Costochondritis what is it?

Common injury, Ribs

Costochondritis by definition is inflammation of the costo-chondral joints, this is where your ribs meet your sternum (or breast bone) on the front of your chest. Other names this may be associated with is Tietze’s syndrome, which is most common in rib joints 2-5 (90% of cases). 

There are a couple of tell tale signs between costochondritis and Tietze’s Syndrome, Costochondritis can be found in any of the rib joints unlike Tietze’s above, Costochondritis can be bilateral – meaning it occurs on both sides of the sternum, Tietze’s syndrome often has  visible swelling. However a lot of texts will use them interchangeably as the pathophysiology and pain presentation is very similar. 

Who?

  • Costochondritis is a relatively common condition, with nearly 1 in 20 people having a case in their lifetime. 
  • Typically the population affected by costochondritis is adolescents through to 50 years of age, and is more common in the active population, and is twice as likely to occur in females. 
  • Athletic and sporting people are most commonly injured due to the respiratory stress coupled with the chance of direct blows, however desk workers are also susceptible from lack of movement or activity. 
  • There are also cases that come post illness, particularly something that has a lot of coughing and sneezing over the course of infection, this includes those who may suffer from asthma or hayfever

Signs and symptoms of costochondritis 

  • Anterior chest pain – can be one sided or both sided
  • Pain can be shooting and inconsistent. 
  • Inflammation and pain
  • May have been from a direct blow
  • Pain is made worse by coughing and sneezing 
  • In some cases it may have begun from an upper respiratory tract infection and a cough – such as pneumonia, pleurisy or any smoking related conditions. 

With any anterior chest pain it is best to approach with caution, one study in an emergency department found that around 30% of patients who presented with chest pain had a rib complaint, but better to be safe than sorry!

Diagnosis of costochondritis 

Often not straight forward, and requires elimination other causes of pain such as 

  • Heart or lung involvement 
  • Any muscle strains – such as pecs or intercostals
  • Fractures and dislocations of the ribs
  • Anxiety is also a known cause of chest pain 
  • Finally reflux is also another cause of chest pain. 

Usually diagnostic imaging is not required but may be used to confirm a diagnosis, or if we are unable to rule out a potential more sinister cause of the pain. 

How long does it take to recover?

Recovery time frames are still somewhat of an unknown, when dealt with early we usually see much better results, even as little as 2-3 weeks. However typically we’re looking at approximately 6 weeks for full resolution but it is not unheard of to be longer, particularly if aggravating factors can’t/won’t be changed such as work conditions or persisting with sport. If pain is not easing we combine treatment with anti-inflammatory medication from the GP.

Treatment

Our job as Osteos in the early stages is to provide symptomatic relief so that you can move and sleep better. This may include stretching, joint articulation and massage to relieve affected areas. 

Once we are managing the pain we will work with you to improve your flexibility and strength and if necessary work through some breathing exercises to help your rib cage and diaphragm work more efficiently. 

 

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