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You have chest pain. You probably think that you have a heart disease.

Costochondritis Overview

Chest pain may also be a symptom of costochondritis. If you have costochondritis don’t worry. Costochondritis is a benign condition.  Costochondritis is inflammation of the rib cage muscles. It is a common cause of chest pain in children and adolescents. Most frequently it affects young adults between 20 and 40 years old. In contrast to myocardial ischemia or infarct, costochondritis is a benign cause of chest pain.

Costochondritis occurs in women and people over age 40, can affect anyone, even infants and children. When costochondritis is accompanied by swelling it is called Tietze's syndrome. You shoul know that Tietze syndrome is often referred to as costochondritis, but the two are distinct conditions.

In most of cases the cause is unknown, idiopathic, and costochondritis goes away without treatment. When the cause is unknown the goal of treatment is pain relief.

If you have chest pain you should know that it is medical emergency.  Underlying diseases which can cause chest pain can be very serious.  Chest pain may be caused by heart diseases, lung diseases, gastrointestinal problems and costochondritis. When you have chest pain your doctor will first rule out heart disease. You will have some tests; they are needed to rule out other diseases.  If chest pain isn’t caused by heart disease you probably have costochondritis. You should know that costochondritis affects more  woman than men. In some cases this condition can be caused by infection.

What are the signs and symptoms of costochondritis?

Pain and tenderness are localized in the places where your ribs attach to your breastbone. If you have costochondritis you will feel sharp pain or gnawing pain. Pain caused by costochondritis can occur on either side of your chest, but occurs most often on the left side of your breastbone. Pain is usually worsened by activity or exercise. Because of the many nerves that branch away from the chest, you can feel pain in the shoulder or arms as well.

Most common symptoms of costochondritis are: pain when coughing, pain when taking deep breaths, difficulty breathing.  When you movement stops, pain decreases.  Chest pain is usually preceded by exercise, or an upper respiratory infection or minor trauma. This chest pain increases as you take deep breath. When you take deep breath you stretch the inflamed cartilage and that can cause exquisite pain. Sometimes simply touching the area involved will be extremely painful for you.

What are the causes of costochondritis?

Cause of costochondritis in most of cases is unknown, usually it has no definite cause. But there are some cases where the cause can be determined.  Costochondritis can be caused by injury; a blow to the chest could also cause costochondritis.
Infection also can be cause of costochondritis. Viral respiratory infections, bacterial infections after surgery and very rare fungal infection are known causes of costochondritis. This condition commonly occurs with viral respiratory infections because of the inflammation rib cage muscles from the viral infection itself, or from straining from coughing. When costochondritis recurs that can be sign of fibromyalgia. Patient who have fibromyalgia often have several tender spots. The upper part of the breastbone is a common tender spot. Repeated minor trauma to the chest wall also can be cause of this costochondritis. Frequently, surgery to upper chest can be cause of costochondritis.

If you have chest pain you should see a doctor. Only doctor can diagnose costochondritis. There are difference between costochondritis pain and pain caused by heart attack. Costochondritis pain is localized on small area, and pain caused by heart attack is more widespread. Heart attack pain may worsen with stress or physical activity.  Costochondritis pain is constant. Never try to diagnose by yourself chest pain, leave that for your doctor. Every chest pain should be taken very serious.

Screening and diagnosis

To help your doctor make the right diagnose, you must describe your chest pain. Pain of costochondritis can be very similar to the pain associated with heart disease, lung disease, and gastrointestinal problems. So doctors often missdiagnose costochondritis. Costochondritis is also a common cause of chest pain in children and adolescents.
There are no tests for costochondritis, this condition can't be seen on chest X-rays or other imaging tests.
When doctor suspect that you have costochondritis my order some tests to rule out other conditions. The only way  to diagnose this condition is to take your personal medical history and to do physical exam.  Costochondritis occurs fairly frequently in people who had cardiac surgery.

What is the treatment for costochondritis?

Patients with costochondritis usually don’t need any treatment. Costochondritis pain usually lasts a week or two and then goes away.  In some cases doctor can prescribe nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve).  You should discuss with your doctor about those medication because they have some side effects.
Nonsteroidal anti-inflammatory medications can help decrease symptoms of pain, also they help decrease inflammation, which is the primary problem. Some doctors prescribed tricyclic antidepressants if pain is making it difficult to sleep.

Your doctor may give you a local anesthetic and steroid injection in the area that is tender, if the pain does not respond to medications.   Very rare surgery (removal of the sore cartilage) is performed.  If costochondritis is caused by infection usually treatment s are IV antibiotics.
The pain should improve within a few weeks, and resolve completely within six months.  There are patients in whom this problem persists for some time. If you have chest pain which last more than few months see your doctor. If you had the costochondritis once that does not increase your chances of experiencing the symptoms again.

Self - care

There are several helpful things to do in order to help manage the symptoms of costochondritis.  Self - care is most important part of treatment. You should rest, and avoid activites which make your pain worse. In order to decrease the inflammation, you should avoid activities that cause pain and inflammation. Deep breathing, exercise,  and strain on the muscles of the chest may worsen pain and slow the healing process. Avoid or limit activities that worsen your pain.
Walking or swimming can keep your body healthy. When exercise increases your pain you should stop. Also you can apply heating pad to the painful area several times a day.  Local heat or ice may be helpful to relieve pain. Ice packs or heating ads these techniques help to decrease your pain may help you better manage your symptoms. You should find out more about chronic pain. The pain associated with costochondritis significantly improves within the first 4-8 weeks. Some pain may persist, it is only associated with strenuous activity.

How to prevent costochondritis?

There is no prevention for this condition because costochondritis has no definite cause.