Costochondritis, or inflammation of the cartilage in the area between your ribs and your sternum, may be painful to the touch or when your chest cartilage is lifted, such as when you cough or take a deep breath. As the condition worsens, it can cause sharp pain that radiates down your arm or chest pain that interferes with your daily activities.
Costochondritis, also known as Costosternal Syndrome or Costosternal Chondrodynia, usually improves on its own within two to three weeks, but in some cases, treatment may require medical attention. Most treatments focus on relieving the patient’s pain, depending on the symptoms and severity of the condition.
Symptoms of Costochondritis
Costochondritis may cause a stabbing or pressing pain in the breastbone. If severe, the pain may spread to the back or abdomen, most commonly on the left side of the body. In some cases, the pain may occur in more than one rib, most commonly in the 4th through 6th ribs. The pain is worsened by taking a deep breath or coughing, but is usually relieved by being still and breathing gently. Costochondritis pain is most often caused by exercise, a minor injury, or an upper respiratory infection.
However, chest pain can also be caused by other life-threatening conditions, such as coronary artery disease . Patients should see a doctor to determine the cause, especially if they have chest pain and the following symptoms:
- Difficulty breathing
- Have a high fever that does not go down after taking fever-reducing medications, such as acetaminophen.
- There are signs of infection, such as swelling, redness, or pus.
- Have persistent chest painand may have other symptoms such as nausea, sweating, pain in the left arm, or pain in any part of the chest, etc.
Causes of Costochondritis
The exact cause of Costochondritis is currently unknown, but it is thought to be caused by the following factors:
- Injuries to the chest, such as from a car accident or a fall from a height.
- Performing strenuous activities, such as heavy lifting, strenuous exercise, or severe coughing.
- The result of arthritis, such as osteoarthritis, rheumatoid arthritis, Reiter’s Syndrome, or ankylosing spondylitis.
- Viral, bacterial, or fungal infections such as tuberculosis, syphilis, and aspergillus in the joint area can cause intercostal joint infections.
- Costosternal joint tumors, both benign and malignant, can also cause costochondritis. The cancer cells may spread to other parts of the body, such as the chest, thyroid gland, or lungs.
Costochondritis is more common in women and people over 40, people who are physically demanding, people who are allergic or hypersensitive, and people who have symptoms of arthritis, such as ankylosing spondylitis or Reiter syndrome.
Diagnosis of Costochondritis
The doctor will ask about any abnormal symptoms, ask about the patient’s medical history and family history, and then perform a preliminary physical examination to diagnose the pain in the rib area. They may also take blood tests to find possible causes of inflammation or infection.
In addition, your doctor may perform additional diagnostic tests to rule out unrelated causes, as the pain of costochondritis can resemble pain caused by heart disease, lung disease, gastrointestinal problems, and osteoarthritis, as follows:
- X-rays in cases where the patient may have pneumonia
- A blood test to measure the number of white blood cells that may be associated with infection.
- Electrocardiogram (ECG/EKG) or chest X-ray to check if the patient has no symptoms of coronary artery disease or other heart conditions.
Costochondritis Treatment
Costochondritis usually goes away on its own. It may take several weeks or more, but if treated by a doctor, the focus is usually on relieving the patient’s pain. Treatment methods can vary depending on the symptoms and severity of the condition.
Self-care at home
Patients can take care of themselves at home to relieve initial pain, such as:
- Take over-the-counter pain relievers as recommended by your pharmacist, including NSAIDs such as ibuprofen or naproxen.
- Apply cold or hot compresses to the affected area 2-3 times a day to help relieve pain.
- Avoid strenuous exercise or activities, such as heavy lifting, running, or jumping, as these can make symptoms worse.
- Stretching exercises may help relieve symptoms by gradually applying pressure to the chest area.
Drug use
If the patient’s symptoms become more severe, the doctor may prescribe the following medications:
- Other pain relievers, such as codeine , torelieve pain.
- Tricyclic antidepressants for patients with chronic pain or pain that interferes with sleep .
- Anticonvulsants, such asgabapentin , can help treat chronic pain.
- Local anesthesia and steroid injections are given to the affected area. These are used if the patient has severe pain that is not responding to other treatments or medications.
Physical therapy
In addition to stretching exercises that patients can do on their own, doctors may use transcutaneous electrical nerve stimulation (TENS) to reduce pain.
Surgery
If the patient’s symptoms do not improve with other treatments or do not respond to the above treatments, the doctor may have the patient consult a surgeon to consider the necessity and possible risks after surgery.
Complications of Costochondritis
In general, treatment often causes the pain and inflammation from Costochondritis to gradually disappear on its own. However, if left untreated, it can affect overall health. For patients with chronic Costochondritis, the pain may return when exercising or doing activities that require a lot of energy, even after treatment. Therefore, you should consult a doctor for long-term treatment so that it does not affect your daily life.
In addition, chest pain is similar to pain caused by other diseases such as ischemic heart disease, pneumonia, or fibromyalgia . Therefore , you should see a doctor immediately to diagnose the abnormality.
Costochondritis Prevention
Although there is no way to completely prevent costochondritis, taking precautions in your daily activities may help reduce your risk of developing the disease. For example, avoid heavy lifting, avoid excessive exercise or strenuous activities, and if you feel chest pain during an activity or exercise, stop doing that activity and see a doctor immediately.
