Costochondritis- Signs, Symptoms, And Treatments

Costochondritis is a musculoskeletal condition that involves inflammation of costal cartilage, also known as rib cartilage. The word ‘costo’ refers to the ribs, ‘cond’ refers to cartilage, and the suffix ‘itis’ refers to inflammation. Casual Costochondritis is a common cause of chest pain and it affects all age groups, so it is actually a relatively common complaint that is brought to the emergency department. 

Costochondritis- Signs, Symptoms, And Treatments

The aetiology as to why Costochondritis occurs is not entirely known. It is believed that it may be due to trauma or a previous infection. In order to understand this disease, you need to know the pathophysiology behind why this occurs.

Firstly, it is important to note that Costochondritis is a benign condition but as mentioned before, it is an inflammatory condition. It involves inflammation of parts of the rib cage. Some of those parts include the costal cartilage. This is going to affect the 2nd, 3rd, 4th, and 5th costochondral joints. It is often going to be unilateral which means you will feel pain on one side of your chest, but it can affect both sides as well.

Costochondritis- Signs, Symptoms, And Treatments

Signs and symptoms:

Costochondritis is a common cause of chest pain, so chest pain is obviously going to be the main symptom of Costochondritis. The pain is going to be described as a dull, intense aching or discomfort. It varies in intensity. It can be very mild in some cases or somewhat severe in others. 

Over time the pain worsens with changes in position and movement which may look like positional chest pain. It intensifies while taking a deep breath. 

It is also important to note that there is no swelling that’s present. The costal cartilage does not become swollen during Costochondritis. If it does, that is a different condition. 

As mentioned before, it is most often unilateral and what’s going to be important with regards to Costochondritis is that the chest region, especially the costal cartilage is tender to touch. This pain is often reproducible when palpated or when touched. Therefore, it can be quite focal. This is going to be very important when determining that a patient has Costochondritis because reproducibility to touch is actually a very atypical finding with chest pain from Costochondritis. Having said that, it is not entirely out of the realm of possibilities that if you were to touch an area and you reproduce that pain that it’s going to be Costochondritis. It can be one of the more serious conditions such as coronary artery disease or pericarditis.

Cautions :

Chest pain should not be associated with the following characteristics –

  • Pain that radiates to the neck or the arms
  • Fever
  • Productive cough
  • Nausea
  • Vomiting
  • Pre-syncope or syncope (feeling unconscious)
  • Shortness of breath
  • Arrhythmias 

If any of these are present then the chest pain is more likely to be from a serious cause. It is important to rule out serious causes of chest pain, especially in patients older than the age 35. If the patient is older, it is very important to rule out these other serious causes including myocardial infarction, pericarditis, and so on. In order to do that it is important to perform an ECG to see if there is any sign of myocardial infarction. For instance, it is very important to look out for these more serious causes. So, a patient’s age, clinical history, and necessary medical exams are some of the very important parameters to look for.

Treatments :

Once a patient is diagnosed with Costochondritis, how they are treated is often trivial. Costochondritis itself is a self-limiting condition. Some remedies that can help with the symptoms include the followings –

  • Applying heat to the affected area can help. Beware of how much heat you are applying. Excessive heat can have adverse effects on skin.
  • It is also important to minimize the causative activity. For instance, all those strenuous exercises that may be triggering or exacerbating the pain from the Costochondritis.
  • Anti-inflammatory drugs such as ibuprofen, proxin, acetaminophen or tylenol can be used for patients with Costochondritis. 
  • For patients who continue to have issues with refractory Costochondritis, physical therapy may help. 
  • Along with these, a balanced diet can help as well.
  • Ample sleep is a must for patients suffering from Costochondritis. 
  • Lastly, keep yourself happy. Happiness is the ultimate medicine.

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