Fast facts

  • Costochondritis is a common cause of chest pain. It is caused by inflammation of the joints in the rib cage.
  • The symptoms of costochondritis include sharp chest pain, which feels worse when coughing, sneezing or breathing heavily, and tenderness or soreness of the rib cage.
  • The pain caused by costochondritis usually goes away within a few days or weeks.

What is costochondritis?

Your ribcage is an arrangement of bones and cartilage that protects the inner organs in your chest and helps the lungs to function. The cartilage connects the bones to each other; it is more flexible than bone, and that flexibility allows the ribcage to expand and contract so that you can breathe, cough or sneeze.

Costochondritis is pain caused by inflammation of the joints in the rib cage where the cartilage connects to rib bones or to the breastbone (sternum). It is a common cause of chest pain.

Inflammation and costochondritis.Costochondritis is inflammation of rib joints. 

Causes and risk factors

Costochondritis can be caused by several factors, including muscle over-use, arthritis, or vitamin D deficiency.

Muscle overuse and strain

Repetitive, strenuous exercise or work can lead to muscle over-use and strain the rib joints. Repetitive coughing can also strain these joints.

Arthritis

Arthritis is the inflammation of joints. Rheumatoid arthritisosteoarthritis and ankylosing spondylitis all increase your risk of costochondritis. 

Vitamin D deficiency

Low levels of vitamin D can cause the costochondral junctions in the rib to grow, and this can potentially cause costochondritis. 

Ankylosing spondylitis

A type of inflammatory arthritis that affects the joints of the spine, particularly where the spine attaches to the pelvis.

Vitamin D

A vitamin that is important for the health of bones and teeth as it promotes absorption of calcium from the diet.

Signs and symptoms

Symptoms of costochondritis include:

  • Sharp chest pain, which feels worse when coughing, sneezing or breathing heavily, and;
  • Tenderness or swelling in the joints between the cartilage and rib or breastbone.

Methods for diagnosis

Physical examination

Your doctor may diagnose costochondritis by asking about your symptoms and performing a physical exam. They may gently press on your rib joints to see whether you feel pain or tenderness in that spot.

Tests to rule out other causes

X-ray

An X-ray of the chest may be used if the diagnosis is uncertain.

Electrocardiography

Electrocardiography (ECG) uses electrodes attached to your chest to check your heart rhythm. If you are at risk of heart disease, you may undergo electrocardiography to rule out heart attack as a cause of your chest pain.

Computerised tomography (CT) scan

This scan is usually done when other causes, such as infection or tumours, are suspected as the cause of your chest pain.

Vitamin D test

Vitamin D levels can be checked using a blood test.  

X-ray

A scan that uses ionising radiation beams to create an image of the body’s internal structures.

Vitamin D

A vitamin that is important for the health of bones and teeth as it promotes absorption of calcium from the diet.

Types of treatment

Pain-relief medications

Treatment for costochondritis focuses on pain relief. Non-steroidal anti-inflammatory drugs, such as ibuprofen, are used to reduce inflammation and the pain associated with it. In rare instances, a combined injection of a local anaesthetic and corticosteroid are used to reduce pain and inflammation.

Physical therapy

If the cause of the pain is muscle overuse and strain, physical therapy, heat pads and minimising the intensity and frequency of exercise or work can reduce pain.

Corticosteroid

A medication that resembles the cortisol hormone produced in the brain. It is used as an anti-inflammatory medication.

Local anaesthetic

A type of medication that, when administered to an area, creates a localised loss of sensation by blocking nerve activity.

Potential complications

Costochondritis is not a disease, but a symptom (chest pain due to inflammation). Different causes, such as rheumatoid arthritis or osteoarthritis, have different complications associated with them.

Prognosis

The pain caused by costochondritis usually goes away in a few days or weeks. Because your chest moves whenever you breathe, cough or sneeze, recovery can be slow, and your condition can sometimes get worse before it gets better. 

Prevention

There is no way to prevent costochondritis. It occurs at any age and without warning.