Costochondritis

What is costochondritis?

Costochondritis is a condition that causes pain in the cartilage and joints connecting your ribs to your sternum (breastbone). Cartilage is the tough, bendable tissue that protects bones. Joints are the places in your body where two or more bones meet, such as your knees or elbows. Ribs are the bones that go from your sternum to your spine, protecting your lungs and heart. The pain of costochondritis may be in one or more joints, and often affects the second through fifth ribs. With costochondritis, it may be painful to do your usual activities, such as work and sports. Costochondritis pain may go away without treatment, usually within a year. If you need treatment, it may decrease your pain, and help you return to doing your usual activities sooner.

What causes costochondritis?

Caregivers may not know what caused your costochondritis, or it may be caused by any of the following:

• Chest injury: An injury to the chest may cause costochondritis. A chest injury can occur during a car accident, when the steering wheel hits the driver's chest.
  
  
• Strain: Activities that strain the chest wall muscles can lead to costochondritis. This includes hard coughing. Strains can also occur while playing sports with repeated arm movements, such as rowing, weight lifting, and volleyball.
  
  
• Infection: Lung or chest infections can cause costochondritis.

What increases my risk of getting costochondritis?

• Activity: If you do sports such as rowing, volleyball, or weight lifting, you are more likely to get costochondritis.
  
  
• Heart surgery: Having heart surgery increases your chance of getting costochondritis.
  
  
• Inflammatory diseases: Diseases that cause swelling around your joints, such as rheumatoid arthritis, increase your risk of getting costochondritis.
  
  
• Intravenous drugs: Using intravenous (IV) drugs increases your risk of getting costochondritis.
  
  
• Tumors: Having a tumor (growth) in your chest makes you more likely to get costochondritis.

What are the signs and symptoms of costochondritis?

Costochondritis causes pain in the area where your sternum joins with your ribs. The pain may be in a small or large area. It may come and go, and may get worse or better over time. The pain may be sharp, or dull and aching. It may be painful to touch your chest. The pain may spread to your back, stomach, or down your arm. It may get worse when you move, breathe deeply, or squeeze, push, or lift an object. The pain may make it hard for you to sleep or do your usual activities. Your chest may also feel stiff.

How is costochondritis diagnosed?

Your caregiver will ask you about your signs and symptoms. He will touch your chest, and may move your arms to see if this causes pain. You may need one or more of the following tests to check for other causes of your pain:

• Heart monitor: This test is also called an EKG or ECG. Sticky pads are placed on your skin to record your heart's electrical activity. An EKG gives information about how your heart is working. Lie as still as possible during the test.
  
  
• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Bone scan: a bone scan is done to take pictures of your bones. You are given a small amount of dye through an intravenous (IV) before the pictures of your bones are taken. An IV is a small tube that is placed into a blood vessel. Broken bones, infections, and other problems may be seen using a bone scan.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.
  
  
• Ultrasound: An ultrasound is a simple test that looks inside of your body. Sound waves are used to show pictures of your organs and tissues on a TV-like screen.
  
  
• Computed tomography scan: This test is also called a CT scan. A CT scan uses a computer to take pictures of your chest. You may be given dye before the pictures are taken to help caregivers see the pictures better. Tell caregivers if you are allergic to iodine or shellfish (lobster, crab, or shrimp), as you may also be allergic to this dye.

How is costochondritis treated?

Your treatment depends on the cause of your costochondritis. You may need one or more of the following treatments:

• Medicines:
  
  
  • Acetaminophen: This medicine is used to decrease pain and lower a high body temperature (fever). Taking too much acetaminophen can hurt your liver. Read labels so that you know the active ingredients in each medicine that you take. Talk to your caregiver before taking more than one medicine that contains acetaminophen. Ask your caregiver before taking over-the-counter medicine if you are also taking pain medicine prescribed (ordered) for you.
    
    
  • Nonsteroidal anti-inflammatory medicine: Nonsteroidal anti-inflammatory medicine (also called NSAIDs) may help decrease the pain of costochondritis. This medicine can be bought with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. Always read the medicine label, and follow the directions on it before using this medicine.
    
    
  • Steroid injections: Steroid medicine may be given as an injection (shot) in the joints of your chest to decrease pain.
    
    
  • Local anesthesia: Local anesthesia is a shot of numbing medicine injected into painful joint areas. It is used to numb the area and decrease pain.
    
    
  • Nerve block: A nerve block is a shot of medicine that makes you lose feeling in an area of your body. You may need a nerve block if your pain is not going away, or is getting worse.
  
  

• Therapy:
  
  
  • Physical therapy: You may need to see a physical therapist. This caregiver will teach you exercises to help strengthen your chest muscles and decrease your pain. Physical therapy may help you return to your usual activities faster. Your therapy may also include manipulation, which is when caregivers move your joints. Caregivers may massage painful areas.
    
    
  • Acupuncture: Acupuncture is a treatment based on a belief that fluids flow through channels in our bodies. Caregivers insert very thin needles just under your skin. This is believed to open the channels, allowing fluids to flow better. This treatment may decrease pain and improve healing. Always see a caregiver for acupuncture. Do not try to give this treatment to yourself.
  
  

What can I do to help decrease the pain caused by costochondritis?

• Rest: You may need to rest and avoid painful movements and activities. Avoid carrying objects, such as a purse or backpack, if this causes pain. Avoid activities such as weight lifting until your pain decreases or goes away. Ask your caregiver which activities are best for you to do while you recover.
  
  
• Heat and ice: A heating pad or an ice pack placed on painful areas may be used to decrease your pain. Wrap an ice pack in a towel before using it. Never sleep with a heating pad or ice pack left in place, as this can damage your skin. Ask your caregiver how often you should use heat or ice on your injury.
  
  
• Supportive clothing: If you are female, wearing a bra that provides support may make you feel more comfortable and decrease your pain.
  
  
• Exercises: Your caregiver may give you exercises to do at home to decrease your pain. It is best to start slowly, and do more as you get stronger. Ask your caregiver for more information about exercises that you can do at home.

When should I call my caregiver?

Call your caregiver if:

• You have a fever.
  
  
• The painful areas of your chest look swollen, red, and feel warm to touch.
  
  
• You cannot sleep because of the pain.
  
  
• You have questions or concerns about your condition.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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