Costochondritis: Symptoms, Causes, Diagnosis, Treatment

Costochondritis or costochondritis is inflammation of the area where the upper ribs join the cartilage that holds them to the breastbone. This area is called the intersection costochondral.

This condition causes chest pain, but is usually harmless and goes away without any treatment. However, any chest pain experienced by adults should not be underestimated. So, it’s a good idea to see a doctor if you experience chest pain to be checked and tested for heart problems.

A rare condition called Tietze syndrome is often referred to as costochondritis, but the two are different conditions. Reported WebMDthe different is:

  • Tietze syndrome usually comes on suddenly, with chest pain radiating to the arm or shoulder and lasting several weeks.
  • Tietze syndrome causes swelling in the painful area (where the ribs and sternum meet).

Costochondritis is sometimes referred to as chest wall pain, costosternal syndrome, or chondrodynia costosternal. Sometimes, swelling accompanies the pain (Tietze syndrome).

1. Cause

Experts still don’t know for sure why costochondritis occurs, but several things can cause it. This includes:

  • Minor recurrent injury to the chest wall.
  • Overuse of arms.
  • arthritis. Constochondritis is sometimes a sign of osteoarthritis, rheumatoid arthritis, ankylosing spondylitisor other conditions that affect cartilage.
  • Tumor. It can move from the joints and other parts of the body and settle in the chest.
  • Respiratory infections caused by viruses.
  • Bacterial infections, especially in people who use intravenous drugs or have had surgery near the upper chest.
  • Fungal infections, but these are rare.

Constochondritis is most common in women and in people over the age of 40.

Tietze syndrome generally appears in adolescence and young adulthood, and with equal frequency in boys and girls.

2. Symptoms

Chest pain associated with costochondritis usually occurs after exercise, minor trauma, or an upper respiratory infection. Here are the symptoms you need to know:

  • Sharp pain in the front of the chest, near where the sternum and ribs meet, usually on the left side. It may spread to the back or abdomen.
  • Pain when taking a deep breath or coughing. The condition will improve when you stop moving or when you breathe more calmly.
  • There is pain when pressing the rib joint. If not, it’s probably not costochondritis.
  • If costochondritis is due to an infection after surgery, there may be redness, swelling, or pus discharge at the surgery site.

Call your doctor if you have any of the following symptoms:

  • Difficulty breathing.
  • High fever.
  • Signs of infection include redness, pus, and increased swelling of the rib joints.
  • Continuing or worsening pain despite taking medication.
  • Nauseous.
  • Sweating.
  • Dizzy.

Go to a hospital emergency room immediately if you have difficulty breathing or any of the following symptoms, as these are not usually caused by costochondritis:

  • High fever that doesn’t get better with fever-reducing medications such as acetaminophen or ibuprofen.
  • Signs of infection at the painful site, such as pus, redness, increased pain, and swelling.
  • Persistent chest pain of any kind accompanied by nausea, sweating, or pain in the left arm. These may be signs of a heart attack. If you’re not sure what’s causing your chest pain, go to the emergency room.
Costochondritis: Symptoms, Causes, Diagnosis, Treatmentcostochondritis illustration (mayoclinic.org)

Also Read: Heart Attack: Causes, Symptoms, Treatment, Prevention

3. Diagnosis

quote National Health Serviceif there are symptoms that suggest costochondritis, the doctor may examine and touch the upper chest area around the joint costochondral.

The doctor may ask when and where the pain occurred and look at the patient’s recent medical history.

Before the diagnosis is confirmed, several tests may need to be done to rule out other possible causes of chest pain. This may include:

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  • Electrocardiogram (ECG), which records the rhythm and electrical activity of the heart.
  • Blood tests to check for signs of underlying inflammation.
  • Chest X-ray.

If no other conditions are suspected or found, a diagnosis of costochondritis can be made.

4. Treatment

Costochondritis usually goes away on its own, although it may last for a few weeks or longer. Treatment focuses on relieving pain. This may include:

1. Drugs

  • Nonsteroidal anti-inflammatory drugs (NSAIDs). Although certain medications, such as ibuprofen or naproxen sodium, are available without a prescription, your doctor may prescribe a stronger type of medication. Side effects to watch out for are damage to the lining of the stomach and kidneys.
  • Narcotics. If the pain is severe, your doctor may prescribe medication that contains codeine, such as hydrocodone/acetaminophen or oxycodone/acetaminophen. Narcotics can be habit-forming, so their use must be closely monitored.
  • Antidepressants. Tricyclic antidepressants, such as amitriptyline, are often used to control chronic pain, especially if they keep a person awake at night.
  • Antiseizure drugs. The epilepsy drug gabapentin has also been shown to be successful in controlling chronic pain.

2. Therapy

  • Stretching exercises. Gentle stretching exercises for the chest muscles may be helpful.
  • Nerve stimulation. With the transcutaneous electrical nerve stimulation (TENS) procedure, the device sends a weak electric current through an adhesive patch on the skin near the area of ​​pain. The current may interfere with or mask pain signals, preventing them from reaching the brain.

3. Surgery and other procedures

If conservative measures don’t work, your doctor may suggest injecting numbing medication and corticosteroids directly into the painful joint. Patients may need surgery to remove diseased cartilage if other treatments don’t help. For this, the doctor will refer the patient to a surgeon.

4. Lifestyle changes and home remedies

Patients may be frustrated by the pain caused by costochondritis. However, self-care measures may provide comfort. These can include:

  • Over-the-counter NSAID pain relievers. Ask your doctor about taking ibuprofen or naproxen sodium.
  • Hot or ice compresses. Try placing a compress or heating pad on the painful area several times a day. Keep the heat on a low setting. An ice or cold compress may also help.
  • Rest. Avoid physical activity that makes the pain worse.
Costochondritis: Symptoms, Causes, Diagnosis, Treatmentchest pain illustration (freepik.com/KamranAydinov)

5. Complications that can occur

Usually the treatment of inflammation and pain makes costochondritis eventually go away on its own. In people with chronic costochondritis, pain may persist or return, even with medication, during exercise or certain activities, citing Healthline.

In these cases, the patient may need to seek long-term care to ensure that costochondritis does not affect the patient’s quality of life and ability to perform daily activities.

Pain associated with costochondritis can indicate other problems. Chest pain is often a sign of problems with the heart or lungs. So, check with your doctor if you have chest pain to make sure it’s not a heart attack, pneumonia, or other serious medical condition.

Chest pain associated with costochondritis can be a symptom of fibromyalgia. With fibromyalgia, a person may experience pain in the chest in addition to:

  • Pain all over the body.
  • Fatigue and inability to rest due to pain.
  • Difficulty focusing or concentrating.
  • Feelings of depression.
  • Headache.

If you experience chest pain along with any of these other symptoms, talk to your doctor for a fibromyalgia exam. Understanding the condition can help patients manage their symptoms and ensure they don’t interfere with daily life.

In addition, make sure that the costochondritis condition is not caused by other diseases such as heart disease and pneumonia. So see a doctor for an early diagnosis and at the same time get the right treatment.

according to American Family Physician, costochondritis can last from a few weeks to months. This condition can also recur if caused by physical exercise or strain. This condition usually does not last more than a year. However, adolescents with costochondritis can sometimes have longer-lasting symptoms.

Read also: Causes chest pain, these 7 diseases are often mistaken for a heart attack