What Causes Costochondritis And How Can It Be Treated?

Costochondritis is a form of chest or upper abdominal pain which develops in the costochondral joints of the chest. As the term costo (rib), chondr (cartilage), itis (inflammation) implies, it is thought to represent an inflammation of the area of each rib where a short piece of cartilage attaches the rib to the breast bone. These are known as the costochondral junctions, and are not true joints, like an elbow or shoulder. Therefore having costochondritis does not imply that one will develop arthritis in any other joints. Pain in these attachments is also sometimes called Tietze’s syndrome, although many doctors reserve that name for pain with swelling in these junctions.

Costochondritis is typically a condition seen in middle-aged adults, who are also in the age group where they may be starting to worry about having a heart attack, and it is this fear that often brings people with costochondritis to the doctor or the emergency room.

The pain of costochondritis often begins suddenly, may be aching, throbbing, or is occasionally described as stabbing. Although it arises from the cartilage attaching the rib to the breastbone, it may be felt farther away from the breastbone, often on the left side over the heart. There is usually no history of any kind of trauma, or other arthritic condition.

The pain often is worse with breathing, which makes our ribs move up and down; this motion aggravates the pain. Twisting of the chest or coughing may also make the pain worse. None of these are typical of the pain of a heart attack, and therefore serve as clues to the doctor that the pain is not coming from heart disease.

On examining the chest of a person with this pain, pressing on the costochondral junctions along the sides of the breastbone will often duplicate the pain that the person is feeling, and serves to confirm the diagnosis of costochondritis.

Plain aspirin is often completely effective at relieving this pain. A nonsteroidal anti-inflammatory such as ibuprofen (Advil, Nuprin and others) will also usually relieve it. Acetominophen (Tylenol) generally does not provide as much relief. In severe cases, especially when the junction is swollen and red, injecting a bit of cortisone into the area is an easy way to reduce the inflammation and relieve the pain.

Most people do not describe the pain of costochondritis as terribly severe, but the fear that this is a symptom of something terrible going on in the heart is very distressing to many people. With reassurance from the doctor that the pain is not coming from the heart, it often can be tolerated with little treatment. The condition does tend to recur, but can again be effectively treated with aspirin or a nonprescription nonsteroidal anti-inflammatory.

The information provided on Health Search Online is for educational purposes only and is not a substitute for medical advice, diagnosis or treatment.