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That Pain in Your Chest Could Be Costochondritis

Any time you have chest pain, you might worry that you’re having a heart attack. If you suspect a heart attack or aren’t sure what’s causing your chest pain, it’s important to call 911 and get medical care immediately.

But of course, many conditions other than a heart attack can cause chest pain. One of those conditions is costochondritis.

Costochondritis happens when the cartilage that connects one of your ribs to your breastbone (sternum) gets inflamed. Because the pain is in the same area as your heart, it might feel like a heart attack or another heart or lung condition. 

Ernest Vina, MD, a rheumatologist with Banner – University Medicine, answered some of our questions about the condition.

What are the symptoms of costochondritis?

Costochondritis usually feels like a sharp or aching pain in the front of your chest. “It might feel worse when you take a deep breath, cough or move your upper body,” Dr. Vina said.

You might also notice:

  • Tenderness or swelling in your chest wall
  • A pop or click when you move your chest
  • Shortness of breath
  • Trouble sleeping

If you have symptoms of costochondritis, it is important to get medical care. It is especially vital to seek care if you have:

  • Chest pain that is severe or does not go away with rest
  • Chest pain along with shortness of breath, sweating or lightheadedness
  • Chest pain that spreads to your arms, back, neck or jaw
  • Fever
  • Weight loss
  • Night sweats
  • Swollen lymph nodes
  • Difficulty breathing

These symptoms could be signs of a serious condition, not costochondritis.

What causes costochondritis?

We don’t know exactly what causes the condition. But these factors can trigger it:

  • Injuring your chest
  • Heavy lifting or repeated movements
  • An infection
  • Using your chest muscles too much in sports or strenuous exercise
  • Autoimmune diseases like rheumatoid arthritis and psoriatic arthritis
  • Pregnancy

You’re also at higher risk if you are between ages 40 and 60 and physically active.

How is costochondritis diagnosed?

“There’s no specific test that can diagnose costochondritis, but your health care provider can diagnose it based on your medical history, symptoms and physical examination,” Dr. Vina said.

When you see your provider for chest pain, they will start by asking you about your medical history and symptoms. Be prepared to answer questions like:

  • When did the pain start?
  • Where is it located?
  • What does it feel like?
  • Is it worse when you take a deep breath, cough or sneeze?
  • Have you had any recent injuries or illnesses?
  • Do you have any other medical conditions?

Your provider will also ask about your family medical history and lifestyle habits.

Next, your provider will perform a physical exam. They will usually listen to your heart and lungs, look for signs of infection or inflammation and press on your chest to see if you have any tenderness or swelling.

Your provider might also recommend one or more of these diagnostic tests to rule out other causes of your chest pain:

  • Electrocardiogram (EKG), which measures your heart’s electrical activity.
  • Chest X-ray, which can show images of your heart, lungs and bones.
  • Blood tests, which can check for signs of infection or inflammation.

Other conditions that can cause chest pain include:

  • Heart disease
  • Lung disease
  • Gastroesophageal reflux disease (GERD)
  • Muscle strain
  • Anxiety or panic attack

What can you do if you have costochondritis?

There are steps you can take to reduce pain and symptoms:

  • Avoid heavy lifting and repetitive movements that make your pain worse. 
  • Use good posture to reduce stress on your ribs and chest muscles.
  • Take breaks throughout the day to stretch and move.
  • If you have to sit for a long time, be sure to use a supportive chair or pillow.
  • Try heat or ice to reduce pain and swelling.
  • Get plenty of sleep — sleeping on your back or side is best.
  • Manage your stress since stress can make symptoms worse.
  • Consider over-the-counter (OTC) pain relievers like ibuprofen (Advil) or acetaminophen (Tylenol).

You’ll want to find the right balance of rest and activity. Rest is important, but not moving for too long can make your muscles stiff.

“In general, rest when you have pain and avoid activities that make your pain worse. You may begin exercising again a few days after your symptoms improve,” Dr. Vina said. Start with low-impact activities like walking. Gradually exercise more often and for longer periods. Listen to your body and take breaks when you need to. If you’re not sure whether you should try a certain activity, talk to your provider.

How is costochondritis treated?

If those steps aren’t giving you enough relief, your provider may recommend other options for treating costochondritis. You and your provider can work together to come up with a treatment plan that’s right for you, based on how severe your symptoms are.

“With treatment, most people with costochondritis feel better within a few weeks,” Dr. Vina said. Here are some options that may help:

  • Medication: Your provider might prescribe stronger pain medication if OTC options aren’t working well.
  • Physical therapy: A physical therapist can teach you gentle exercises and deep breathing techniques that improve flexibility and range of motion in your chest. They can also help you come up with a plan for getting back to your normal activities without making your pain worse.
  • Injections: While usually not necessary, steroid injections may help reduce your pain.

Even if your symptoms improve, it is important to follow up with your provider to make sure that you are healing properly and you’re not developing any complications.

How can you keep costochondritis from coming back?

You can’t guarantee that costochondritis won’t return, but along with the suggestions listed above for reducing the pain, you can take steps to make it less likely:

  • Exercise in ways that don’t cause symptoms. Warm up before you exercise and cool down afterward.
  • Listen to your body and rest when you need to.
  • Stay informed about your condition.
  • Maintain a healthy weight.
  • Eat a healthy diet.
  • Avoid smoking.

How can you cope with chronic pain?

Most of the time, costochondritis clears up in a few weeks. But sometimes it can last and chronic pain can have an impact on your emotional life, leading to anxiety, depression, anger and frustration.

To cope with chronic pain, you may want to:

  • Practice relaxation techniques
  • Get regular exercise in ways that don’t make your pain worse
  • Get enough sleep
  • Choose a healthy diet
  • Avoid alcohol and drugs
  • Talk to your provider
  • Join a support group
  • Get professional help

The bottom line

Costochondritis is a condition where the cartilage that connects one of your ribs to your breastbone gets inflamed, so it can feel uncomfortable or painful. Heavy lifting, injury, overuse or other conditions can cause it.

Your provider or a Banner Health provider can diagnose costochondritis and help you develop a treatment plan. Most of the time, the condition clears up within a few weeks.

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