What is costochondritis?

Costochondritis is inflammation in the cartilage that joins your ribs to your breastbone (sternum). It usually affects your 2nd to 5th ribs. These ribs are closest to your heart and lungs and help protect them. The inflammation causes chest pain.

It's also called costosternal syndrome or anterior chest wall syndrome. Costochondritis usually gets better on its own without needing long-term treatment. It can sometimes last longer or can return, but this is rare.

What are the symptoms of costochondritis?

If you have costochondritis, you may feel constant sharp or dull pain and tenderness in your chest. The pain you may feel:

• usually develops slowly
• is usually felt on one side of your breastbone — but it can be felt on both sides
• affects more than one rib
• is not accompanied by swelling

Your pain may get worse when you:

• cough
• sneeze
• breathe deeply
• stretch or move in certain ways
• put pressure on your chest

Your symptoms can be similar to serious health conditions such as a heart attack or lung problems.

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What causes costochondritis?

There is usually no clear cause for costochondritis.

Sometimes it can be triggered by:

• a lot of coughing
• a chest injury
• physical strain from exercise or lifting something heavy
• an infection
• injecting drugs into a vein

Costochondritis may be related to other conditions that cause inflammation in your muscles and joints. You are also more likely to get costochondritis if you are aged 40 to 50 years.

When should I see my doctor?

You should see your doctor as soon as possible if you have chest pain. Your doctor can assess your symptoms. They can work out the cause and whether immediate treatment is needed.

How is costochondritis diagnosed?

Your doctor will ask about your symptoms and what tends to make them worse.

Your doctor will examine you. As part of the examination, they will check to see if gentle pressure on the joints where the ribs meet the breastbone causes pain. They will also check to see if movement makes the pain worse.

To help with the diagnosis, you may also be asked to have:

• blood tests
• x-rays or other scans
• an electrocardiogram (ECG)

These tests can help rule out other causes for your pain.

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How is costochondritis treated?

Treatment for costochondritis aims to relieve your symptoms. Usually, your symptoms will get better by themselves within a few weeks.

Here are tips how you can help manage your pain:

• Apply a heat pack where you feel pain.
• Use pain relief gels or patches.
• Take paracetamol or anti-inflammatory medicines
• Avoid activities that trigger symptoms.
• Do stretching exercises.

Living with costochondritis

If you have costochondritis, try to maintain good posture and avoid heavy lifting or actions that worsen the pain. It's also important to follow your treatment plan and see your doctor if your symptoms get worse.

What are the complications of costochondritis?

Costochondritis does not usually cause any complications. It may rarely come back, or symptoms may not improve. If this happens, your doctor may refer you to a rheumatologist (a doctor specialising in diseases that affect the joints, muscles and bones).

Your rheumatologist may recommend corticosteroid injections if your symptoms don't improve.

Can costochondritis be prevented?

To help prevent costochondritis, it's important to avoid activities that strain your chest.

Here are tips to help prevent costochondritis:

• Maintain good posture.
• Avoid activities such as lifting heavy objects or repetitive movements.
• Do gentle, low-impact exercises to strengthen your chest muscles.
• Manage stress.
• Address underlying conditions such as chest infections or joint issues.

Resources and support

• The NSW Government Emergency Care Institute provides a fact sheet on chest pain.
• Musculoskeletal Health Australia offers information on how low-impact exercises can help prevent costochondritis.
• Call the Healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Looking for information for Aboriginal and/or Torres Strait Islander people?

• Find an Aboriginal Community Controlled Health Organisation (ACCHO) or Affiliate near you.