Costochondritis

Costochondritis

Costochondritis is a poorly understood, self-limiting condition that is more common in women, and generally presents pain and tenderness on the cartilage that connects the ribs to the sternum, without swelling.2 Pain caused by costochondritis might mimic that of a heart attack or other heart conditions. Costochondritis usually has no apparent cause. Treatment focuses on easing your pain while you wait for the condition to improve on its own, which can take several weeks or longer.1

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Anatomy

Ribs consist of bone and cartilage, with cartilage serving as an elastic bridge between the bony portion of the rib and the sternum.1 Anteriorly, the costal cartilage of the first rib connects with the manubrium via a rigid fusion of bone and cartilage. The next seven pairs of ribs articulate with the sternum via cartilage at synovial-lined joints.1 Ribs eight through 10 attach in front to the cartilaginous portion of the rib above them and often have synovial-lined interchondral articulations.1 The lowest two ribs do not articulate with any structure anteriorly.The ribs move with respiration and with truncal motion or movement of the upper extremities.1

Who does it affect?

Costochondritis can affect any person. A study of chest pain in an outpatient adolescent clinic found that 31 percent of adolescents had musculoskeletal causes, with costochondritis accounting for 14 percent of adolescent patients with chest pain.1 Costochondritis is a common diagnosis in adults with acute chest pain and is seen quite often in athletes who stress the costochondral joint, such as, swimming and rowing.1

Symptoms

The primary symptom of costochondritis is chest wall pain of varying in intensity, typically described as sharp, aching, or pressure-like.1 The pain can worsen by upper body movement, deep breathing, and exertional activities. History of an illness with coughing or sneezing can be present. The second to fifth costochondral joints are most often affected, especially ribs three and four, but any of the seven costochondral junctions can be involved.1 Pain can be noted at more than one location, but most often is unilateral and can be reciprocated by palpation.

Treatment

Treatment is usually directed at pain relief with anti-inflammatory drugs. Applying heat with compresses or heating pads can help, particularly in the case of muscle overuse. Minimizing activities that provoke the symptoms.1 Other conservative treatments such as spinal manipulative therapy, Active Release Techniques therapy, and rehabilitative exercises, have also been used in the treatment of chronic costochondritis in athletes.2

Sources:

1 Proulx, A. (2009, September 15). Costochondritis: Diagnosis and Treatment. Retrieved April 24, 2015, from http://www.aafp.org/afp/2009/0915/p617.html

2 Cubos, J., Cubos, A., & Di Stefano, F. (2010). Chronic costochondritis in an adolescent    competitive swimmer: a case report. The Journal of the Canadian Chiropractic Association, 54(4), 271–275.