What is Costochondritis?

Costochondritis is a condition that results from an inflammation of the junctions where the upper ribs join with the cartilage that holds them to the breastbone, or sternum. Being a relatively harmless condition, it usually goes away without the need for medical treatment.

Costochondritis commonly occurs in young children and adolescents, between the ages of 12-14.

Costochondritis is also considered as a possible diagnosis for adults who have chest pain, affecting females more than males (70% versus 30%). However, it is important to note that chest pain in adults may be a sign of a heart condition and the necessary tests to rule out same should be carried out prior to a diagnosis of costochondritis being made.

The causes of Costochondritis are generally unknown. Studies have shown that it may arise as a result of repeated trauma to the chest wall, overuse of the arms, or viral respiratory and/or bacterial infections. It may also occur as a result of the use of IV drugs, or in those who have had surgical procedures carried out on their upper chest. This is due to the fact that, after surgery, the cartilage can become more prone to infection, because of reduced blood flow in the region that has been operated on, resulting in persons experiencing pain and discomfort consistent with the condition.

There are three know types of infectious diseases that can cause costochondritis:
(1) Viral: Costochondritis commonly occurs with viral respiratory infections because of the inflammation of the area from the viral infection itself, or from straining from coughing.
(2) Bacterial: Costochondritis may occur after surgery and be caused by bacterial infections.
(3) Fungal: Fungal infections may also cause costochondritis, although this is rare.

The most common symptoms of costochondritis are as follows;
• Pain that is usually sharp and located on your front chest wall. It may radiate to the back or abdomen, and is most common on the left side. Pain may also be dull.
• Pain may present with a deep breath or cough.
• The most common sites of pain are the fourth, fifth, and sixth ribs. Pain may increase with physical movement or deep breathing, and decrease when movement is limited or with quiet breathing.
• Finally, tenderness when pressing on the rib joints (costochondral junctions) is a constant feature of costochondritis. Without this tenderness, a diagnosis of costochondritis is unlikely.

The treatment of costochondritis can vary, depending on whether one’s medical attendant is of the opinion that medication/surgical intervention is required, or whether symptoms can be relieved by way of home remedies.

If no medical or surgical intervention is required, the following treatment can provide relief to those suffering from Costochondritis;
• Over-the-counter pain relievers such as nonsteroidal anti-inflammatory medications; i.e. ibuprofen or naproxen, as needed;
• Administering heat or ice locally, to relieve pain;
• Avoiding unnecessary exercise or activities that worsen the symptoms until such time that normal activities can be resumed as tolerated.
Where symptoms persist and are not relieved by any of the above, it may be necessary to attend your medical practitioner, who may provide the following treatment;
• Local anesthetic and/or a steroid injection in the area that is tender in circumstances where normal activities are painful and symptoms are not relieved having taken medication.
• Infectious (bacterial or fungal) costochondritis can be treated initially with antibiotics, and subsequent oral antibiotics.
• The affected cartilage may require surgical removal If one remains symptomatic having exhausted all of the above treatment.

Should you suffer from any of the previously mentioned symptoms as a result of a surgical procedure on your upper chest area, it is advised that you attend your doctor in this regard in order to explore any treatment options available to you.