Costochondritis
ByLaurence Schubert APAM
What is Costochondritis?
Costochondritisis a painful condition at the joints between the sternum and the ribs. Thereare 12 individual ribs that make up the rib cage, 7 of these attach to thesternum bone. Importantly, the ribs do not attach directly to the sternum, theyattach via cartilage known as "œcostal cartilage". These are the areas that areaffected by Costochondritis.
Thiscondition is closely linked with Tietze’s syndrome but have key differences.Through modern Latin language, "itis"refers to inflammation, which is the maindistinguishing factor between the two conditions. Tietze's syndrome does nothave inflammation of the costal margin, whereas Costochondritis does.
What are the symptoms ofCostochondritis?
Costochondritisis very painful and often debilitating. This condition is characterised byactivity related pain and tenderness localised to the costochondral junction. Eachpresents differently but it is likely that pain will be elicited byactivity/exercise, sneezing, coughing and deep breathing. Pain can refer to theback as well as the arms and shoulders. Due to the inflammation, increasedredness, temperature increase and swelling of the cartilage may be presentthrough palpation and observation. Symptoms can occur gradually and can takemultiple months to settle down. Alternatively, red flags should always be ruledout as differential diagnosis may include cardiac pathology or tumour.
What Causes Costochondritis?
Theexact cause of costochondritis is unknown; however, it is likely that patientswho have increased inflammatory markers are at greater risk.
- Certain types of arthritis; particularly rheumatoid.
- Certain viruses such as tuberculosis and syphilis, or anything that increases joint inflammation.
- Trauma to the chest, e.g. from a fall or car accident.
- Tumours in the costal region.
- Physical strain from activities that involve strenuous exercise (secondary cause).
What is the Treatment for Costochondritis?
Costochondritiswill involve medication to reduce the inflammation as well as physical therapyto reduce symptoms. It is important to re-assure the patient that thiscondition can be managed and that you shouldn't stop your activity completely,due to this condition. Local injections, topical or oral analgesics, as well assteroidal medication can be used.
Yourphysiotherapist can assist with physical therapy techniques in order to reducethe intensity and frequency of your symptoms. This can include trigger pointtherapy, cross fibre friction massage, mobilisation of the ribs/thoracic regionand recommendation on activities to avoid. Stretching and progressive exercisesare very likely to benefit this condition.
Anassessment by your physiotherapist or health care practitioner is necessary inorder to rule out any other more serious conditions and to identify the mainproblem(s).
If you have any questions about chest pain or costochondritis then please contact us or book online for an appointment.
