety of tests to rule out the possibility of other conditions with similar symptoms. One of the more dangerous situations that have similar symptoms is heart disease.

The first exam will involve the fourth to sixth ribs. A doctor will try to reproduce the pain or tenderness. He or she will also feel for swelling. If the swelling is present, the patient may have Tietze Syndrome and not costochondritis.

Sometimes a doctor will order blood work and a chest x-ray. Neither of these tests can help diagnose costochondritis, but both can help to identify heart disease or infection.

According to Healthline, if your physician believes infection is the cause of the pain, he or she will do the following physical exams and tests:

  • Look for pus, redness, drainage, and swelling
  • Ask for a gallium scan to be performed
  • Evaluate the white blood cell count
  • Ask for a chest x-ray to check for pneumonia
  • Ask for ECG or other heart tests to help eliminate heart issues as a cause

What current methods are used to treat costochondritis condition?

Costochondritis is not treated itself; however, the pain and inflammation caused by the condition are treated. A variety of methods are used to ensure relief from the pain.

These methods include home remedies, medications, exercises, natural remedies, prescription therapies, and surgery.

What are some home remedies used to relieve pain from costochondritis? 

After the patient has been diagnosed with costochondritis, he or she has a variety of treatment options. One of these options involves utilizing home remedies.

Some home remedies associated with relieving the pain caused by costochondritis include: 

  • Using heat and ice on the area to relieve acute pain
  • Reduce or eliminate unnecessary exercises and activities that worsen the symptoms
  • Complete stretching exercises daily
  • Take nonsteroidal anti-inflammatory medications (Advil, Motrin, Aleve)

What are some of the leading medications for costochondritis? 

In most cases of costochondritis, the condition goes away within a few weeks, regardless of treatment. Typically, the treatment involves providing relief from the pain. Prescription medications may be used to make the healing process more bearable.

The four types of conventional drugs a doctor may prescribe are anti-seizure drugs, narcotics, antidepressants, and nonsteroidal anti-inflammatory drugs or NSAIDs.

One example of an anti-seizure drug used to control chronic costochondritis pain is gabapentin. Hydrocodone and oxycodone are narcotics that are sometimes prescribed to control severe pain.

When a person is losing sleep due to the pain associated with costochondritis, a doctor may prescribe tricyclic antidepressant amitriptyline. This drug is an antidepressant used to control chronic pain.

The most common prescription medicine used for costochondritis is NSAIDs. These types of drugs include ibuprofen, Motrin, and other stronger varieties.

A physician will offer other treatment options before prescribing these medications because each one has side effects.

NSAIDs have been blamed for stomach lining and kidney damage. Narcotics are incredibly addictive and habit-forming.

Antidepressants have a connection to an increased chance of developing bipolar disorder and mania.

What type of exercises can be used to treat costochondritis? 

When a doctor recommends exercises for the treatment of costochondritis, he or she is referring to stretching exercises.

Strenuous physical activities can cause costochondritis to be triggered or worsen, while stretching can actually have a relieving effect on the patient.

According to Dr. Mercola, a study involving the use of NSAIDs found that patients did not have any relief until stretching exercises were added to the treatment plan.

An example of a stretching exercise consists of the patient holding his or her arms up where the arm is bent parallel to a wall. The patient applies pressure to the wall while twisting in the opposite direction.

What natural remedies can be used to treat costochondritis? 

A variety of options are available to treat costochondritis pain naturally. Some experts believe a few simple changes to a person’s lifestyle can treat costochondritis. One of the first steps a patient should take is changing eating and exercising habits.

The best food diet for a person who suffers from costochondritis pain is an anti-inflammatory diet. According to Dr. Mercola, this diet includes foods high in antioxidants, minerals, vitamins, and essential fatty acids.

Nuts, green leafy vegetables, seeds, and bone broth are some examples of anti-inflammatory foods. Eliminating or avoiding sugars and refined grains are also part of a costochondritis healthy diet.

Exercise is excellent, but a person with this condition should avoid activities that involve sharp or sudden movements that apply pressure to the chest.

Another natural remedy is to use analgesic and anti-inflammatory herbs. These herbs include ginger, fennel, ginseng, devil’s claw, chamomile, and Gotu Kola.

Are there any prescription therapies available to treat costochondritis? 

When home remedies and other treatments do not work, WebMD states some physicians will prescribe a variety of interventions to encourage relief from the pain associated with costochondritis.

Physical therapy is one of these interventions. This type of treatment involves utilizing physical methods to treat a variety of injuries.

These physical methods include heat treatment, exercise, and massage. Physical therapy is known to be excellent in treating a variety of musculoskeletal pain.

Another intervention is local injections lidocaine and corticosteroids. When the costochondritis pain is severe and does not respond to other treatments, a physician may recommend these types of steroids to provide relief.

However, these types of prescription therapies are typically saved as a last resort.

Can surgery be performed to treat costochondritis? 

If a person has tried home remedies, medications, exercise, natural remedies, and prescription therapies without experiencing relief from costochondritis, a physician may explore surgery as a treatment option. Surgery is considered to be a drastic method for treating costochondritis.

This fact is especially true because costochondritis typically heals itself within a few weeks. One example of a surgical cure for this condition is removing the painful cartilage. This procedure is an invasive process with its own risks.

It would take time for a person to heal from the procedure thoroughly. During the healing process, a person may experience pain similar to costochondritis making the treatment as painful as the condition.

Before choosing surgery as a treatment option, a person should talk to the physician to ensure the patient has a complete picture of the situation.

What is the best treatment for costochondritis? 

A variety of doctors have very different opinions on this subject. Some physicians would say medicine, while others would say therapy exercise. The Mayo Clinic would suggest a combination of treatments in stages.

If the condition has been identified and no other more serious conditions are present, lifestyle changes and home remedies should be used.

If the patient’s condition worsens or the pain is not relieved, stretching exercises or nerve stimulation can be added to the treatment pain.

When the pain from costochondritis is extreme, medications prescribed by a physician may become necessary.

How to find relief from costochondritis? 

The only way to find relief from costochondritis is to alleviate the pain using the above methods.

These methods include using medications or using pain-relieving creams. Stretching exercising may provide relief from the pain of costochondritis.

A variety of home remedies and natural remedies are also available to help lessen the pain associated with costochondritis.

With treatment, the pain should gradually decrease with a few days. Without treatment, symptoms will also lesson, but it may take much longer.

Are there ways to prevent a person from developing costochondritis? 

Although costochondritis is a relatively harmless condition, it can be irritating and painful. The fabulous news is it may be almost entirely preventable according to Dr. Mercola supports the idea that to prevent costochondritis; the patient must avoid triggers.

These triggers are the items that put the sternocostal joint or the costosternal articulation in jeopardy of becoming inflamed.

Physical strain is one of the primary triggers associated with costochondritis. Dr. Mercola gives the following tips to avoid injuries from exercising:

  • The patient should always warm-up so the core temperature is increased and blood flow is boosted.
  • The individual should have a variety of routines to give the different muscles a break while still working out.
  • If an individual doesn’t know how to start an exercise regiment, a personal trainer should be considered to avoid injuries.
  • A person needs to ensure to eat the types of foods that help repair muscles and help people stay hydrated.
  • The right workout clothes can also help prevent exercise injuries.

Besides physical strain, infections are the second most common reason inflammation happens. The best way to fight infections is to keep the immune system in optimal working condition.

This fact can be accomplished by eating right, sleeping enough, getting probiotics, and decreasing stress.

Who is at risk for developing costochondritis? 

According to Healthline, costochondritis can affect anyone of any age, but it appears more often in women and those who are over the age of 40.

If a person participates in the following activities, he or she is also at a higher risk of developing costochondritis:

  • Men and women who engage in high-impact activities such as vigorous exercises.
  • Men and women who perform manual labor as a career.
  • Individuals who are exposed to massive quantities of irritants or have extreme allergies.

A variety of other health conditions can also increase the risk of having or developing costochondritis.

These health conditions include rheumatoid arthritis, fibromyalgia, pregnancy, ankylosing spondylitis, and reactive arthritis.

It is also vital to mention that when heavy loads are mishandled, it can stress the muscles of the chest.

Young adults and children should use care when lifting heavy bags and backpacks. Adults should use caution when performing manual labor.

What are some complications of costochondritis? 

When costochondritis causes long-term pain, it can be debilitating when left untreated. However, if the inflammation and pain are treated, costochondritis typically goes away on its own according to Dr. Mercola.

Sometimes the pain associated with costochondritis can indicate other conditions such as heart disease and fibromyalgia.

After evaluating these facts, it is safe to assume there are no serious complications related to costochondritis unless it develops into chronic costochondritis.

What is chronic costochondritis and is it curable? 

Chronic costochondritis is when the pain and inflammation associated with the condition last for a prolonged period. If a person has developed chronic costochondritis, the pain may go away and then return even with treatment.

Specific activities and exercises may trigger a chronic costochondritis episode. If a person develops a chronic case of this condition, he or she needs to investigate long-term care.

Long-term care can ensure this chronic condition does not affect the individual’s quality of life or ability to engage in daily activities.

Chronic costochondritis can last for weeks, but most chronic cases do not last longer than one year.

A person can decrease the chances of developing chronic costochondritis by following doctor’s orders and carrying and lifting heavy loads correctly.

He or she should also reduce the amount of high-impact exercises and manual labor performed.

What is the prognosis for people who have costochondritis? 

According to WebMD, the prognosis of costochondritis recovery is excellent. Typically, most patients see a complete lessening in the condition within a few days to six months.

After one year, only 50% of patients complain of mild discomfort, and 33% complain of tenderness with palpation. In both cases, a complete recovery is almost 100%.

Is costochondritis life threatening?

Some individuals who suffer from costochondritis would say the pain feels like they are dying. However, in reality, costochondritis is not fatal.

If a patient has only costochondritis, he or she is in no danger of dying, but it is incredibly critical for the patient to rule out any other significant conditions that may be adding or causing the pain.

It is essential to know if the symptoms are caused only by costochondritis because other conditions may be life-threatening if left untreated.

Is costochondritis hereditary? 

According to Healthline, costochondritis involves the cartilage where the ribs meet the breastbone.

An inflammation of this cartilage causes the pain. Similar to other inflammation diseases, the exact cause of costochondritis is not known at this time.

However, many experts believe heredity or a genetic predisposition, trauma, or a virus may play a role in costochondritis developing.

How long does costochondritis last? 

Dr. Mercola states that typically, costochondritis is not a persistent condition. It will almost always go away on its own even without treatment.

When a person experiences mild costochondritis, the pain and other symptoms may go away in a few days.

However, chronic cases can last from weeks to months in some cases. If a person avoids excess manual labor and high-impact exercises, the condition may heal faster. This fact is also true if the person gets plenty of rest and sleep.

Regardless of whether the costochondritis is minor or a chronic case, very few patients experience any symptoms for longer than a year.

How are costochondritis and Tietze’s syndrome different? 

According to Scotland’s National Health Information Service, Tietze’s syndrome is frequently confused with costochondritis.

This confusion occurs because both conditions involve the costochondral joint being inflamed. Both conditions can also cause other remarkably similar symptoms.

A significant difference between the two conditions is costochondritis is somewhat common while Tietze’s syndrome is much less common. Tietze also causes chest swelling. This swelling can last long after the tenderness and pain have gone away.

Typically, if a person has costochondritis, he or she does not experience any swelling, and the pain is localized.

Another significant difference is costochondritis affects adults over 40 while Tietze’s syndrome usually happens to people under the age of 40.

Can RA cause costochondritis?

RA stands for Rheumatoid Arthritis which is a chronic condition. This condition causes joint pain, stiffness, and swelling.

It also can cause fatigue and muscle pain. The primary cause of RA is the body’s immune system is making too much TNF-alpha and other proteins.

Most of these proteins being overproduced encourage inflammation which causes the above RA symptoms.

Even though costochondritis is not directly related to Rheumatoid Arthritis, the condition can increase the likelihood of injury or damage to the rib cage.

When a person has RA, his or her joints do not work correctly. This fact means he or she can quickly move the wrong way and cause more damage to already weakened or damaged joints.

In conclusion, costochondritis and RA are connected, and the symptoms associated with RA can promote costochondritis.

Is costochondritis related to arthritis?

Almost every joint in a person’s body can develop some form of arthritis. The general arthritis term translates as joint inflammation.

This term can be used to describe over 100 different joint diseases. Some types of arthritis even affect other sections of a person’s body.

It can affect the internal organs and skin causing a rash or fever. The inflammation caused by arthritis can lead to damage to tissue if the individual has suffered for prolonged time periods.

Inflammatory arthritis is an autoimmune disorder where the body sends messed up messages to the white blood cells.

These messages cause the blood cells to attack the tissues of the body. This attack can lead to inflammation which in turn can be described as costochondritis.

So according to the Mayo Clinic, arthritis can be related to costochondritis because of this inflammation.

Can anxiety cause costochondritis?

According to the Mayo Clinic, there isn’t a confirmed link between costochondritis and stress and anxiety at this time. However, stress and anxiety can be a reason behind chest pain.

When a person has a panic attack or a panic disorder, he or she may experience shortness of breath as well as tightness or pain in the chest area as symptoms.

Some of the treatments for anxiety and stress can alleviate the pain caused by costochondritis.

These treatments include acupuncture, yoga, massage, breathing exercises, and stretching. While these treatments are reducing the person’s stress and anxiety levels, they are also helping the individual to relax which is also an excellent treatment for costochondritis.

How does pregnancy affect costochondritis? 

A woman’s rib cage can be stretched during pregnancy. This stretching can cause inflammation, pain, and discomfort within the connective cartilage.

A pregnant woman presents a unique issue when it comes to this condition and the available treatments for it.

During the second trimester according to Healthline, it is prevalent for the woman to feel discomfort in the area of the rib cage. The woman’s body is expanding to accommodate the baby as he or she grows.

The growth of the stomach causes pain, tenderness, swelling, and soreness to develop near or in the rib cage region.

Because of the woman’s body changing, rib dysfunction is common in the back or side of the rib cage.

Costochondritis in pregnant women involves pain which is caused by tightness, stress, and tiredness of the intercostal fibers.

Inflammation causes this stress and fatigue. The unique dilemma with pregnancy and costochondritis is the available treatment options.

Various drugs and therapies are not appropriate or safe for pregnant women. This fact requires alternative treatments designed for pregnant women including the use of a pregnancy pillow or a belly support brace.

Both of these alternatives can help alleviate pain and discomfort by taking the stress away from the rib cage.

Can costochondritis cause fibromyalgia? 

Costochondritis does not cause fibromyalgia, but fibromyalgia may cause costochondritis. Because fibromyalgia patients deal with an excessive amount of pains all over their bodies, sometimes they do not realize the chest or rib pain is a separate condition.

Other sources of pain can worsen fibromyalgia (FMS), so it is vital to treat costochondritis. FMS and costochondritis go hand in hand but many experts do not entirely believe the chest pain felt with FMS is costochondritis.

These same experts are not even sure why the two are so intimately connected. However, according to Dr. Mercola, one established theory is FMS is associated with inflammation of the fascia.

The fascia is the thin layer of tissue used as a connector within the body. This connective tissue may be one of the reasons costochondritis is so prevalent in FMS patients.

Can costochondritis cause pain in the breast? 

The very definition of costochondritis verifies that it will cause pain in the breast area. The Mayo Clinic declares that costochondritis is an inflammation of cartilage.

The Mayo Clinic also says that one of the defining characteristics of this condition is the pain the patient feels in the costosternal joint.

This joint is where a rib attaches to the sternum which is located directly behind the breast. The sharp pain of costochondritis can seem to be radiating from the breast when, in fact, it is coming from behind the breast.

Can costochondritis cause pain in the arm? 

According to WebMD, when discussing the main symptoms of costochondritis, pain and tenderness where the ribs meet the breastbone is the number one symptom. The pain will increase when the patient moves or breathes deeply.

The pain will decrease when the patient lies downs, rests, and his or her breathing is quiet. Typically, this pain varies in intensity.

When it is severe, it is described as sharp or extreme pressure-like. This pain radiates from the front of the chest and can travel to the abdomen, arm, back, or shoulder.

However, the pain generally stays on the left side of the chest, but sometimes many people say it affects both sides.

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