Costochondritis Occurrence and Pain Relief

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Costochondritis Occurrence and Pain Relief

Question:

Within the past couple of weeks I have developed costochondritis. Is this common? What can I do for the pain? How long does costochondritis last?

Answer:

Costochondritis is a common condition in which there is inflammation in the chest wall between the ribs and the breastbone. Pushing on this area typically produces the pain; in rare cases there is swelling.

The cause of costochondritis is unknown in most cases. However, it can follow trauma, an overuse injury or accompany other types of arthritis. Rarely, it is due to an infection.

Costochondritis can be quite bothersome. However, unless infection is present, it is not dangerous. It can mimic other, more serious conditions, such as a heart attack. So, for people with chest wall pain, it's important to be evaluated for other causes of chest pain.

In most cases, costochondritis goes away on its own after a week or two. However, it can last many weeks or months. Standard treatment includes:

• Rest, with a gradual increase in activity

• Avoiding activities that triggered the condition or those that increase the pain

• Acetaminophen

• Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen

• Heat

When there is swelling, fluid from the sore area can be tested for the presence of infection. For costochondritis due to a bacterial infection, antibiotic therapy is appropriate. If no infection is present, an injection of steroids into the painful joint can be highly effective. This is typically reserved for cases in which other treatments fail.

Robert Shmerling, M.D., is associate physician and clinical chief of rheumatology at Beth Israel Deaconess Medical Center and an associate professor in medicine at Harvard Medical School. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program and has been a practicing rheumatologist for over 25 years.

Last updated:	July 20, 2009