What is Costochondritis?

There are more than a few medical terms and conditions that I have never heard of and don't even know exist. This was the case up until a few days ago when I first heard about this condition. My teenage son started complaining of pain in his upper chest which worsened with deeper breaths. According to him it had started a few days prior and had been 'coming and going'. As the nurse of the family, I was of course expected to know exactly what this was, and how to make it promptly disappear. Before I got the chance to do my extended research, my zealous teen did his own fact-finding and proudly announced he had costochondritis! Whether you have already heard about it or not, this article aims to explain in further detail what this condition involves.

What exactly is Costochondritis?

According to The Mayo Clinic it is an "inflammation of the cartilage that connects a rib to the breastbone (sternum)”. This area is known as the costochondral joint, hence the name. The inflammation in turn can cause pain and tenderness in the chest region, and may be alarming for the patient who may liken the pain to a heart attack. Thankfully in most cases, this is a fairly benign syndrome which will go away as mysteriously as it arrived.

Signs and Symptoms

• PAIN -  The main symptom experienced is pain which normally occurs on the left side of the breastbone and worsens with a sharp intake of breath. It may spread over the shoulder region and to the back. The pain can be sharp, achy or pressure-like in nature and can be exacerbated by coughing or physical activity.
• TENDERNESS - This is felt in the general area of the rib joints when gently pressed.

Causes 

While there are usually no clear-cut reasons for this condition to arise, there are a few causes which may bring it on :

1. Physical strain from heavy lifting (eg. moving furniture, lifting weights).
2. Severe and prolonged coughing.
3. An injury to the chest such as blunt impact from a car accident or fall.
4. An infection such as respiratory tract infection.
5. Having an eccentric load on your shoulder such as a heavy backpack which is often carried on one strap.
6. Tumors - In rare cases tumors may travel from joints and other parts of the body and settle in the chest region.

Diagnosis

Oftentimes costochondritis will go away on its own without any medical intervention. However if the symptoms are prolonged or become severe, it may be necessary to visit the doctor. Some tests might be required such as ECG, blood tests and chest x-ray to eliminate other reasons for chest pain. Once any other potentially serious conditions are ruled out, a diagnosis of costochondritis can be made.

Treatment

• Limit activities which make the condition worse and take painkillers such as Tylenol to ease the pain. 
• Anti-inflammatories such as Advil may be necessary for the pain and swelling.
• In severe cases, steroid injections into the costochondral joint may be required to eliminate symptoms unaided by over the counter medications. 
• It may be soothing to apply heat packs to the area for some relief or use a transcutaneous electrical nerve stimulation (TENS) device for the pain.
• Gentle stretching exercises for the chest muscles may prove helpful.

Prognosis

The outlook for people who have experienced costochondritis is generally very favorable. Most cases appear to be mild and settle relatively quickly with little intervention. Mild cases may only last a few days while chronic cases may stick around for weeks or more, but most cases don't last longer than a year.

Take-Away

Costochondritis is a condition which doesn't pose much cause for concern and tends to clear up on its own. However, if symptoms persist for an extended period it might require some further medical treatment. As always, with any symptoms such as chest pain or breathing problems, it is advisable to seek emergency medical attention immediately to rule out life-threatening causes. In my son's case, thankfully after less than a week his symptoms are starting to improve. My guess is that his school backpack and heavyweight sessions at the gym were the prime culprits!

References

Mayo Clinic - Costrochondritis

NHS - Costrochondritis

WebMD - What is Costrochondritis?

Healthline - What is Costrochondritis?