Costochondritis
By
Laurence Schubert APAM
What is Costochondritis?
Costochondritis
is a painful condition at the joints between the sternum and the ribs. There
are 12 individual ribs that make up the rib cage, 7 of these attach to the
sternum bone. Importantly, the ribs do not attach directly to the sternum, they
attach via cartilage known as "œcostal cartilage". These are the areas that are
affected by Costochondritis.
This
condition is closely linked with Tietze’s syndrome but have key differences.
Through modern Latin language, "itis"refers to inflammation, which is the main
distinguishing factor between the two conditions. Tietze's syndrome does not
have inflammation of the costal margin, whereas Costochondritis does.
What are the symptoms of
Costochondritis?
Costochondritis
is very painful and often debilitating. This condition is characterised by
activity related pain and tenderness localised to the costochondral junction. Each
presents differently but it is likely that pain will be elicited by
activity/exercise, sneezing, coughing and deep breathing. Pain can refer to the
back as well as the arms and shoulders. Due to the inflammation, increased
redness, temperature increase and swelling of the cartilage may be present
through palpation and observation. Symptoms can occur gradually and can take
multiple months to settle down. Alternatively, red flags should always be ruled
out as differential diagnosis may include cardiac pathology or tumour.
What Causes Costochondritis?
The exact cause of costochondritis is unknown; however, it is likely that patients who 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?
Costochondritis
will involve medication to reduce the inflammation as well as physical therapy
to reduce symptoms. It is important to re-assure the patient that this
condition can be managed and that you shouldn't stop your activity completely,
due to this condition. Local injections, topical or oral analgesics, as well as
steroidal medication can be used.
Your
physiotherapist can assist with physical therapy techniques in order to reduce
the intensity and frequency of your symptoms. This can include trigger point
therapy, cross fibre friction massage, mobilisation of the ribs/thoracic region
and recommendation on activities to avoid. Stretching and progressive exercises
are very likely to benefit this condition.
An
assessment by your physiotherapist or health care practitioner is necessary in
order to rule out any other more serious conditions and to identify the main
problem(s).
If you have any questions about chest pain or costochondritis then please contact us or book online for an appointment.
