Costochondritis

Signs and symptoms

Cartilage is tough but flexible connective tissue. It is found throughout the body, including in the joints between bones. It acts as a shock absorber, cushioning the joints.

The area, at the end of each rib, is known as the costochondral junction.  When the costochondral junction becomes inflamed it can result in sharp chest pain and tenderness. This may develop gradually or start suddenly.

The pain may be made worse by:

• a particular posture – such as lying down
• pressure on your chest – such as wearing a seatbelt or hugging someone
• deep breathing, coughing and sneezing
• physical activity

When to seek medical help

It can be difficult to tell the difference between the chest pain associated with costochondritis and pain caused by more serious conditions, such as a heart attack.

A heart attack usually causes more constant widespread pain and additional symptoms, such as breathlessness, nausea and sweating.

If you, or someone you're with, experiences sudden chest pain and you think there's a possibility it could be a heart attack, dial 999 immediately and ask for an ambulance.

If you've had chest pain for a while, don't ignore it. Make an appointment to see your GP so they can investigate the cause.

Causes of costochondritis

Inflammation is the body's natural response to infection, irritation or injury.

It's not known exactly why the costochondral junction becomes inflamed. In some cases it's been linked to:

• severe coughing – which strains your chest area
• an injury to your chest
• physical strain from repeated exercise or sudden exertion that you're not used to – such as moving furniture
• an infection – including respiratory tract infections (RTIs) and wound infections
• wear and tear – your chest moves in and out 20 to 30 times a minute, and over time this motion can lead to discomfort in these joints

Treating costochondritis

Costochondritis often gets better after a few weeks. Self-help measures and medication can help manage the symptoms.

Self-help

Costochondritis can be aggravated by any activity that places stress on your chest area. This can include strenuous exercise or even simple movements like reaching up to a high cupboard.

Any activity that makes the pain in your chest area worse should be avoided until the inflammation in your ribs and cartilage has improved.

You may also find it soothing to regularly apply heat to the painful area. For example, using a cloth or flannel that's been warmed with hot water.

You should make sure the flannel is not too warm to avoid a scald or burn.

Painkillers

Painkillers, such as paracetamol, can be used to ease mild to moderate pain.

Taking a type of medication called a non-steroidal anti-inflammatory drug (NSAID) – such as ibuprofen –can also help control the pain and swelling. 

These medications are available from pharmacies without a prescription. You should make sure you carefully read the instructions that come with them before use. Ask your pharmacist if you need advice.

Contact your GP if your symptoms get worse despite resting and taking painkillers, to discuss alternative treatment. 

Tietze's syndrome

Costochondritis may be confused with a separate condition called Tietze's syndrome. Both conditions involve inflammation of the costochondral joint and can cause very similar symptoms.

Tietze's syndrome is much less common and often causes chest swelling. This may last after any pain and tenderness has gone.

Costochondritis also tends to affect adults aged 40 or over. Tietze's syndrome usually affects young adults under 40.

As the conditions are very similar, most of the information above also applies to Tietze's syndrome.

• find out more about costochondritis on the NHS website

More useful links

• How to use your health services