Costochondritis

This information may be useful if you have been diagnosed with costochondritis. If you have new or ongoing symptoms, you should see a doctor for advice.

When the costochondral joint becomes inflamed, it can cause sharp chest pain and tenderness. These symptoms may come on slowly or start suddenly.

Call for emergency help straight away 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 spreads down the left arm, or both arms, or to the neck, jaw, back or stomach
• unconsciousness
• seizures or fitting
• difficulty breathing (snoring or rasping)
• a rapid heart beat
• a low or undetectable heart beat
• blue or pale tingling of knees, hands and lips
• chest pain and breathlessness, nausea, sweating or coughing up blood

• there's been new significant trauma within the last 7 days, for example a fall from height or a direct blow to the chest or ribs
• there's a change in the shape of your ribcage, like lumps or indentations
• you have increased shortness of breath or new breathing difficulties
• your pain is so bad that you can't breathe deeply
• you're coughing up blood
• you start to feel generally unwell
• you have a tingling or burning feeling in the chest, neck or arms

• you have a persistent cough
• you're coughing up yellow or green mucus (phlegm)

If your doctor's chamber is closed, contact a doctor or the 16263 health line.

Costochondritis is the medical term for inflammation of the cartilage that joins your ribs to your breastbone (sternum).

Cartilage is tough but flexible connective tissue. It works as a shock absorber and cushions the joints.

Costochondritis will normally improve on its own after a few weeks, though sometimes it takes longer. It doesn't lead to any permanent problems, but it can occasionally flare up.

The main symptom of costochondritis is chest pain in the centre of the chest. It doesn't usually spread across the chest or into the arms.

The pain may get worse with:

• certain positions or activities, like wearing a seatbelt or hugging someone
• deep breathing
• coughing and sneezing

Changing your activities while you recover may help ease your symptoms.

Inflammation is how your body naturally responds to infection, irritation or injury. Doctors don't know exactly why the area around the ribs becomes inflamed in costochondritis, but in some cases it has been linked to:

• severe coughing which strains your chest area
• an injury to your chest
• physical strain from repeated exercise or sudden exertion that you're not used to, such as moving furniture
• an infection, including respiratory tract infections (RTIs)

A doctor needs to assess you before costochondritis can be diagnosed. They'll start by asking you some questions and then examine you physically. Sometimes you may need a further examination, which is done to rule out other health conditions that could be causing your symptoms.

Costochondritis often gets better after a few weeks. Doctors call it a self limiting condition, which means it can get better on its own over time. Self-help steps and painkillers can help you manage the symptoms in the meantime.

Anything that puts stress on your chest area can make costochondritis worse, for example strenuous exercise or repetitive movements.

If a movement makes the pain in your chest worse, change how you do it until the inflammation in your ribs and cartilage has improved.

Some examples of modified 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

With costochondritis, pain medicine can help you move more comfortably, and that in turn helps you manage your symptoms. There is more about taking painkillers.

Using heat or ice on your chest and ribs can help reduce the symptoms of costochondritis. Take care to use a barrier, like a towel, to protect your skin from a burn. Never place heat or ice directly on your skin. Apply it for no longer than 20 minutes at a time, and leave a few hours between treatments.

If you're using heat or ice for costochondritis, stop treating the area as soon as you notice more redness, discolouration or blistering of the skin.

If you have any problems with circulation or sensation, you shouldn't use heat or ice for chest and rib pain at all.

Costochondritis usually settles best if you keep moving as normally as you can while you recover. Try to avoid long periods of rest where possible.

You can increase your activity gradually, and that helps recovery. Too much rest can slow it down, so start moving and using the affected area as soon as you can.

A little activity is better than nothing. 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 understand if you're pacing your daily activities at the right level as you progress. It also shows how much pain or discomfort is acceptable.

It can help 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. Doing more can bring some extra discomfort as your body gets used to regaining your activity levels.

Aim to keep your pain within a rating of 0 to 5. If it goes above this level, you can change how much you do by:

• reducing the number of times you do a movement
• reducing the pace of an activity
• increasing rest time between activities

With costochondritis, you may sometimes need to take a little time off work so your body can recover. How long you stay off depends on how bad your costochondritis is and on the kind of work you do.

You don't have to be free of symptoms before you think about going back. Carrying on with work, or returning as soon as you're able, will help your recovery.

Getting back into your normal daily activities bit by bit can also build up your strength and stamina.

Keep doing whatever activities you can manage, as far as your pain allows, and build up a little at a time.

Costochondritis may make things harder at the start. That does get better as you slowly work back towards all of your usual activities.

If you follow this advice for costochondritis, you should see gradual improvement over time.

Talk to a doctor if:

• your symptoms haven't improved within 8 weeks of following this advice
• your symptoms get worse

Find out about access to MSK services in your area.

With any health condition, it's important to look after your mental wellbeing too, because it can affect your recovery.

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