Costochondritis

This information may be useful for those who have been diagnosed with costochonditis. If you are experiencing new or ongoing symptoms you should contact your healthcare professional. You might need an assessment to help with diagnosis and treatment.

When the costochondral joint becomes inflamed it can result in sharp chest pain and tenderness. These symptoms may develop gradually or start suddenly.

Phone 999 immediately if:

You or someone else has symptoms like:

  • central chest pain or discomfort that doesn’t go away – it may feel like pressure, tightness or squeezing
  • pain that radiates down the left arm, or both arms, or to the neck, jaw, back or stomach
  • unconsciousness
  • seizures or fitting
  • difficulty breathing (snoring or rasping)
  • rapid heart beat
  • low or undetectable heart beat
  • blue or pale tingling of knees, hands and lips
  • chest pain and breathlessness, nausea, sweating or coughing up blood

Phone 111 if:

  • there’s been new significant trauma within the last 7 days, for example a fall from height or direct blow to the chest or ribs
  • there’s a change in the shape of the ribcage like lumps or indentations
  • you have an increased shortness of breath or new breathing difficulties
  • your pain levels are preventing you from breathing deeply
  • you’re coughing up blood
  • you start to feel generally unwell
  • tingling or burning sensation in the chest, neck or arms

Contact your GP if:

  • you have a persistent cough
  • you’re coughing up yellow/green mucus (phlegm)

If your GP surgery is closed, contact 111.

About costochondritis

Costochondritis is the medical term for inflammation of the cartilage that joins your ribs to your breastbone (sternum).

Cartilage is tough but flexible connective tissue. It acts as a shock absorber, cushioning the joints.

Costochondritis will normally improve on its own after a few weeks but sometimes takes longer. The condition doesn’t lead to any permanent problems, but can occasionally flare up.

Symptoms of costochondritis

The main symptom of costochondritis is chest pain that appears centrally. The pain doesn’t usually spread across the chest or into the arms.

The pain may be made worse by:

  • certain positions or activities, like wearing a seatbelt or hugging someone
  • deep breathing
  • coughing and sneezing

Modifying your activities while you recover may help reduce your symptoms.

Causes of costochondritis

Inflammation is the body’s natural response to infection, irritation or injury.

It’s not known exactly why this area becomes inflamed but in some cases it’s been linked to:

  • severe coughing which strains your chest area
  • an injury to your chest
  • physical strain from repeated exercise or sudden exertion that you’re not used to, such as moving furniture

an infection, including respiratory tract infections (RTIs)

Diagnosing costochondritis

For costochondritis to be diagnosed you’ll need an assessment from a healthcare professional.

They’ll initially ask you questions and then carry out a physical examination.

You may sometimes need to have a further examination. This is to rule out other possible health conditions.

Treating costochondritis

Costochondritis often gets better after a few weeks. Self-help measures and medication can manage the symptoms.

Costochondritis can be made worse by any activity that places stress on your chest area, for example strenuous exercise or repetitive movements.

Any movement that makes the pain in your chest area worse should be modified until the inflammation in your ribs and cartilage has improved.

Some examples of modified activity include:

  • taking regular breaks
  • changing your position regularly while sitting or lying down
  • holding objects close to your body when lifting them

hugging a cushion while you cough

Pain treatments

The following can help to reduce the pain:

  • pain medication – this can help you move more comfortably, which can help your recovery
  • heat packs

More about taking painkillers.

Treating with heat

Remember to never place heat directly on your skin. Use a barrier, like a towel, to protect your skin from a burn.

How long you use heat as a treatment can depend on the painful area. Generally up to 15 minutes of heat, leaving a few hours between treatments, is the most useful.

You should stop treating the area with heat and seek advice from a medical professional if you notice:

  • an increase in redness
  • discolouration
  • blistering of the skin

If you have any issues with circulation or sensation, you shouldn’t use heat as a treatment.

Keeping active

It’s important to try to keep moving as normally as possible during your recovery. It’s best to avoid long periods of rest where possible.

You can try to increase your activity gradually to help your recovery.

Pacing your activity levels

Too much rest can slow down your recovery. As soon as you can, start moving and using the affected area.

Remember a little activity is better than nothing. Continue to stay within acceptable pain limits but you don’t need to be pain free. Aim to do a little bit more each day or every few days.

How to tell if you’re moving at the right level

This guide can help you to understand if you’re pacing your daily activities at the right level as you progress. It’ll also let you see how much pain or discomfort is acceptable.

It can be helpful to rate your pain out of 10 (0 being no pain, 10 being the worst pain you’ve ever had), for example:

  • 0 to 3 – minimal pain
  • 4 to 5 – acceptable pain
  • 6 to 10 – excessive pain

Pain during and after activity

Activity should not make your existing pain worse overall. Increasing activity can lead to increased discomfort as your body gets used to regaining your activity levels.

Aim to keep your pain within a rating of 0 to 5. If your pain gets above this level, you can change the level of activity by:

  • reducing the number of times you do a movement
  • reducing the pace of an activity
  • increasing rest time between activities

Work

Your return to work will depend on the type of work you do and your employer. It may be possible to discuss a phased return to work or changed duties.

You don’t need to see a healthcare professional to return to work.

Hobbies and interests

Keep doing any activities you’re able to, as your pain allows. Gradually increase what you do.

Your symptoms may make things more difficult to start with. This will get better as you slowly build up to all of your usual activities.

Help and support

If your symptoms worsen or haven’t improved within 8 weeks following this advice, it’s a good idea to talk to a healthcare professional.

Find out how to access MSK services in your area.

When dealing with any health condition it’s important to also look after your mental wellbeing as this can impact your recovery.


Last updated:
14 December 2023