Costochondritis: What It Is, How You Get It, & How to Treat It

Costochondritis affects as much as 10% of the population. For individuals who have costochondritis, the symptoms can be disabling and even frightening. Many times, symptoms of costochondritis can mimic more serious conditions, such as a heart attack. 

Rest assured, costochondritis is a musculoskeletal condition that will not harm your cardiac health. However, costochondritis can become challenging to live with, especially when it is chronic. According to American Family Physician, costochondritis can last up to a year — or, in rare cases, longer.

What is costochondritis, how do you get it, and how can you manage costochondritis in your everyday life? Here is everything you need to know to help you overcome costochondritis. 

What is Costochondritis?

The word “costochondritis” means inflammation of the rib cartilage. The condition gets its name from the costochondral junction, the cartilage’s name that joins the ribs to the spine.

This rib cartilage inflammation causes pain of the chest wall or breastbone, which can mimic symptoms of a heart attack or lung conditions. 

Costochondritis is diagnosed clinically (i.e., via a clinical exam by your doctor) and does not require any tests to diagnose. However, your doctor may order cardiac and lung tests to rule out other, more severe diseases, especially if you are over age 40.

Other symptoms of costochondritis include:

● Sharp, aching, or pressure-like pain

● Left-sided chest pain

● Pain that worsens with a deep breath

● Pain that worsens with coughing

Sometimes, visible swelling is present alongside costochondritis symptoms. This rare condition is known as Tietze Syndrome and most often affects individuals under the age of 40.

While the pain associated with costochondritis can be severe, it usually goes away on its own. Sometimes, however, costochondritis can become chronic or relapse and remit. 

The good news is that, although costochondritis may impact your quality of life, it will not lead to serious complications or reduce your lifespan in any way.

What Causes Costochondritis?

Doctors have suggested many causes to explain the origins of costochondritis. In some cases, the causes of costochondritis may be clear — for example, if you recently suffered a chest injury — or less obvious. Your doctor will work with you to investigate the potential cause of your costochondritis, especially if you have not suffered a physical strain or injury.

Mechanical Strain

Most frequently, costochondritis is caused by a mechanical strain. “Mechanical strain” is a medical term for a physical injury, such as a pulled muscle or blow to the chest. In some cases, you might remember a specific incident that preceded the diagnosis of costochondritis. Other times, there might not be a particular event that triggered it, as it may be due to a repetitive motion injury. One example is the practice of chest-binding in female-to-male transgender patients, which, if done improperly, can lead to costochondritis over time.

Vitamin D Deficiency

Infrequently, patients with low vitamin D may develop costochondritis. The research is minimal, and it is unclear whether this is due to causation or correlation. More scientific evidence is needed to support this claim. However, because vitamin D levels are easy and inexpensive to test and treat, some professionals believe it is still worth investigating patients’ vitamin D levels when they present with costochondritis.

Infection

Infection is considered an uncommon cause of costochondritis. The few cases reported in the literature have suggested many types of infection could cause costochondritis. Some examples include E. coli costochondritis due to a urinary tract infection and Candida Albicans costochondritis due to drug needle sharing or surgery. More recently, however, long-haul COVID-19 patients — those who recover from the illness but never fully bounce back — are reporting cases of costochondritis. Chief medical advisor Dr. Anthony Fauci says that myalgias such as costochondritis are common in COVID-19 “long-haulers.”

How Do You Treat Costochondritis?

Unfortunately, there is no quick, simple fix for costochondritis. Many times, costochondritis goes away on its own with rest. Other times, it may be chronic and require long-term management. The majority of costochondritis cases last less than one year. Regardless, there are a few things you can try to reduce the negative impact of costochondritis on your life.

Pain Medication

According to American Family Physician, the first-line treatment for costochondritis is non-steroidal anti-inflammatory drugs — NSAIDs for short. These are over-the-counter medications, such as aspirin, ibuprofen, and naproxen sodium, that reduce inflammation and decrease pain. Sometimes, your doctor might also recommend cough suppressants alongside NSAIDs, since coughing can worsen costochondritis pain.

When NSAIDs and cough suppressants don’t work, your doctor might recommend several alternatives. They might suggest you try physical therapy, or they may offer injectable medications, such as lidocaine or steroids. Lidocaine is an analgesic, or pain-relieving medicine, while steroids work to reduce inflammation. Both can help with intractable cases of costochondritis.

Heat and Ice

Just like you might use a hot or cold pack on a sprained ankle, you can use hot & cold therapy to relieve costochondritis pain. Heat and ice are strong options for costochondritis because they can be used frequently with few (if any) side effects. You can apply a hot or cold pack to your chest as often as every two hours, for as long as 20-30 minutes at a time. 

So, how do heat and ice work to relieve costochondritis pain? Heat works as an analgesic to relieve pain, while ice reduces inflammation and swelling associated with the condition. It’s a good idea to alternate between heat and ice so you can reap the benefits of each. Some hot & cold packs can be both frozen and microwaved.

Physical Therapy

Costochondritis patients are not often referred to physical therapy unless their case does not respond to conventional treatment. That being said, preliminary research shows that PT can help treat costochondritis. So, what can you expect from physical therapy for costochondritis?

Physical therapists can help costochondritis patients in many ways. The primary way PT aids in costochondritis recovery is through patient education: teaching the patient more about their condition and how to manage it.

Another way in which PT can correct costochondritis is through manual therapy. In manual therapy, the physical therapist puts their hands on the patient and physically manipulates their muscles, fascia, and other tissues. This can help decrease pain and inflammation associated with costochondritis.

Lastly, your physical therapist might assign you a home exercise program for costochondritis. Movement can help decrease pain and swelling associated with costochondritis. However, some forms of exercise may worsen your pain. 

Your physical therapist will let you know which types of exercise are safe and which to avoid. For example, they might recommend stretching or yoga but discourage you from lifting weights. These restrictions are typically lifted once you feel better. However, you should keep in mind that reinjuring your chest may lead to a recurrence of costochondritis.

Stretching

Gentle stretching is potentially the most effective form of movement for alleviating costochondritis pain. 

A relatively large study (by costochondritis standards) found statistically significant, progressive improvement in costochondritis symptoms among patients who completed a stretching program. The researchers concluded that gentle stretching might be more effective than NSAIDs and other analgesics at relieving costochondritis pain.

Any stretching program for costochondritis should be gradual. In other words, your activity will increase as your tolerance increases. As your costochondritis pain gradually fades, you will be able to tolerate a greater range of motion. 

You should always avoid doing any activity that aggravates your costochondritis pain. Stretching shouldn’t hurt, but if it does, make sure to stop and only resume your stretching program when you are no longer in pain.

Read on to discover some simple stretches you can perform at home to alleviate pain caused by costochondritis:

Side-Lying Stretch

Start by laying down on a yoga mat with a supportive pillow beneath your head. Extend your arms in a T-shaped position. Bend your knees and gently drop them to one side. To deepen the stretch, you can turn your head to the side facing away from your knees. Hold the stretch for 10-15 seconds and repeat on the opposite side.

Wall Stretch

Stand beside the wall with one shoulder next to the wall. You should start about one foot away from the wall. Reach behind you with a straight arm and place your palm against the wall. Slowly and gently, walk toward the wall, closing the gap between the shoulder and the wall. Stop when you feel a deep stretch but before you feel pain. Breathe into this position for 10-15 seconds and repeat on the opposite side.

Forward Fold

To perform this yoga-inspired stretch:

  1. Start in “mountain pose” (i.e., standing facing forward with your feet together and your arms by your sides).
  2. Clasp your hands behind your back.
  3. Gently pull your clasped hands away from your back, so your shoulders round backward and your chest arches forwards. You can hold this stretch if it is enough for you — or, to deepen it, exhale as you gently fold forward toward your toes.
  4. Stay in whichever position you choose for 30 seconds.

Disclaimer: The Content is not meant to substitute for professional medical advice, diagnosis, or treatment. Always seek your physician’s advice or other qualified health providers with any questions regarding a medical condition.

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