Costochondritis - Causes, Symptoms, and Treatment

Rib Pain Resulting From Inflammation of the Chest Wall

rib pain
Costochondritis can cause pain in the ribcage. Peter Dazeley / Getty Images

Costochondritis is a condition that causes chest pain due to inflammation of the cartilage and bones in the chest wall. Costochondritis occurs when there is inflammation at the junction of the rib bone and breastbone (sternum). At this junction, there is cartilage joining these bones. This cartilage can become irritated and inflamed. Depending on the extent of the inflammation, costochondritis can be quite painful.

Cause of Costochondritis

It is often difficult to identify a single cause of costochondritis. The condition is thought to be most commonly due to repetitive microtrauma, or overuse. This means that activities are causing repeated damage to the cartilage of the chest wall leading to inflammation. The most frequently affected age group is young adults between 20 and 40 years old. Costochondritis can also be found as an overuse injury in athletes. In particular, this condition has been identified in competitive rowers.

Costochondritis can also be found after a traumatic injury. For example, a car accident where the driver's chest strikes the steering wheel can cause costochondritis by injuring the ribs and cartilage on the front of the chest. Viral infections, usually upper respiratory infections, have also been identified as a cause of costochondritis.

Signs of This Condition

Most patients with costochondritis experience pain over the front of the upper chest (the area of the breastbone).

Because of serious conditions, most importantly conditions related to heart problems, costochondritis should only be diagnosed after excluding other more serious problems.

Costochondritis pain is usually worsened by activity or exercise. Often the pain is worsened when taking a deep breath. This stretches the inflamed cartilage and can cause significant pain.

Touching the area involved by costochondritis can be extremely painful for the patient.

Because of the many nerves that branch away from the chest, pain may be experienced in the shoulder or arms as well. A related condition called Tietze's Syndrome causes focal pain at one rib (usually the second) and is often accompanied by redness and or swelling in the areas most tender.

Treatment Options

Costochondritis usually responds well to some simple treatment steps including:

  • Rest:  In order to decrease the inflammation, you will have to avoid activities that cause pain and exacerbation of the costochondritis. Exercise, deep breathing, and strain on the muscles of the chest may worsen the symptoms of pain and slow the healing process. As a general rule of thumb, avoid or limit activities that worsen your symptoms.
  • Heat Applications:  Applying hot packs to the chest can be helpful in relieving symptoms of costochondritis. Apply heat several times each day, especially before activities that may irritate your symptoms. While ice application can hep with most conditions of inflammation, applying ice to the chest can be quite uncomfortable.
  • Anti-Inflammatory MedicationsNonsteroidal anti-inflammatory medications (e.g. Motrin, Advil) help with two aspects of costochondritis. First, they help decrease symptoms of pain making patients more comfortable. Second, these medications help to decrease inflammation, which is the primary problem. Check with your doctor before taking anti-inflammatory as they have potential side effects.

While these symptoms usually improve within a few weeks and resolve completely within a few months, there are patients in whom this problem persists for some time.  In some unusual and persistent circumstances, costochondritis may be treated with cortisone injections if other treatments have failed to provide relief over the span of several months.

Sources:

Flowers, LK "Costochondritis" eMedicine. Aug 9, 2007.

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