Costochondritis
Costochondritis
Costochondritis: Overview
This information may help if you have been diagnosed with costochondritis. If your symptoms are new or ongoing, please see your healthcare professional for advice.
When the joint between a rib and the breastbone becomes inflamed, it can cause sharp chest pain and tenderness. These symptoms may build up gradually, or they may start suddenly.
About costochondritis
Costochondritis is the medical term for inflammation of the cartilage that joins your ribs to your breastbone (sternum).
Cartilage is a tough but flexible connective tissue. It acts as a shock absorber, cushioning the joints.
Costochondritis usually improves on its own after a few weeks, though it can sometimes take longer. It doesn't lead to any lasting problems, but it can occasionally flare up again.
Common Symptoms
Emergency Warning Signs
Phone 999 immediately if you or someone with you has any of these symptoms:
- chest pain or discomfort in the centre of the chest that does not go away, which may feel like pressure, tightness or squeezing
- pain that spreads down the left arm, or both arms, or into the neck, jaw, back or stomach
- loss of consciousness
- seizures or fitting
- difficulty breathing, with snoring or rasping sounds
- a very fast heartbeat
- a very slow or undetectable heartbeat
- blue or pale tingling skin on the knees, hands or lips
- chest pain along with breathlessness, nausea, sweating or coughing up blood
Seek urgent medical advice the same day if:
- you have had a significant new injury in the last 7 days, such as a fall from a height or a direct blow to the chest or ribs
- the shape of your ribcage has changed, with new lumps or dents
- your breathlessness is getting worse or you have new difficulty breathing
- the pain is so bad you cannot take a deep breath
- you are coughing up blood
- you start to feel unwell in general
- you notice tingling or a burning feeling in the chest, neck or arms
Contact your doctor if:
- you have a cough that will not go away
- you are coughing up yellow or green mucus (phlegm)
If you cannot reach your usual doctor, go to the nearest clinic or hospital instead.
When should you stop using heat or ice?
Stop treating the area with heat or ice if you notice more redness, discolouration or blistering of the skin. If you have any problems with circulation or with feeling sensation, you should not use heat or ice on chest and rib pain at all.
Staying active
It helps to keep moving as normally as you can while you recover, rather than resting for long stretches. Build your activity up gradually. Resting too much can actually slow your recovery, so start moving and using the affected area as soon as you are able to.
Even a small amount of activity is better than none. You do not need to be completely free of pain before you move about, just stay within a level you can manage, and try to do a little more each day or every few days.
It can help to rate your pain out of 10, where 0 is no pain and 10 is the worst pain you have ever felt:
- 0 to 3, minimal pain
- 4 to 5, acceptable pain
- 6 to 10, too much pain
Being more active should not make your overall pain worse, though some extra discomfort as your body adjusts is normal. Try to keep your pain between 0 and 5. If it goes above that, ease off by doing the movement fewer times, slowing the pace, or resting longer between activities.
Work
With costochondritis, you may sometimes need some time off work to recover. How long depends on your condition and the kind of work you do. You do not need to wait until your symptoms are completely gone before going back. In fact, returning to work as soon as you reasonably can will support your recovery, and easing back into your normal daily routine helps rebuild your strength and stamina.
Hobbies and interests
Keep up with the activities you can manage, within your pain limits, and increase them gradually. Things may feel harder at first because of your symptoms, but this will improve as you slowly work back up to your usual activities.
Getting help and support
Following this advice, you should notice steady improvement over time. Talk to a healthcare professional if your symptoms have not improved after 8 weeks of following this advice, or if they get worse. You can also ask about access to MSK, or musculoskeletal, services in your area.
Looking after your mental wellbeing matters too when you are dealing with a health condition, since it can affect how well you recover. When discussing your case, avoid sharing personal details such as your name, location or other personal health conditions.
⚠️ This symptom list is for educational purposes. Having these symptoms does not mean you have this condition. See a doctor for proper diagnosis.
Medicines Commonly Used
⚠️ These medicines are commonly used for confirmed diagnoses of this condition. This is NOT a recommendation or prescription. Treatment must be determined by your doctor.
No medicines have been linked to this condition yet.
When to See a Doctor
Phone 999 immediately if:
You or someone else has symptoms like:
- central chest pain or discomfort that doesn’t go away – it may feel like pressure, tightness or squeezing
- pain that radiates down the left arm, or both arms, or to the neck, jaw, back or stomach
- unconsciousness
- seizures or fitting
- difficulty breathing (snoring or rasping)
- rapid heart beat
- low or undetectable heart beat
- blue or pale tingling of knees, hands and lips
- chest pain and breathlessness, nausea, sweating or coughing up blood
Phone 111 if:
- there’s been new significant trauma within the last 7 days, for example a fall from height or direct blow to the chest or ribs
- there’s a change in the shape of the ribcage like lumps or indentations
- you have an increased shortness of breath or new breathing difficulties
- your pain levels are preventing you from breathing deeply
- you’re coughing up blood
- you start to feel generally unwell
- tingling or burning sensation in the chest, neck or arms
Contact your GP if:
- you have a persistent cough
- you’re coughing up yellow/green mucus (phlegm)
If your GP surgery is closed, contact 111.
When should I stop using heat or ice?
You should stop treating the area with heat or ice if you notice an increase in redness, discolouration or blistering of the skin.
Read more about burns and scalds
If you have any issues with circulation or sensation, you shouldn’t use heat or ice as a treatment for chest and rib pain.
Keeping active
It’s important to try to keep moving as normally as possible during your recovery. It’s best to avoid long periods of rest where possible.
You can try to increase your activity gradually to help your recovery.
Too much rest can slow down your recovery. As soon as you can, start moving and using the affected area.
Remember a little activity is better than nothing. Continue to stay within acceptable pain limits but you don’t need to be pain free. Aim to do a little bit more each day or every few days.
This guide can help you to understand if you’re pacing your daily activities at the right level as you progress. It’ll also let you see how much pain or discomfort is acceptable.
It can be helpful to rate your pain out of 10 (0 being no pain, 10 being the worst pain you’ve ever had), for example:
- 0 to 3 – minimal pain
- 4 to 5 – acceptable pain
- 6 to 10 – excessive pain
Activity should not make your existing pain worse overall. Increasing activity can lead to increased discomfort as your body gets used to regaining your activity levels.
Aim to keep your pain within a rating of 0 to 5. If your pain gets above this level, you can change the level of activity by:
- reducing the number of times you do a movement
- reducing the pace of an activity
- increasing rest time between activities
Work
Costochondritis can sometimes mean you need to take some time off work to help recovery. How long you’re off will depend on your costochondritis and your role at work.
You don’t need to be symptom free before you consider returning to work. Continuing to go to work, or returning to work as soon as is possible for you, will help your recovery.
Gradually getting back to your normal daily activities can help to build up your strength and stamina levels.
Hobbies and interests
Keep doing any activities you’re able to, as your pain allows. Gradually increase what you do.
Your symptoms may make things more difficult to start with. This will get better as you slowly build up to all of your usual activities.
Help and support
Following this advice, you should see gradual improvements over time.
Talk to a healthcare professional if:
- your symptoms haven’t improved within 8 weeks following this advice
- your symptoms get worse
Find out about access to MSK services in your area
When dealing with any health condition it’s important to also look after your mental wellbeing. This can impact your recovery.
Don’t include personal information e.g. name, location or any personal health conditions.
Causes
Doctors don't fully understand why this happens, but inflammation, the body's natural response to infection, irritation or injury, is often behind it. In some cases it's been linked to:
- severe coughing that strains your chest area
- an injury to your chest
- physical strain from repeated exercise or sudden exertion you're not used to, such as moving furniture
- an infection, including respiratory tract infections (RTIs)
Diagnosis
To find out if you have costochondritis, you should see a healthcare professional for an assessment. They'll usually start by asking you about your symptoms and then examine you.
Sometimes a further examination is needed as well, simply to rule out other health conditions.
Treatment
Costochondritis usually settles down on its own within a few weeks, so doctors often describe it as a self limiting condition. In the meantime, a few simple self-help steps and the right painkillers can keep your symptoms under control.
Anything that puts strain on your chest, such as strenuous exercise or repeated movements, can make costochondritis worse. If a movement makes the pain in your chest worse, try to change how you do it until the swelling in your ribs and cartilage settles down.
Some ways to modify your activity include:
- taking regular breaks
- changing your position regularly while sitting or lying down
- holding objects close to your body when lifting them
- hugging a cushion while you cough
Pain management
Painkillers can make it easier to move comfortably, which in turn helps you manage your symptoms.
More about taking painkillers.
Treating with heat or ice
Putting heat or ice on your chest and ribs can help ease your symptoms. Protect your skin with a barrier such as a towel, and never place heat or ice directly on your skin. Apply it for no more than 20 minutes at a time, and leave a gap of a few hours between treatments.
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