Sharp chest pain is understandably frightening, and any chest pain should always be checked by a doctor first to rule out serious causes, especially anything to do with the heart. Once serious causes have been excluded, one common and usually harmless reason for pain in the front of the chest is costochondritis, an irritation of the cartilage that joins the ribs to the breastbone.
This article explains what costochondritis is, why chest pain must be assessed by a doctor first, what the condition tends to feel like, and how it is usually managed. It is general information only and is not a way to self-diagnose chest pain.
In this article
What is costochondritis?
Costochondritis is inflammation of the cartilage that joins your ribs to your breastbone, the flat bone in the centre of your chest. When this cartilage becomes irritated, it can cause pain and tenderness in the front of the chest wall. It is a common and usually harmless cause of chest-wall pain, and in most cases it is self-limiting, meaning it tends to settle over time.
Because the pain is felt in the chest, it can be worrying. That worry is completely understandable, and it is exactly why any chest pain needs to be assessed by a doctor before it is put down to the chest wall.
When to seek urgent care
Chest pain must always be assessed by a doctor first to rule out serious causes, especially heart-related ones. Call 000 straight away if your chest pain is severe or crushing, spreads to the arm or jaw, or comes with shortness of breath, sweating, nausea, dizziness or fainting. Never assume chest pain is coming from the chest wall without being checked.
Is it my heart or my chest wall?
This is the most important question, and it is not one to answer on your own. Only a doctor can safely tell the difference between chest pain coming from the heart or another serious cause and pain coming from the chest wall. Please do not use this article, or anything online, to decide that your chest pain is harmless.
That said, it can be reassuring to know that once serious causes have been ruled out, the chest wall is a genuinely common source of pain. Musculoskeletal causes account for a large share of noncardiac chest pain, so sharp pain that hurts to press on or worsens with a deep breath is often coming from the chest wall rather than the heart. The key word is once, and only after a doctor has assessed you.
Usually self-limiting
Costochondritis is a common and usually harmless cause of chest-wall pain, and it typically settles over time. Musculoskeletal problems account for a large share of noncardiac chest pain.
What does costochondritis feel like?
When serious causes have been excluded, costochondritis tends to have a fairly typical pattern. People often describe:
- Sharp, aching or pressure-like pain in the front of the chest, near the breastbone
- Pain that is tender or reproducible when you press on the affected area
- Pain that gets worse with a deep breath, coughing or certain movements of the trunk
- Discomfort that can affect more than one rib and is usually felt on one side
The fact that the pain can be brought on by pressing on the area or by breathing deeply is a feature of chest-wall pain. Even so, this is information for after a doctor has assessed you, not a checklist for self-diagnosis.
What causes costochondritis?
The exact cause is often not clear, but costochondritis is thought to relate to irritation of the rib cartilage. Recognised contributors can include:
- Repetitive strain or overuse of the upper body
- A recent bout of heavy coughing
- A minor knock or strain to the chest wall
- Unaccustomed lifting or activity involving the arms and trunk
For many people no single cause stands out, and the condition still tends to settle with time and sensible management.
What helps costochondritis?
Because costochondritis is usually self-limiting, management focuses on easing symptoms and keeping you comfortable while it settles. Once a doctor has confirmed the diagnosis, an approach may include:
- Reassurance and understanding that it is a common, usually harmless condition
- Modifying activities that clearly aggravate the area for a while
- Gentle movement and breathing rather than complete rest
- Guidance on posture and load through the upper body
- Advice from your doctor about simple pain relief where appropriate
A physiotherapist can help you stay comfortable and confident with movement while the cartilage irritation settles, and can check that nothing else in the chest wall or upper back is contributing.
When should you see a physiotherapist?
If your chest pain has been assessed by a doctor and serious causes have been ruled out, a physiotherapist can help you manage chest-wall pain, restore comfortable movement and build confidence. A visit to a physiotherapist in Mount Gravatt can help you understand your symptoms and put a practical plan in place while costochondritis settles.
Always get chest pain checked first
Never try to diagnose chest pain yourself. Chest pain must always be assessed by a doctor first to rule out serious causes, especially heart-related ones. Call 000 if pain is severe or crushing, spreads to the arm or jaw, or comes with shortness of breath, sweating, nausea, dizziness or fainting. Physiotherapy is for chest-wall pain that a doctor has already checked.
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Helping You Perform at Your Best
At ACE Sports Medicine in Upper Mount Gravatt, our physiotherapists help people across Brisbane's southside manage chest-wall pain once a doctor has ruled out serious causes. Your first appointment includes an assessment and a practical plan to keep you moving comfortably while costochondritis settles.