Costochondritis is an inflammation of the cartilage that connects a rib to the breastbone (sternum). It causes sharp pain in the costosternal joint — where your ribs and breastbone are joined by rubbery cartilage.

What is it?

  • Pain caused by costochondritis may mimic that of a heart attack or other heart conditions.
  • Your doctor might refer to costochondritis by other names, including chest wall pain, costosternal syndrome and costosternal chondrodynia. When the pain of costochondritis is accompanied by swelling, it's referred to as Tietze syndrome.
  • Most cases of costochondritis have no apparent cause. In these cases, treatment focuses on easing your pain while you wait for costochondritis to improve on its own.


Costochondritis is the most common cause of chest pain originating in the chest wall.

Symptoms include:

  • Pain and tenderness in the locations where your ribs attach to your breastbone (costosternal joints)
  • Often sharp pain, though also dull and gnawing pain
  • Location often on left side of breastbone, but possible on either side of chest

Other costochondritis symptoms may include:

  • Pain when taking deep breaths
  • Pain when coughing
  • Difficulty breathing


Doctors don't know what causes most cases of costochondritis. Only some cases of costochondritis have a clear cause. Those causes include:

  • Injury. A blow to the chest could cause costochondritis.
  • Physical strain. Heavy lifting and strenuous exercise have been linked to costochondritis.
  • Upper respiratory illness. An infection that produces sneezing or a cough may produce costochondritis.
  • Infection. Infection can develop in the costosternal joint, causing pain.
  • Fibromyalgia. Recurring costochondritis could be a symptom of fibromyalgia. People with fibromyalgia often have several tender spots. The upper part of the breastbone is a common tender spot.
  • Pain from other areas of your body. Pain signals can sometimes be misinterpreted by your brain, causing pain in places far away from where the problem occurs. Your doctor might refer to this as "referred pain." Pain in your chest can sometimes be caused by problems with the bones in your spine compressing the nerves.

Risk factors

Costochondritis occurs most often in women and in people older than 40. However, costochondritis can affect anyone, including infants and children.

Tests and diagnosis

Your doctor will conduct a physical exam to diagnose costochondritis. He or she will ask you to describe your pain and what influences it. The pain of costochondritis can be very similar to the pain associated with heart disease, lung disease, gastrointestinal problems and osteoarthritis. Your doctor will feel along your breastbone for areas of tenderness or swelling.

Costochondritis generally can't be seen on chest X-rays or other imaging tests used to see inside your body. Sometimes your doctor orders these tests or others to rule out other conditions.

Treatments and drugs

Costochondritis usually goes away on its own and is short-lived, although in some cases it may last for several months or longer.

To ease your pain until it fades, your doctor may recommend:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen
  • Antidepressants, specifically a category of medicines called tricyclic antidepressants, if pain is making it difficult to sleep at night
  • Muscle relaxants, which can also help ease pain

Lifestyle remedies

It can be frustrating to know that there's little your doctor can do to treat your costochondritis. But you can take self-care measures to make yourself more comfortable, which can give you a greater sense of control over your condition. To help relieve the pain of costochondritis, try to:

  • Rest. Avoid activities that make your pain worse.
  • Exercise. It may seem contradictory to rest, but gentle exercises, such as walking or swimming, can improve your mood and keep your body healthy. Don't overdo it, and stop if exercise increases your pain.
  • Use a heating pad. Apply a heating pad to the painful area several times a day. Keep the heat on a low setting.

Once your pain is gone, continue taking it easy. Slowly work your way back to your normal activities.


Although the cause of costochondritis is often unknown, there's some evidence that children who carry a heavy school bag, especially over one shoulder, are at increased risk of this condition. Upper respiratory infections, heavy lifting and strenuous exercise also may be linked to costochondritis.

Common-sense preventive steps that may reduce the risk of costochondritis and protect you and your family's overall health include:

  • Encourage your child to use school bags properly. Make sure your child's bag is not so heavy that your child's shoulders slump, and show your child how to carry the bag appropriately.
  • Avoid activities that seem to trigger costochondritis-like pain. If chest pain and tenderness seem to result from physical exertion, ask your doctor to provide safe guidelines for your exercise program and for lifting.
  • Take steps to prevent respiratory infection. Wash your hands thoroughly and often, avoid sharing drinking glasses or utensils with others and limit your exposure to people who are ill.