Health Library

Costochondritis(Tietze’s Syndrome)

Pronounced: COST-o-kon-DRY-tis

Definition

Costochondritis is pain in the front of the chest wall. In particular, it is irritation where the bone and cartilage part of the ribs meet.

Sometimes there is also swelling and inflammation. This is a condition referred to as Tietze’s syndrome. Neither costochondritis nor Tietze’s syndrome is a serious disease. However, their symptoms are similar to those of several dangerous conditions, like a heart attack .

The Rib Cage

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Causes

The cause of costochondritis is often not known. At other times, the condition can occur due to injury or overuse.

Risk Factors

Trauma to the chest.

Arthritis, especially:

  • osteoarthritis
  • rheumatoid arthritis
  • ankylosing spondylitis

Heavy lifting and strenuous exercise

Symptoms

If you have any of these symptoms, do not assume it is due to costochondritis. These symptoms may be caused by other, serious health conditions such as heart attack , digestive problems, and bone cancer . See your doctor of you have any of these symptoms:

  • Sharp, localized chest pain, which may be made worse by sneezing, coughing, deep breathing, or twisting motions of the chest
  • Tenderness or swelling over a joint between
    • rib cartilage and breast bone
    • rib cartilage and rib bone
Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor may do further tests if the diagnosis is not clear. Tests to examine the ribs more closely may include:

Treatment

Talk with your doctor about the best treatment plan for you. Most costochondritis will eventually go away on its own. Treatment is optional but choices include the following:

Hot or Cold Compresses

Compresses may help provide relief until the condition resolves itself. Try hot and cold compresses to see which is more helpful.

Over-the-Counter Analgesics

Your doctor may recommend some over the counter medicines. These may include aspirin , acetaminophen, ibuprofen, or naproxen.

Cortisone Injections

A local anesthetic and medication called cortisone may be injected directly into the area. This may be done if the discomfort does not respond to other treatments.

Prevention

Costochondritis occurs spontaneously at any age. It often occurs without warning or identified causes. There is no way to prevent it.

RESOURCES:

The American Academy of Family Physicians
http://familydoctor.org

Kids Health
http://kidshealth.org

CANADIAN RESOURCES:

Canadian Family Physician
http://www.cfpc.ca

Health Canada
http://www.hc-sc.gc.ca/index_e.html

References:

Costochondritis. EBSCO Dynamed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated November 30, 2009. Accessed September 12, 2012.

Gilliland BC. Relapsing polychondritis and other arthritides. In: Isselbacher K, et al. Eds. Harrison's Principles of Internal Medicine . 14th ed. New York, NY: McGraw-Hill; 1998:1055.

Proulx AM, Zryd TW. Costochondritis: diagnosis and treatment. Am Fam Physician . 2009 Sep 15;80(6):617-620.



Last reviewed September 2012 by Brian Randall, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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