Costochondritis, also known as chest wall pain, costosternal syndrome, or costosternal chondrodynia, occurs when the cartilage between the ribs and the sternum (breastbone) becomes inflamed and swollen. Symptoms of this disease can be similar to those of a heart attack, so you should always visit your doctor after experiencing the first symptoms of chest pain. The doctor will also be able to recommend the best way to relieve pain while waiting for the disease to heal completely.  X Mayo Clinic Trusted Source Visit source
Seeking Medical Help
Go to the doctor immediately or call emergency services immediately if you experience chest pain. Your doctor will be able to determine whether you are having a heart attack or a less serious condition such as costochondritis.
Know what is done in the doctor’s clinic. The doctor will feel or palpate (examine with a finger) along the sternum to determine where the pain is and the severity of the inflammation. If you still feel pain when you touch your doctor, you may not have a heart attack, but costochondritis. The doctor will also ask about your recent events, such as whether you recently had an injury that might be the cause.
Your doctor will ask you to undergo several tests to confirm other conditions commonly associated with chest pain, such as osteoarthritis, lung disease, gastrointestinal disorders, or joint infections. Your doctor may suggest an X-ray, CT scan, MRI, or electrocardiograph.
Tell your doctor if you have heart, liver, or kidney disease, high blood pressure, ulcers, or have ever had internal bleeding. This way, your doctor can tailor the best pain treatment for you.
Get a prescription for antibiotics if your doctor recommends it. If your costochondritis is caused by an infection in your joint, your doctor will likely prescribe antibiotics to take by mouth or intravenously.
Usually this is not necessary because infection rarely causes costochondritis.
Discuss prescription drug options with your doctor. If the pain doesn’t go away after a few weeks and commercial NSAIDs ( nonsteroidal anti-inflammatory drugs) don’t work, your doctor can prescribe a stronger medication to relieve the pain. Some medications that your doctor may prescribe are:
A strong drug (NSAID) similar to ibuprofen (Advil, Motrin). This is the main treatment for costochondritis. If you take this medicine for a long time, you should be monitored by a doctor because it can hurt your stomach and kidneys.
Drugs containing codeine, eg Vicodin, Percocet , etc. These drugs can be addictive.
Some antidepressants or anticonvulsants are also effective in treating chronic pain.
Consider a more invasive procedure to combat the pain. Most cases of costochondritis resolve on their own over time. However, if the pain is unbearable, your doctor may suggest:
Injections of corticosteroids and numbing drugs directly into the painful joint.
Transcutaneous electrical nerve stimulation ( TENS ). This technique uses weak electrical signals to interfere with pain signals and prevent their realization in the brain.
Discuss surgical options to remove or repair damaged cartilage if there is no other way. This procedure is sometimes necessary, especially if the cartilage has been severely damaged by infection.
The results are usually satisfactory when accompanied by the use of antibiotics.
Once healed, have yearly checkups to make sure the joints remain healthy.
Managing Pain at Home
Try a commercial pain reliever. NSAID drugs are usually quite effective. Ask your doctor for advice about using over-the-counter pain relievers. These drugs are usually able to relieve pain.
Consult your doctor before taking commercial medications if you are taking prescription medications for this or any other condition. Your doctor will tell you about potential interactions between commercial drugs and other drugs.
Follow the manufacturer’s instructions and consult your doctor if you will be taking the drug for more than a few days. Do not take the drug more than the instructions in the instructions on the package.
Talk to your doctor before taking any of these medicines, even commercial ones, if you have heart disease, high blood pressure, kidney disease, liver disease, or are prone to ulcers or internal bleeding.
Rest to heal the body. This means that you will need to stop strenuous exercise for a few weeks. Costochondritis usually results from activities that stretch the cartilage and muscles around the chest wall. The doctor’s main advice in treating this disease is to stay away from activities that cause discomfort. The pain usually goes away after a few days or weeks, but sometimes it can take several months.
Rest until you no longer feel pain.
Return to physical activity slowly to rebuild lost muscle and stamina.
You need to be especially careful with activities that require sharp, sudden movements, put a lot of stress on your chest muscles, or have the potential to hit your chest. Some of these activities include tennis, baseball, golf, basketball and karate.
Heat the painful area. This can help increase blood flow and help relax muscles that may be tense.
Use a hot water bottle or heating blanket.
Do not apply the heat source directly to the skin. If you use a hot water bottle, wrap it in a towel so you don’t burn yourself.
Hold on to the heat source for a few minutes and remove to cool the skin.
Apply the ice pack on the affected area. The joint is the area where the sternum and ribs meet. The ice pack will help reduce swelling and relieve inflammation
You can use a bag of frozen beans or corn wrapped in a towel.
Do not apply the ice pack directly to the skin.
Remove the ice pack after 15-20 minutes, and allow your skin to warm up. Repeat 3-4 times every day.
Stretch the tight chest muscles. Do it carefully, slowly, gently, and only with a doctor’s approval. Your doctor will refer you to a specialist to learn which type of exercise is best for your condition.
Start with light stretching of the chest muscles using slow deep breaths.
When you feel ready, add a pectoral stretch. The easiest way to do this is to support your forearms against the threshold and then lean forward until you feel the muscles under and around your shoulders stretch.
Yoga postures combined with deep breathing are a great way to relax and stretch. Try the Sphinx posture. Lie on your stomach while supporting your body with your elbows. Then, open your chest and stretch up and down.
If you feel pain during exercise, you should stop immediately.
Experiment with different sleeping positions until you find one that relieves discomfort. Try not to do positions that put pressure on the painful joint.
Lying on your stomach may not be comfortable.
Improve posture to reduce pressure on the chest. Sitting and standing with a slight stoop will exacerbate costochondritis and increase discomfort.
Practice sitting, standing, and walking with a book balanced overhead.
Concentrate on opening your chest and letting your shoulders roll back.
Understanding Symptoms and Causes
Recognize the symptoms of the disease. Costochondritis can cause extreme discomfort. This pain can be:
Sharp, throbbing, or pressure-like pain that is felt on the side of the breastbone. Usually occurs in the fourth, fifth, and sixth ribs.
Pain may also radiate to the abdomen or back.
The pain may radiate to more than one rib and is exacerbated by coughing and deep breathing.
Be aware that the symptoms of costochondritis and a heart attack are similar enough to be difficult to tell apart. The main difference is that during costochondritis the painful area is usually sensitive to pain and is felt when the doctor examines and palpates you. However, if you experience chest pain, you should immediately see a doctor to make sure the cause is not a heart attack.
Like a heart attack, pain often occurs on the left side. The pain may be sharp and get worse when you breathe in, twist your body, or move your arm.
A heart attack is usually a dull pain and is associated with numbness in the arm and jaw.
Find out what causes costochondritis. Costochondritis can have several causes. Some of the common causes include:
An injury that damages the cartilage that connects the ribs to the breastbone. This includes squeezing or stretching from carrying heavy objects or coughing vigorously. An upper respiratory infection that causes a severe cough can trigger costochondritis.
Arthritis in the joints. Osteoarthritis, rheumatoid arthritis, and ankylosis spondylitis can cause chest pain.
Infections in the joints, such as tuberculosis, syphilis, or aspergillosis. Most cases of costochondritis are caused by a bacterial infection in the joint. Sometimes, costochondritis is caused by a bacterial infection in the joint after surgery.
Tumors affecting the joints.
In some cases, the cause of the disease is not clear.