Overview

Costochondritis (kos-toe-kon-DRY-tis) is an inflammation of the cartilage that connects a rib to the breastbone (sternum). Pain caused by costochondritis might mimic that of a heart attack or other heart conditions.

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

Costochondritis usually has no apparent cause. Treatment focuses on easing your pain while you wait for the condition to improve on its own, which can take several weeks or longer.

Costochondritis usually goes away on its own, although it might last for several weeks or longer. Treatment focuses on pain relief.

Symptoms

The pain associated with costochondritis usually:

  • Occurs on the left side of your breastbone
  • Is sharp, aching or pressure-like
  • Affects more than one rib
  • Worsens when you take a deep breath or cough

When to see a doctor

If you have chest pain, you should seek emergency medical attention to rule out life-threatening causes such as a heart attack.

Causes

Costochondritis usually has no clear cause. Occasionally, however, costochondritis may be caused by:

  • Injury. A blow to the chest is one example.
  • Physical strain. Heavy lifting, strenuous exercise and severe coughing have been linked to costochondritis.
  • Arthritis. Costochondritis might be linked to specific problems, such as osteoarthritis, rheumatoid arthritis or ankylosing spondylitis.
  • Joint infection. Viruses, bacteria and fungi — such as tuberculosis, syphilis and aspergillosis — can infect the rib joint.
  • Tumors. Noncancerous and cancerous tumors can cause costochondritis. Cancer might travel to the joint from another part of the body, such as the breast, thyroid or lung.

Risk factors

Costochondritis occurs most often in women and in people older than 40.

Tietze syndrome usually occurs in teenagers and young adults, and with equal frequency in men and women.

March 20, 2015
References
  1. Ferri FF. Costochondritis. In: Ferri's Clinical Advisor 2015: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2015. https://www.clinicalkey.com. Accessed Feb. 4, 2015.
  2. Phillips K, et al. Treatment of musculoskeletal chest pain. http://www.uptodate.com/home. Accessed Feb. 4, 2015.
  3. McMahon SB, et al. Thoracic pain. In: Wall & Melzack''s Textbook of Pain. 6th ed. Philadelphia, Pa.: Saunders Elsevier; 20015. https://www.clinicalkey.com. Accessed Feb. 4, 2015.
  4. Wise CM. Major causes of musculoskeletal chest pain in adults. http://www.uptodate.com/home. Accessed Feb. 4, 2015.
  5. Frontera WR, et al. Costernal syndrome. In: Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 20013. https://www.clinicalkey.com. Accessed Feb. 4, 2015.
  6. AskMayoExpert. What are the most common causes of chest wall pain? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
  7. McConaghy JR, et al. Outpatient diagnosis of acute chest pain in adults. American Family Physician. 2013;87:177.