Costochondritis: Common cause of chest pain, can mimic a heart attack and other heart conditions

Chest pain is always taken seriously as it can be a strong indicator that something is wrong with your heart. You may notice when you go in for a checkup the doctor will usually ask if your symptoms include chest pain as they try to rule out heart issues. But sometimes chest pains don’t necessarily result in a heart condition. In fact, if you have costochondritis, the pain will subside on its own without you having to worry about your heart.

Costochondritis is sometimes confused with Tietze syndrome, a condition in which inflammation occurs between the tissues that connect the rib to the sternum (breastbone). To some, this pain can be alarming because it may feel similar to the pain caused by an oncoming heart attack.

Costochondritis causes

The cause of costochondritis isn’t clear, but there are some suspected reasons as to why inflammation may occur. Some potential causes of costochondritis are injury (blow to the chest), physical strain (heavy lifting, strenuous exercise), arthritis, joint infection, and tumors (cancerous and non-cancerous).

Costochondritis accounts for nearly 10–30 percent of all chest pain in children, with the peak age of the condition occurring at 12–14 years of age. Adults suffering from this form of chest pain tends to be more worrisome as it could potentially be interpreted as a sign of heart problems, leading doctors to perform a battery of tests to rule it out. Costochondritis is known to affect females more than males (70 percent vs 30 percent) and also be the result of an infection or even a complication of surgery to the sternum.

Costochondritis symptoms

Commonly seen symptoms:

• Chest pain: May be dull but is usually sharp in nature and isolated to the front wall. Occasionally, pain may radiate to the back or abdomen, with the left side more commonly affected.
• Pain with deep breath.
• Cough.
• Rib pain: Common sites of pain are your fourth, fifth, and sixth ribs. Pain typically increases with movement of the trunk or while taking deep breaths. Patients can often find relief by decreasing movements.
• Tenderness: Pressing on the costochondral junction (rib joints) will often produce pain and is a constant feature of costochondritis for making a diagnosis

You should seek medical care if experiencing the following symptoms:

• Trouble breathing
• High fever
• Nausea
• Sweating
• Worsening pain
• Signs of infection (redness, pus, and increase swelling at the rib joints)

How long does costochondritis last?

Costochondritis typically isn’t persistent, as the condition goes away on its own. Mild cases may go away after a few days, but chronic cases can last for weeks or more. However, most cases of the condition don’t last any longer than a year. To reduce the chances of costochondritis becoming a persistent phenomenon, it is recommended to do fewer high-impact exercises or manual labor. Calling your doctor when experiencing chest pain that is out of the ordinary is also advised.

Related: Costochondritis: Complications, diagnosis, and treatment options

Costochondritis treatment and diagnosis

Typical treatment of costochondritis includes taking anti-inflammatory medications, physical therapy, and – in very severe cases – surgery.

Common treatments include:

• Non-steroidal anti-inflammatory drugs (NSAIDs): A common pain-relieving medication that can be found in many pharmacies and grocery stores. They are designed to reduce pain and swelling. However, long-term use of these drugs can lead to liver damage and even increase the risk of heart attacks. NSAIDs can also be found in topical solutions that don’t pose as much risk as oral formats.
• Narcotics: Often reserved for severe pain and can only be prescribed by a doctor. These medications include codeine such as hydrocodone/acetaminophen (Vicodin, Norco) or oxycodone/acetaminophen (Tylox, Roxicet, Percocet).
• Other medications: Amitriptyline, an tricyclic antidepressant, has been known for helping to control unwanted pain. The commonly used anti-seizure drug, gabapentin (Neurontin), has also proven to show some benefit for controlling chronic pain.

Costochondritis home remedies and prevention

Since costochondritis can occur from physical strain, therapy may be helpful to stretch out the area. Stretching out the muscles in the chest may help alleviate pain associated with costochondritis.

Applying cold and hot compresses, too, can help alleviate pain. But most of all, it is best to rest to avoid further aggravating the pain. Costochondritis will go away on its own, but if you notice the pain is sticking around for weeks, seek out medical attention.

Related: Costochondritis exercises and diet tips