If you’ve been diagnosed with costochondritis, you might find yourself wondering one or two things. Firstly, how on earth are you ever going to learn how to spell that? And secondly, what on earth is it?
We can’t help too much with the spelling (thank goodness for autocorrect!) but we can certainly give you the costochondritis rundown. The good news is that it’s treatable, and often it doesn’t last for too long – these are all things we like to hear. Costochondritis also goes by the easier name chest wall pain syndrome, and it is an inflammation of the joints where cartilage in your rib cage connects to your ribs and to your sternum.
But let’s break it down a little bit further! The cartilage found in your rib cage is a connective tissue that connects your ribs to your sternum, which is the bone at the front of your rib cage that many of your ribs connect to. The cartilage around your sternum plays an important role because it stretches to allow for your chest to rise and fall when you breathe (you can take a big breath and watch your rib cage expand for those playing along at home) or when you stretch your rib cage. This inflammation most frequently affects the joints near the sternum (sternocostal joints), and this may be an area that feels tender if you have costochondritis. When these joints connecting the cartilage to the sternum are inflamed, it can cause a general aching pain which worsens into a sharp pain when the cartilage is stretched or pressure is applied to the chest. Aka, it could be the reason why you felt like you got stabbed by a tiny invisible pitchfork when you took a deep breath at your desk.
It can also be felt further away from your sternum at the costochondral junction – where your ribs join to meet the cartilage coming out from your sternum (see image below).
This can cause chest pain that’s uncomfortable and often scary – many people are concerned that their pain may be due to a heart attack or lung infection.
|If you are experiencing chest pain, seek immediate medical attention from your doctor or local hospital emergency department.
The good news is, that even though it can cause uncomfortable and sharp pain in your chest with certain movements or even with breathing, costochondritis is benign. We do know that this still can get in the way of living your daily life, which is why we are here to help. You may be asking “How long will it last? Just make my chest stop hurting!” The answer is, it varies. It may clear up after a few days or weeks, although in a few unlucky cases it can hang around for longer. This information should not be discouraging to you as there are many practical ways we can help guide you through managing this condition in terms of pain and restriction of movement while your body’s natural processes aid in recovery.
Symptoms of costochondritis
People with costochondritis may feel a range of symptoms including:
- An aching pain in their chest
- Tenderness when rib joints are pressed
- Pressure around their chest
- Pain worsening with movement and certain positions such as exercise, coughing, sneezing, wearing a seatbelt and typically worsens when taking a deep breath
- Pain quality is variable but can be described as a sharp or dull pain
Causes and risk factors for costochondritis
Costochondritis usually has no clear cause. Occasionally, possible causes for costochondritis may include:
- Repeated trauma to the chest wall or heavy straining (such as strenuous activity, heavy lifting or severe coughing fits)
- A chest injury or joint infection (viruses, bacteria and fungi – such as tuberculosis, syphilis etc can infect rib joints)
- Respiratory infections
- Tumours (non-cancerous and cancerous tumours may travel to the joint from another part of the body such as the breast, thyroid or lung)
Costochondritis is more common in women, Hispanic people and people over the age of 40. However, it can still affect children and adolescents as well as adults.
How is costochondritis diagnosed?
There is no single diagnostic test for costochondritis and should be a diagnosis of exclusion. A doctor will typically diagnose costochondritis by first ruling out other more serious conditions such as:
- Acute coronary syndrome
- Pulmonary embolism
- Tietze’s disease (this condition is similar, but less common compared to costochondritis and which causes chest swelling in addition to costochondritis symptoms)
You might not be too happy with a diagnosis of costochondritis – but your doctor is likely to be jumping for joy that it isn’t anything more severe! Your practitioner may order blood tests or heart tests such as an electrocardiogram (ECG) to rule out these other more unpleasant causes of chest pain. They will also do a physical examination, such as palpating the joints, and take down a thorough record of your pain and medical history in order to make their diagnosis. Patients older than 35 years of age, with a history or risk of coronary artery disease and any patient with cardiopulmonary symptoms are often ordered to get an electrocardiogram and possibly a chest radiograph. Again, this is to completely RULE OUT any other causes of the chest pain that are associated with increased morbidity and mortality.
Treatment options for costochondritis
Treatment for costochondritis is not always straightforward, as the specific cause is often not known. Treatment is mainly focused on pain relief while the condition improves/resolves on its own. Doctors may recommend symptomatic relief such as pain killers, rest and heat to ease the pain associated with this condition. Anti-inflammatories may be prescribed by your doctor and in severe cases, steroids may be utilised via an injection into the joint to help to ease symptoms.
How physiotherapy can help
At Sycamore Health, we won’t judge you if you can’t spell or pronounce costochondritis!
What we will do is provide friendly service and help you to understand possible causes of your inflammatory pain, alongside your body’s natural healing processes. Our physiotherapists can provide education, reassurance and advice regarding the management of costochondritis symptoms, but we don’t stop there.
We can also give you some practical aids such as stretching and joint manipulation, soft tissue mobilisation therapy, and taping. While exercising with this condition may seem daunting and scary, we are well equipped in guiding you through exercising safely with this condition, the aim being to gradually increase range of motion and reduce sensitivity to movement.
If the cause is possibly related to strain or chest wall trauma, one of our physios can provide assessment and advice about how to avoid overusing your chest muscles, hopefully reducing the chances of costochondritis returning, so that you can enjoy taking deep breaths and going to the gym again. If you think that sounds like a good plan, you can book an appointment online.
All information is general in nature. Patients should consider their own personal circumstances and seek a second opinion.