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Top Treatments for Costochondritis

Written by Andrew Le, MD

UpdatedMarch 20, 2024

Costochondritis is a chest condition that causes inflammation in the cartilage where the upper ribs connect to the breastbone, leading to chest pain and discomfort. In this article, we will explore the top treatment options for costochondritis, including pain medications, physical therapy, steroid injections, surgery, and alternative therapies.

We will also discuss what costochondritis is, what causes it, its symptoms, diagnosis, and how it can be prevented.

Key Takeaways:

  • Pain medications are commonly used to manage the pain of costochondritis, but physical therapy and steroid injections can also be effective treatment options.
  • Costochondritis can be caused by a variety of factors, including genetics and injury.
  • Symptoms of costochondritis may include chest pain, tenderness, and swelling in the affected area.

What Are the Treatment Options for Costochondritis?

Costochondritis can be treated with a combination of approaches aimed at reducing symptoms and helping you recover.

Healthcare providers often recommend over-the-counter (OTC) pain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and relieve discomfort.

In addition, physical therapy exercises and techniques can help improve chest wall flexibility and strengthen the surrounding muscles.

For severe cases, steroid injections directly into the affected area may be suggested to reduce inflammation and pain.

Some people get relief through alternative therapies such as acupuncture, chiropractic care, or herbal remedies.

Pain Medications

Pain medications can help reduce the pain and inflammation in the chest area. Typically, NSAIDs like ibuprofen (Advil, Motrin) or naproxen (Aleve) are recommended. In more severe cases, your doctor may prescribe stronger pain relievers, like opioids, or muscle relaxants.

Physical Therapy

Physical therapy plays a key role in costochondritis treatment, involving targeted exercises and therapeutic interventions to improve your movement and reduce inflammation.

It’s helpful to see a physical therapist, who can recommend appropriate stretches and exercises and perform other treatments.

The exercises should help strengthen the chest muscles and improve posture, ultimately reducing the discomfort. Specific stretching techniques can effectively relieve tension in the affected area, improving your flexibility and range of motion.

Steroid Injections

Steroid injections may be needed to reduce inflammation and relieve symptoms if your costochondritis is severe.

Corticosteroids are powerful anti-inflammatory medications that work by suppressing the immune response and inflammation. This can help to decrease pain and swelling.


Surgery is considered a last resort, reserved for costochondritis cases that do not improve with other treatments, like rest, physical therapy, and pain management.

The specific procedures can vary depending on the underlying causes and the severity of the condition. For patients with other musculoskeletal conditions, such as rheumatoid arthritis, surgery can help correct any structural abnormalities in the joints and ribs that contribute to the inflammation and pain.

Alternative Therapies

Alternative therapies, such as transcutaneous electrical nerve stimulation (TENS), acupuncture, and chiropractic care have shown promising results. These therapies focus on addressing the underlying imbalances in the body and promoting natural healing processes, making them a viable complement to conventional treatment methods.

Additionally, relaxation techniques and mind-body interventions, including yoga and meditation, can help reduce stress, which often exacerbates costochondritis symptoms.

What Is Costochondritis?

Costochondritis occurs when the cartilage where the ribs attach to the sternum become inflamed, causing chest pain and tenderness. It has been linked to excessive physical activity or trauma. Because it occurs in the chest area, it can mimic more serious cardiac issues, causing undue anxiety.

Though generally benign, it can cause pain and limit your daily activities. It can disrupt the normal movement of the rib cage, affecting breathing and overall posture.

What Causes Costochondritis?

Costochondritis can stem from various factors, including genetics, traumatic injuries, and underlying conditions such as rheumatoid arthritis (RA).

People with a family history of this condition may be more prone to experiencing it.

Traumatic injuries, such as a hard blow to the chest during a sports activity or a car accident, can lead to costochondritis. The impact from such events can cause inflammation in the costosternal joints, resulting in pain and discomfort.

Underlying conditions like RA can increase your risk of developing costochondritis. The persistent inflammation associated with RA can extend to the costosternal junctions, contributing to costochondritis symptoms.

Is Costochondritis Hereditary?

Research suggests that certain genetic factors may play a role in the susceptibility to costochondritis, although the precise mechanisms are not fully understood. Studies have shown that people with a family history of autoimmune diseases, such as rheumatoid arthritis or lupus, may have an increased risk of costochondritis.

Genetic predispositions linked to inflammation and musculoskeletal disorders could potentially raise the risk of costochondritis.

Can Costochondritis Be Caused by an Injury?

Costochondritis can be triggered by chest trauma or repetitive motions, leading to localized tenderness and discomfort.

If you have chest trauma from a fall, car accident, or direct blow, the ribs and chest wall can suffer significant impact and stress. This can cause inflammation in the cartilage connecting the ribs to the breastbone, leading to costochondritis.

Repetitive motions such as heavy lifting or certain sports activities can also lead to overuse injuries and costochondritis.

What Are the Symptoms of Costochondritis?

The symptoms of costochondritis include sharp chest pain that is worse when you move and tender to the touch. You may have tenderness at the junction of the ribs and the breastbone, making breathing deeply or coughing uncomfortable.

In some cases, the pain can radiate to the back or abdomen, mimicking symptoms of cardiac issues, leading to anxiety and distress.

It's important for healthcare providers to consider other diagnoses, such as heart conditions or other musculoskeletal disorders.

Doctors will do a physical exam by gently palpating the chest area to pinpoint areas of tenderness and discomfort. Diagnostic techniques such as chest X-rays and MRI scans can help rule out other potential causes of chest pain.

Is Chest Pain the Only Symptom of Costochondritis?

While chest pain is the main symptom of costochondritis, you may have tenderness or swelling, particularly where the ribs attach to the breastbone. Some people have respiratory symptoms, like discomfort when taking deep breaths. It's important to note that costochondritis can occur with other conditions, such as fibromyalgia, ankylosing spondylitis, or psoriatic arthritis. Therefore, healthcare providers need to conduct a comprehensive check for these conditions as well.

Do the Symptoms of Costochondritis Come and Go?

The symptoms of costochondritis can come and go. The flare-ups can be influenced by movement and activities, poor posture, prolonged periods of sitting, and the condition of the cartilaginous structures.

Fortunately, there are therapeutic approaches that can help manage and prevent the recurrence of symptoms. Regular stretching exercises tailored to alleviate tension in the chest muscles, as well as incorporating ergonomic adjustments in daily activities, can help.

How Is Costochondritis Diagnosed?

Diagnosing costochondritis involves a clinical exam, targeted tests, and differential considerations to distinguish it from similar conditions.

A thorough physical examination can help identify local tenderness and swelling in the chest wall area. The clinician may apply pressure to the costosternal, costochondral, and costovertebral joints to elicit pain, a characteristic feature of costochondritis.

Imaging studies such as chest X-rays or magnetic resonance imaging (MRI) may be needed to rule out other potential causes of chest pain, such as rib fractures, infections, or tumors.

Considering the overlap of symptoms with other musculoskeletal and cardiovascular conditions, it’s important for your healthcare provider to rule out other conditions. These include pericarditis, myocardial infarction, and fibromyalgia.

Can Costochondritis Be Misdiagnosed?

Costochondritis can be prone to misdiagnosis, especially due to its overlapping symptoms with cardiac conditions. That’s why you need a comprehensive evaluation that may include cardiac exams like an ECG.

How Can Costochondritis Be Prevented?

Preventing costochondritis involves adopting a range of strategies including exercises, posture improvements, and techniques such as breathing exercises and stability ball workouts. These are especially helpful for people at risk due to conditions like rheumatoid arthritis.

Regular physical activity, such as gentle stretching and low-impact exercises, can help maintain flexibility and strength in the chest wall muscles.

Incorporating good posture habits in daily activities, like sitting and standing with proper alignment, can also alleviate strain on the chest area. Targeted exercises using a stability ball can improve core stability and support the chest, reducing the likelihood of chest pain and inflammation.

Practicing deep breathing exercises can help relax the chest muscles and reduce tension, helping prevent and manage costochondritis.

Frequently Asked Questions

What are the top treatments for costochondritis?

The top treatments for costochondritis include non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy, rest, and heat or ice therapy.

Can over-the-counter pain relievers help with costochondritis?

Yes, over-the-counter pain relievers such as ibuprofen and acetaminophen can help manage the pain associated with costochondritis.

Are there any natural remedies that can help with costochondritis?

Yes, some natural remedies that may help with costochondritis include applying a warm compress, taking turmeric supplements, and practicing deep breathing exercises.

Are there any lifestyle changes that can improve costochondritis?

Yes, avoiding activities that may aggravate the condition and maintaining good posture can help improve costochondritis.

Is physical therapy necessary for treating costochondritis?

Physical therapy is not always necessary, but it can help reduce pain and improve movement in the affected area.

How long does it take for costochondritis to heal?

The healing time for costochondritis varies from person to person, but it typically improves within a few weeks to a few months with proper treatment and rest.