Understanding and Managing Costochondritis: A Guide to Relief

Costochondritis, often described as a persistent, nagging chest pain, can be alarming because it mimics the pain associated with heart conditions. However, this inflammation of the cartilage where the upper ribs attach to the sternum is non-cardiac and, while uncomfortable, is generally not dangerous. In this blog post, we'll explore what costochondritis is, its symptoms, causes, and effective ways to manage and treat it.

What is Costochondritis?

Costochondritis is an inflammation of the costal cartilage, the connective tissue joining your ribs to the sternum (breastbone). This condition results in chest pain that can affect one or more of the upper ribs, typically on the left side of the chest. Though it can occur at any age, it's more common in women and people over 40. The wild thing about costochondritis, is people can suffer from this afflication for months and years, yet there is usually lots that can be done to help.

Symptoms of Costochondritis

The primary symptom of costochondritis is sharp, aching, or pressure-like chest pain that worsens with certain activities, such as:

• Taking deep breaths

• Coughing or sneezing

• Physical activity

• Pressing on the affected area

The pain may radiate, mimicking that of a heart attack or other heart conditions, which is why it's important to always seek medical evaluation for chest pain if you're unsure of its cause.

Causes and Risk Factors

The exact cause of costochondritis often remains unclear, but several factors may contribute to its development:

• Physical Strain: Heavy lifting, strenuous exercise, or unusual physical activity can strain the chest wall.

• Injury: A blow to the chest can lead to costochondritis.

• Arthritis: Conditions like osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis can be associated with costochondritis.

• Infections: In rare cases, bacterial or fungal infections can cause inflammation of the costal cartilage.

Managing and Treating Costochondritis

Lifestyle Modifications

Making simple changes can significantly reduce the strain on your ribcage:

• Avoid strenuous activities that exacerbate the pain.

• Practice good posture to reduce pressure on the ribcage.

• Use heat or ice packs on the chest area to reduce pain and inflammation.

Medication

Over-the-counter pain relievers like ibuprofen or naproxen can help reduce inflammation and alleviate pain. Always consult with a healthcare provider before starting any new medication. Always have a plan to get off pharmaceuticals when you can.

Physical Therapy

Physical therapy can be highly beneficial in managing costochondritis. A physiotherapist may recommend:

• An exercise program to:

  • Improve mobility in the chest wall and surrounding musculature - e.g. pectoralis major/minor muscle stretching.

  • Strengthen exercises to support the muscles around the back - e.g. lower trap raises.

• Manual therapy interventions such as:

  • Dry needling (to de-activate trigger points)

  • Muscle scraping (to remodel fascia)

  • Joint adjustments (‘cracking’ joints to reduce stiffness)

  • Soft tissue mobilisation (to reduce inflammation)

  • Assisted stretching

  • Laser therapy…

• Breathing retraining exercises

• Relaxation techniques

Alternative Treatments

Some people find relief through alternative treatments such as:

• Acupuncture

• Transcutaneous electrical nerve stimulation (TENS)

• Relaxation techniques, such as deep breathing and meditation, to manage pain.

When to Seek Medical Attention

It's crucial to seek immediate medical attention if you experience severe, unexplained chest pain, especially if accompanied by symptoms like shortness of breath, nausea, or dizziness. These symptoms can signify a heart attack or other serious conditions that require urgent care.

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While costochondritis is typically a benign and self-limiting condition, understanding and managing it can help alleviate pain and prevent future flare-ups. If you suspect you have costochondritis, consult with a healthcare provider to rule out other potential causes of chest pain and discuss the best treatment options for your situation. With the right approach, most people find effective relief and return to their normal activities without lasting issues.