Costochondritis
Fast facts
- Costochondritis is a common cause of chest pain. It is caused by inflammation of the joints in the rib cage.
- The symptoms of costochondritis include sharp chest pain, which feels worse when coughing, sneezing or breathing heavily, and tenderness or soreness of the rib cage.
- The pain caused by costochondritis usually goes away within a few days or weeks.
What is costochondritis?
Your ribcage is an arrangement of bones and cartilage that protects the inner organs in your chest and helps the lungs to function. The cartilage connects the bones to each other; it is more flexible than bone, and that flexibility allows the ribcage to expand and contract so that you can breathe, cough or sneeze.
Costochondritis is pain caused by inflammation of the joints in the rib cage where the cartilage connects to rib bones or to the breastbone (sternum). It is a common cause of chest pain.
Costochondritis is inflammation of rib joints.
Causes and risk factors
Costochondritis can be caused by several factors, including muscle over-use, arthritis, or vitamin D deficiency.
Muscle overuse and strain
Repetitive, strenuous exercise or work can lead to muscle over-use and strain the rib joints. Repetitive coughing can also strain these joints.
Arthritis
Arthritis is the inflammation of joints. Rheumatoid arthritis, osteoarthritis and ankylosing spondylitis all increase your risk of costochondritis.
Vitamin D deficiency
Low levels of vitamin D can cause the costochondral junctions in the rib to grow, and this can potentially cause costochondritis.
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Ankylosing spondylitis
A type of inflammatory arthritis that affects the joints of the spine, particularly where the spine attaches to the pelvis.
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Vitamin D
A vitamin that is important for the health of bones and teeth as it promotes absorption of calcium from the diet.
Signs and symptoms
Symptoms of costochondritis include:
- Sharp chest pain, which feels worse when coughing, sneezing or breathing heavily, and;
- Tenderness or swelling in the joints between the cartilage and rib or breastbone.
Methods for diagnosis
Physical examination
Your doctor may diagnose costochondritis by asking about your symptoms and performing a physical exam. They may gently press on your rib joints to see whether you feel pain or tenderness in that spot.
Tests to rule out other causes
X-ray
An X-ray of the chest may be used if the diagnosis is uncertain.
Electrocardiography
Electrocardiography (ECG) uses electrodes attached to your chest to check your heart rhythm. If you are at risk of heart disease, you may undergo electrocardiography to rule out heart attack as a cause of your chest pain.
Computerized tomography (CT) scan
This scan is usually done when other causes, such as infection or tumors, are suspected as the cause of your chest pain.
Vitamin D test
Vitamin D levels can be checked using a blood test.
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X-ray
A scan that uses ionizing radiation beams to create an image of the body’s internal structures.
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Vitamin D
A vitamin that is important for the health of bones and teeth as it promotes absorption of calcium from the diet.
Types of treatment
Pain-relief medications
Treatment for costochondritis focuses on pain relief. Non-steroidal anti-inflammatory drugs, such as ibuprofen, are used to reduce inflammation and the pain associated with it. In rare instances, a combined injection of a local anesthetic and corticosteroid are used to reduce pain and inflammation.
Physical therapy
If the cause of the pain is muscle overuse and strain, physical therapy, heat pads and minimizing the intensity and frequency of exercise or work can reduce pain.
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Local anesthetic
A type of medication that, when administered to an area, creates a localized loss of sensation by blocking nerve activity.
Potential complications
Costochondritis is not a disease, but a symptom (chest pain due to inflammation). Different causes, such as rheumatoid arthritis or osteoarthritis, have different complications associated with them.
Prognosis
The pain caused by costochondritis usually goes away in a few days or weeks. Because your chest moves whenever you breathe, cough or sneeze, recovery can be slow, and your condition can sometimes get worse before it gets better.
Prevention
There is no way to prevent costochondritis. It occurs at any age and without warning.
References
- Chest Pain and Costochondritis Associated with Vitamin D Deficiency: A Report of Two Cases. Accessed 17 July 2014 from link here
- Costochondritis - National Library of Medicine - PubMed Health. Accessed 17 July 2014 from link here
- Costochondritis: Diagnosis and Treatment - American Family Physician. Accessed 17 July 2014 from link here
- Musculoskeletal chest wall pain. [CMAJ. 1985] - PubMed - NCBI. Accessed 17 July 2014 from link here
- Outpatient Diagnosis of Acute Chest Pain in Adults - American Family Physician. Accessed 17 July 2014 from link here
10 Most frequently asked questions (FAQs)
Costochondritis is pain associated with inflammation of joints in the rib cage where cartilage meets the bone of the ribs or the breastbone. What causes costochondritis? Costochondritis is a symptom (chest pain resulting from inflammation) that can be caused by several factors, such as muscle strain, arthritis, vitamin D deficiency, or more serious causes such as heart problems or tumors. How is costochondritis diagnosed? Costochondritis is usually diagnosed by physical examination with your doctor. They may perform some additional tests, such as ECG and CT scan, to rule out more serious underlying causes of chest pain such as heart problems or infection. Will costochondritis keep coming back? If your costochondritis is caused by muscle overuse, it can keep coming back if you continue the activities that cause muscle strain. Similarly, if conditions such as rheumatoid arthritis or osteoarthritis are the cause of costochondritis, they can potentially lead to further episodes of pain in the future. Is costochondritis serious? Costochondritis is not serious. It will typically resolve itself. However, you will need to be tested to make sure the cause of your chest pain is not something serious, such as a heart problem.
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