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Costochondritis
Costochondritis is the result of cartilage becoming inflamed at the point where the upper ribs attach to the breastbone (sternum), causing chest pain and tenderness.
The pain of costochondritis can be a source of anxiety as it is often confused with that of a heart attack. Costochondritis is a relatively harmless condition and usually goes away without treatment. However, the sudden onset of any degree of chest pain should be assessed immediately by a doctor.
There is often no definitive cause for costochondritis. It can be associated with an injury to the rib cage or by unusual physical activity. It can also occur after a respiratory illness such as a cold or 'flu. Costochondritis affects females more often than males, and more commonly occurs in adolescents and young adults.
Symptoms
The main symptoms of costochondritis are pain and tenderness at the junction of the ribs and the breastbone. The pain increases with movement and deep breathing, and decreases with rest and quiet breathing. Pressure placed directly on the affected area will also cause significant pain.
The pain can vary in intensity, but is often severe. It is often described as sharp, aching or pressure-like in nature. It is usually located on the front of the chest, but can radiate to the back, abdomen, arm or shoulder.
The pain usually occurs on only one side of the chest, most commonly the left, but can affect both sides of the chest at the same time.
Symptoms of costochondritis usually last for between one and three weeks.
Costochondritis is similar to a condition called Tietze syndrome, which affects the same area. However, with Tietze syndrome there is swelling as well as the pain and tenderness. Swelling is not a symptom of costochondritis.
Diagnosis
A diagnosis of costochondritis can usually be made by assessing the nature of the symptoms experienced and by the ability of the pain to be reproduced by pressing on the affected area.
Sometimes tests to rule out other more serious conditions may be recommended. Tests may include:
- A chest x-ray
- An electrocardiogram (a tracing of the heart’s electrical activity)
- Blood tests.
Treatment
Often the symptoms of costochondritis resolve without treatment. Where treatment is required, the aim is to reduce inflammation and control pain. Treatment usually consists of:
- Rest and avoiding activities that worsen the pain
- Anti-inflammatory and pain relieving medications
- Ice and/or heat packs applied to the area.
If the pain is extreme and/or prolonged, a steroid medication such as cortisone may be injected into the affected area to help reduce pain and inflammation.
In rare cases, where the condition does not respond to medical treatment, surgery to remove the inflamed cartilage may be required.
References
Anderson, K.N., Anderson, L.E. & Glanze, W.D. (eds.) (2006) Mosby’s medical, nursing, & allied health dictionary (6th ed.) St. Louis: Mosby-Year Book, Inc.
Sims, J (2006) Costochondritis. The Gale Encyclopedia of Medicine. Third Edition. Jacqueline L. Longe, Editor. Farmington Hills, MI: Thomson Gale.
Last Reviewed – 12/06/07