Costochondritis is inflammation of the cartilage connecting your ribs to your sternum (breastbone). The pain can feel like the sharp, stabbing or pressing, aching pain of a heart attack. You should seek emergency medical care if you have any heart attack symptoms. However, if your diagnosis is costochondritis, it is generally considered a harmless condition.
The condition lasts from a few days to up to a year for some people, though most cases resolve within a few weeks. While it lasts, you may wish to try conventional treatments and natural remedies to help ease symptoms.
What Is Costochondritis?
Costochondritis is a painful condition caused by inflammation in the cartilage that connects the ribs to the breastbone. This area is known as the costochondral joint.
The condition may also be called chest wall pain, costosternal syndrome or costochondrondynia. When there is swelling present, the condition is called Tietze syndrome (also known as chondropathia tuberosa or costochondral junction syndrome).
In most people, the left side is most affected. The symptoms often mimic a heart attack, so accurate diagnosis is essential. Always call a doctor or go for emergency care if you have chest pain.
The condition is fairly common, affecting about 200,000 people per year in the U.S. In most cases, the cause of costochondritis is unknown. Thankfully, the condition does go away on its own in time. It usually takes a few days to a few weeks for costochondritis to resolve, but some people have symptoms for up to a year.
In general, costochondritis can have very distressing and sometimes debilitating symptoms, but it is not considered a medically serious condition. In fact, when it happens in isolation, it is considered harmless, other than the symptoms it causes. However, because its symptoms overlap so much with potentially life-threatening conditions, you should always seek professional medical evaluation for chest pain that seems to be costochondritis.
How is costochondritis linked to other diseases?
There are also many conditions that may be associated with costochondritis or pain that can easily be confused with it. These include: (1)
- Arthritis and rheumatoid arthritis
- Degenerative joint disease
- Ankylosing spondylitis
- Gastroesophageal reflux disease (GERD) or heartburn
- Injury or trauma to the chest, including muscle strain
- High cholesterol and high blood pressure
- Inflammatory bowel disease or abdominal pain
- Acromegaly, rickets and other systemic diseases
- Stress or anxiety
Costochondritis does not lead to cancer. However, swelling caused by Tietze’s syndrome may be mistaken for cancer in some cases, or vice versa. In addition, existing tumors in the chest area may irritate the rib cartilage, causing costochondritis pain.
Costochondritis Signs and Symptoms
Costochondritis symptoms may include:
- Pain on the left side of the sternum
- Sharp or aching chest pain
- A sense of pressure in the chest
- Pain affecting at least one rib, but usually more
- An increase in pain when taking deep breaths, coughing, lifting or doing other strenuous exercise
- Pain that may travel to the back or stomach from the front of your chest
- Sensitivity or tenderness when you press on the affected ribs where they meet the breastbone
- A decrease in pain when you rest and breathe calmly
Costochondritis Causes and Risk Factors
- Injury or trauma to the chest
- Tumors in the chest that grow on, inflame or press on the cartilage connecting the ribs to the breastbone; the tumors may or may not be cancerous
- Heavy exercise, manual labor or lifting heavy items
- Respiratory infections such as pneumonia, or other illnesses that cause heavy coughing
- Infections that can cause joint inflammation, such as tuberculosis, syphilis or other viruses, bacteria or fungi
- Post-surgery or post-intravenous (IV) needle infections
Risk factors for costochondritis include:
- Doing manual labor or heavy lifting
- Being a woman
- Taking part in high-impact activities
- Having regular exposure to irritants, if you have allergies
- Being age 40 or older
- Having rheumatoid arthritis, ankylosing spondylitis or reactive arthritis (Reiter’s syndrome)
Once your pain has been confirmed as a costochondritis diagnosis, your physician will discuss medical treatment options. These depend on the severity of your pain and may include: (4)
- Prescription-strength or over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs)
- Prescription pain relievers, such as narcotics containing codeine
- Antidepressants or anti-anxiety drugs, particularly if your pain keeps you up at night, since some of these drugs control chronic pain
- Anti-seizure drugs, also to control chronic pain
In severe cases or chronic costochondritis, numbing medicine or corticosteroids may be injected directly into the painful rib joints. This can ease pain and relieve inflammation. Costochondritis treatment plans may also include recommendations for physical therapy and rest.
5 Natural Remedies for Costochondritis Symptoms
Costochondritis relief is possible. For many people, symptoms disappear within a few days to several weeks. No matter how long you have to cope with costochondritis symptoms, you may wish to try some natural approaches to managing the pain.
Conventional costochondritis treatment and natural remedies may work well together, too. Always consult a healthcare professional before starting or changing a treatment, exercise or diet plan — including herbs and supplements. Many natural remedies can interact with NSAIDs, insulin or other common medications.
1. Practice costochondritis stretches
Costochondritis exercises may be very helpful in managing sternum pain. A clinical study found that targeted stretching exercises significantly improved pain in 51 patients with costochondritis, compared to 34 matched control patients who did not do stretching. The results got even better over time in terms of relieving pain. (5)
There are many videos and websites demonstrating helpful costochondritis stretches or physical therapy. In general, the exercises focus on stretching the arms, thorax, back and chest muscles.
Costochondritis exercises: (6)
- Wall slide. Stand with your back against the wall. Raise your arms up so that your fingertips point to the ceiling and your elbows are raised about shoulder height. Keeping your arms against the wall, raise them up overhead. Hold and then lower to the start position. Repeat 10 to 12 times per session.
- Scapula squeeze. Stand straight and tall, reaching your head toward the ceiling and breathing comfortably. Squeeze your shoulder blades together and hold the squeeze as long as it feels comfortable. Release. Repeat five to 10 times per session.
- Stretch the pecs. Stand just outside a doorway and reach your arms up as high as you can on either side of the frame. Supporting your weight with your hands, push your chest and body straight forward. Keep your abs tight so that your back doesn’t wobble or arch. Hold for a few seconds and return to the starting position. Repeat five to 10 times per session.
- Thorax stretch. Sit down with your legs straight out in front of you, keeping your back nice and straight. With your hands on the floor at the side of your thighs, lean forward slowly. Curve down over your legs so that your bellybutton moves toward your spine. Hold for a few seconds and slowly sit back up. Repeat five to 10 times per session.
- Side stretch. Starting in the same seated position as you did for the thorax stretch, except place your hands on your lower thighs. Bend your right arm and lean forward. Try to get your right elbow down to the knee on that side, allowing your hand to slide across to your left leg. For extra stretch, hold your elbow on the inside of the right knee, using the pressure between them to turn your chest further toward the left. Slowly release and return to the start position. Repeat with the left side of the body. Alternate sides, stretching each side 10 to 12 times per session.
2. Use heat or ice
Costochondritis pain and inflammation may respond to heating pads or ice packs. Do not use heat or ice for more than 15 minutes at a time. Wrap the heat or cold source in a towel or washcloth to help avoid skin damage.
3. Consider anti-inflammatory foods, herbs or supplements
Because inflammation is at the root of costochondritis, many health experts suggest anti-inflammatory drugs. If you prefer a natural approach — or if your doctor says it’s safe to take certain herbs and supplements in addition to your prescribed or over-the counter medicines — you may wish to fight inflammation with diet and other natural remedies.
- Try an anti-inflammatory diet. The foods discussed below have proven anti-inflammatory effects, and may have numerous benefits beyond fighting inflammation. They are also rich in nutrients.
- Focus on a diet rich in a variety of vegetables and fruits. Particularly good options include berries, grapes, green leafy vegetables, tomatoes, pineapple, bok choy, cherries, avocadoes, broccoli, peppers, mushrooms and beets.
- Get plenty of healthy fats via walnuts, fatty fish (such as salmon or mackerel) and olive oil or coconut oil.
- Incorporate chia seeds and ground flaxseeds, cocoa or dark chocolate into your diet.
- Season foods with bone broth, turmeric and ginger to get an extra anti-inflammatory boost.
- Drink green tea.
- Consider anti-inflammatory herbs and supplements. Please note that some of these interact with NSAIDs, steroids, diabetes drugs and other medications. Always discuss vitamins, herbs and supplements with your healthcare provider before making any changes.
- Turmeric. Not only does turmeric have a well-established reputation for fighting inflammation, it also has gained prominence in the management of arthritis. Over time, it may help improve pain and function and prevent further inflammation. (7)
- Glucosamine. There is some evidence that glucosamine may help relieve inflammation, reduce pain and heal cartilage, especially in conditions such as osteoarthritis. Although there is no clear research linking glucosamine to costochondritis, cartilage and joint health benefits may be enough to make supplementation of interest to some people. However, it should not be taken with NSAIDs in most cases. Studies suggest a dose of 1500 milligrams per day is safe for most people. (8)
- Other anti-inflammatory or pain-relieving herbs and supplements may include: (9, 10, 11)
- Boswellia (Indian frankincense)
- Devil’s claw
- Grape seed extract
- Silymarin (silibinin or milk thistle seed extract)
4. Minimize pain
There are many possible causes of costochondritis pain. Unfortunately, most people do not know what has caused their own case. If you do, however, you can take steps to improve the situation that has caused your condition. And even if you don’t know the cause, you can take steps to avoid making your pain worse. Options include:
- Get treatment for any infections, such as pneumonia, chronic coughing, tuberculosis, respiratory infections or post-operative infections
- Avoid exposure to allergens or things that irritate you
- Rest, and avoid strenuous physical activity, heavy lifting or manual labor
- Avoid things that make the pain worse, such as particular positions, deep breathing, hugging, sleeping on your stomach, singing, getting out of breath, etc.
- Consider natural cough remedies, such as these treatments:
- Drink plenty of water
- Sip on bone broth or ginger tea
- Try a spoonful of honey
- Use a humidifier
- Take vitamin C (1000 mg three to four times per day or as otherwise advised by your doctor)
- Use some homemade vapor rub or essential oils for aromatherapy
- Try some natural painkillers, such as:
- Super spicy foods (cayenne, wasabi), or creams containing capsaicin
- Lavender or peppermint essential oil, massaged into sore areas
5. Try transcutaneous electrical nerve stimulation (TENS)
Sternum pain can be very persistent. However, both the Mayo Clinic and the National Health Service (of the United Kingdom) suggest that TENS can be an effective pain relief method for some people with costochondritis.
For TENS therapy, a small device sends weak electrical current to try to interrupt or mask the pain signals your body sends your brain. It sends the signal through sticky patches on your skin near the painful area. Some people find it relieves pain and relaxes their muscles. It is also possible that TENS boosts your production of endorphins — your body’s own natural painkillers. (14, 15)
- Unless you already have a confirmed diagnosis, costochondritis pain should not be diagnosed or treated at home. Seek emergency evaluation for chest pain and other symptoms of costochondritis. Symptoms may easily be mistaken for a heart attack.
- If your pain changes, gets more severe or does not respond to treatment, contact your doctor.
- Many natural therapies for costochondritis can interact with common medical treatments for the condition. Always work with a healthcare professional to get the right balance of natural and medical therapies for you.
- Costochondritis is an inflammatory condition that causes chest pain. Symptoms may mimic those of a heart attack, but true costochondritis is a fairly harmless condition.
- In many cases, the cause of costochondritis pain and inflammation is unknown. In some cases, however, it is caused by infection, manual labor or heavy lifting, strenuous physical activity, a tumor or systemic disease.
- With or without treatment, costochondritis normally goes away within several weeks. However, some people have symptoms for up to a year.
- Medical treatment of costochondritis involves NSAIDs and physical therapy. In some cases, it may require pain medication, steroid injections or other drugs.
- Natural treatment options for costochondritis aim to provide pain relief and a reduction in inflammation. Common recommendations include practicing costochondritis stretches, using heat or ice, considering anti-inflammatory foods, herbs or supplements, minimizing pain and trying transcutaneous electrical nerve stimulation (TENS).