When chest pain is “just” costochondritis

26 Dec

Costochondritis-7by Carolyn Thomas

Many female heart patients become familiar with the word “costochondritis” only while being misdiagnosed with the condition during an actual cardiac event, as in:

  • “My MD said it was just costochondritis and a  pinched nerve, because my ribs were sore.” (LH, age 51, New York: heart attack)
  • “At first, we looked at musculoskeletal causes. It had to be costochondritis; my chest wall seemed tender to touch, so I even had steroid injections in my chest wall.” (ZM, age 59, Arizona: heart attack, 12 stents, triple bypass surgery)
  • “Pains in chest radiating down arm and up to my chin. My GP reluctantly sent me to a cardiologist who was dismissive, said that my age was a big factor and that it was 99% likely to be just costochondritis as I also have fibromyalgia” (BT, age 42, U.K: heart attack, 90% blocked LAD coronary artery, two stents)  

Costochondritis is an inflammation of the junctions where the upper ribs join with the cartilage that holds them to the breastbone, or sternum. The condition causes localized chest pain that you can often reproduce by pushing on the cartilage in the front of your ribcage.

Costochondritis can be extremely painful yet, mercifully, it’s often relatively benign. Much of the medical literature suggests that it will usually go away on its own within a few days, but some patients report symptoms that can linger for weeks or even months. It can also be a recurring condition that appears to have little or no warning of onset. Pneumonia can be misdiagnosed as costochondritis. Many patients living with fibromyalgia or chronic fatigue syndrome complain of chest wall pain and restriction of movement, often identified by their health care providers as costochondritis.

Chest pain in adults is considered by most doctors to be a potentially serious sign of a heart problem until proven otherwise. Reporting chest pain usually leads to a battery of medical tests to rule out heart disease. If those tests are normal and your physical exam is consistent with costochondritis, your doctor may diagnose costochondritis as the culprit. It may, however, be difficult to distinguish between the two without specific testing. 

Never assume chest pain is “just costochondritis”.

Here’s an example: Emergency physician Dr. Seth Trueger described this study as one that “might be the coolest chest pain study ever done.”

The study found that when rheumatologists using the American College of Rheumatology criteria for diagnosing costochondritis evaluated patients in the E.R. complaining of chest pain:

“Six per cent of the patients the doctors diagnosed with costochondritis actually had an acute myocardiardial infarction (heart attack).”

What rheumatologists were doing in the E.R. was not explained . . .

Most (real) cases of costochondritis seem to have no clear cause. Occasionally, however, the diagnosis might be correlated with:

  • Injury. A blow to the chest
  • Physical strain. Heavy lifting and/or strenuous exercise
  • Arthritis. In some people, costochondritis has been linked to specific problems, such as osteoarthritis, rheumatoid arthritis and ankylosing spondylitis.
  • Joint infection. The rib joint itself can become infected by viruses, bacteria or fungi. Examples include tuberculosis, syphilis and aspergillosis.
  • Tumours. Non-cancerous and cancerous tumours also can cause costochondritis. Cancer may travel to the joint from another part of the body, such as the breast, thyroid or lung.

Costochondritis may also occur as the result of an infection or as a complication of surgery on your sternum.  Sometimes patients with a severe cough can develop this as a result of continued coughing and rapid expansion/contraction of the rib cage.

In New Zealand, physiotherapists like Steve August (see his detailed comments below) not only suffered himself for seven years with costochondritis after a serious climbing fall, but has been successfully treating the backs of his costochondritis patients manually for the past 30 years with non-drug, non-invasive physiotherapy, as he discusses in his video. Yes, you read that right: it is the back that is treated.

He sees costochondritis as often a straightforward musculoskeletal mechanical problem in which the costovertebral rib joints at the back are somehow jammed. This requires the anterior rib joints around the front to work excessively to compensate, leading to irritation, then to the inflammation that doctors call costochondritis.

Watch Steve’s second video in which he describes:

  • exercises and treatments recommended by New Zealand physiotherapists to unlock the rib hinges in the back to ease the symptoms of costochondritis
  • massage therapy for affected shoulder muscles
  • how to stretch tight, scarred muscles in between the ribs
  • gentle stretching exercises you can do at home to help open up the ribcage
  • use of anti-inflammatory gel to apply on the rib hinges at the front of your chest

If you are a physiotherapist or massage therapist, please watch this video and read this 2017 research paper from Zaruba and Wilson.

This condition affects females more than males (70% versus 30%).

Kelly Young is a patient advocate, blogger, and president of the Rheumatoid Patient Foundation. She described costochondritis like this in her blog RA Warrior:

“As early as 1964, the journal ‘Radiology’ published a study explaining that the effects of Rheumatoid Arthritis on the rib joints “have not been adequately described in the literature.”[1] Mayo Clinic’s description of costochondritis makes it clear the word describes a symptom, pain or inflammation of the rib joints that can be caused by various illnesses.[2,3]

“The term is also confusing because there can be varying diagnoses with similar symptoms.”

But Kelly says that she has also read some skeptical articles about costochondritis symptoms, considered by some physicians as the garbage can diagnosis of hypochondriacs.

Costochondritis is not associated with swelling, as opposed to Tietze’s syndrome, where swelling is characteristic.  Tietze’s syndrome is an inflammation of the costochondral cartilages of the upper front of the chest that involves swelling around the joint, the ribs or cartilage near the breastbone. Redness, tenderness, and warmth can also be present, but a localized swelling is the distinguishing finding, although even swelling can be variable from patient to patient. The pain  can cause difficulty with sleeping, and even rolling over in bed is sometimes painful.

Besides physiotherapy as New Zealand physiotherapists treat this condition, possible treatments include heat or ice, and medications like NSAIDs to relieve pain and reduce inflammation*

And until there is improvement in your symptoms, avoid unnecessary exercise or contact sports activities. 


*  CAUTION:  Studies have found that, among those who had already had one heart attack, people who took the painkillers called NSAIDs (non-steroidal anti-inflammatory drugs) such as Vioxx, Bextra, Aleve, Advil, Motrin, etc. were at >40% higher risk of having a second heart attack compared with those who did not take them. If you’re in this group, do NOT take NSAIDS before talking with your physician.


NOTE FROM CAROLYN:   I wrote much more about diagnosis and misdiagnosis in my book, “A Woman’s Guide to Living with Heart Disease” . You can ask for it at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use the JHUP code HTWN to save 20% off the list price).


1  Alpert M, Feldman F. The rib lesions of rheumatoid arthritis. Radiology. 1964 May 82: 872-875
2  Mayo Clinic. Costochondritis. 2012 May 6.
3  HealthHype.com. Severe costochondritis – causes, symptoms, treatment. 2010 May 9.
4  Flowers LK. Medscape. Costochondritis. 2012 Apr 13.


Q:  Have you ever experienced costochondritis?



193 Responses to “When chest pain is “just” costochondritis”

  1. IG May 5, 2019 at 10:52 pm #

    Thank you for this post on costochondritis. I learned a lot.


  2. Linda Meske March 29, 2019 at 7:19 am #

    Recently this week, I’ve had severe pain to chest area, thinking could be heart or lung related, I went to Urgent Care which did an EKG, results negative, was sent to ER, they did an X-ray, CT and labs, all negative, was sent home with Flexeril.

    This pain goes in to the left shoulder, up the left side of neck, pain with breathing. I breathe shallow because it hurts so much to breathe..doing my own research after knowing heart and lungs were good.

    I’ve come to conclusion of Costochondritis. Everything I’ve read about it now fits. I’ve had no injury to bring it on..nothing, illnesses or otherwise – but it is extremely painful.

    Dr. Appointment coming up Tuesday. I have found since that being in a room that is moist, bathroom where air is heated and moist… sure helped to alleviate pain along with heating pad to chest.

    Liked by 1 person

    • Carolyn Thomas March 29, 2019 at 7:29 am #

      Good luck with your doctor’s appointment on Tuesday, Linda.


      • doua2014 April 14, 2019 at 10:40 pm #

        My cardiologist said I have costochondritis, but my family doctor disagrees and I am confused. My problem started 5 months ago, when I started to experience chest pressure every time I would lie flat. Lying flat or leaning back triggers chest pressure, heavy breathing, and a squeezing pain. The symptoms keep getting worse and worse until I sit up and lean forward for relief. I feel no pain as I go about my day; the discomfort only appears when I lean back. I have learned to sleep in an elevated position but when my symptoms flare up, I cannot even lean back an inch and sleeping becomes impossible.

        The process of figuring this out has also been very exhausting. I’ve had blood work done, ecg, echocardiogram, xray, and all results came back negative. The cardiologist concluded that I have costochondritis but my family doctor disagrees, considering it doesn’t hurt me to breathe and the pain is only triggered by a certain position. However, my family doctor does not have any answers at the moment. She told me she will think about it and get back to me in 2 weeks.

        Any thoughts? Do all people with costochondritis have the same experiences with regards to symptoms?

        PS I have tried tecta and that did not work for me


        • Carolyn Thomas April 20, 2019 at 6:17 am #

          Dueling doctors – there’s a confusing dilemma. Which one is correct?

          I’m not a physician so cannot comment on your specific experience, but I can say generally that when people are trying to tell the difference between whether symptoms are due to a cardiac event or to acid reflux, one of the key differences is that lying down makes no difference to the former symptoms but is commonly very uncomfortable in the latter. Lying flat means your throat and stomach are basically at the same level, making it easy for stomach acids to flow up your esophagus, causing heartburn. But many people with costochondritis also report that their pain may be made worse by a particular posture, such as lying down.

          I hope that your doctor thinks of something during the two weeks and you’ll soon be finding relief.


        • Steve August April 20, 2019 at 11:17 pm #

          Hi Doua and Carolyn.

          Since all the tests for anything dire like the heart have come back clear (a good thing!) let’s assume it really isn’t that. Carolyn’s right – that plus the pain coming on when you lie down gives two likely answers: acid reflux or costochondritis.

          Carolyn’s explained the acid reflux possibility. The costo option arises from my New Zealand physiotherapist understanding of costo as NOT a “mysterious inflammation” but strain, pain and localised inflammatory response at the joints where your ribs hinge onto your breastbone, caused by lack of movement at the rib joints round your back.

          You get pain on lying with costo like this because your body weight on my the ribs round the back further strains the already strained rib joints on your breastbone.

          There’s a simple home test you can do for this tight rib bit. It’s on the Costochondritis page It’s not completely conclusive on its own but if you have an obvious restriction turning towards your painful side, then that’s probably what is going on. More info and how we fix it on the Costo page.

          Hope that helps clarify things for you. The tight or immobile rib joints won’t show on X-ray because that’s a still photo and can’t show whether the hinges can move or not, which is the important bit functionally.

          Steve August (B.A.,Dip.Physio.).

          Liked by 1 person

          • Carolyn Thomas April 21, 2019 at 5:58 am #

            Once again, thank you Steve for weighing in here. I hadn’t yet watched the newer video on your Costochondritis page (oh my goodness, what fabulous scenery you have there in New Zealand, and what a great idea to film your presentation on top of a mountain!).

            The idea that costo starts off as a mechanical problem in the BACK, not just an inflammation in the chest that can be “fixed” with anti-inflammatory drugs is a concept that I hope will be better known soon.

            Thanks for doing your part…


        • Colleen Nevins May 4, 2019 at 5:37 am #

          Go have your pancreas checked. My dad had this happen and was having problems with his pancreas. The only way to relieve was leaning forward.


    • Mari May 8, 2019 at 8:05 am #

      Good luck. I hope you feel better soon, I been having pain since September and I still cant find a solution. I wish you the best


  3. Peter Askes PT, cert. MDT, CST February 28, 2019 at 4:59 pm #

    There are a lot of questions when it comes to costochondritis. As a physical therapist I have dedicated the last 8 years to studying this elusive disorder. Recently I published a book on costochondritis that answers the three questions that most costochondritis patients ask:
    “What is it?’ “What causes it?” and “What gets rid of it?”
    In the book I introduce a NEW treatment technique for costochondritis that has proved to be very effective: The Breathing Assisted Recoil Technique.

    The title of the book is : ‘Costochondritis – A Forgotten Condition’

    If you have any questions you can contact me via the website: http://www.ribpainrelief.com


    • Carolyn Thomas March 3, 2019 at 5:32 am #

      Peter, most of the links on your website don’t work. This is neither helpful nor professional. And you don’t explain what your “Breathing Assisted Recoil Technique” is, or offer any published evidence that it works outside of your own clinic. Please let us know sources or publications.


  4. debs6pk January 15, 2019 at 1:16 pm #

    I was diagnosed with costochondritis in 2013 after a work I hurt to the chest area… it’s bothered me on/off since then … last week Tuesday at a different job I wound up twisting turning and having to lift a 100 lb propane tank because a grown man wouldn’t help get his stuff out of the cart under it …went to immediate care after suffering since then (a week later) and diagnosed again . I had pain last week like a stabbing pain for about 20 minutes then it subsided not completely and it comes and goes as a fuller ache now … when I move or push on the area it’s painful the Dr pushed and it was awful… so to say it can’t hurt into the shoulder and jaw is not correct talk to ppl that have it chronically 😞


  5. Denise December 30, 2018 at 2:26 pm #

    So glad I found this blog. Recently had a routine physical and annual mammogram. During my physical I complained to my pcp AGAIN about my weird chest, shoulder and back pain that comes and goes for no reason. She assured me EKG, EEG, and blood work looked good, and my lungs sounded fine after a recent bout with bronchitis where I nearly coughed my head off. I’m a bit top heavy so my mammograms are usually pretty tough to endure. Two days later I’m still lazing around with this pain that I’m now sure is costo.

    My pcp has referred me to a physical therapist suggesting that this is just old age, I’m 67 yo female, aches and pains.
    I’m back on my buspirone due to the anxiety this has caused but I hate not being able to function.

    Liked by 2 people

    • Carolyn Thomas December 30, 2018 at 5:06 pm #

      Hi Denise – the clue in your story that just might point toward costochondritis is of course your description of coughing your head off with bronchitis. That severe cough can often be a common trigger for costo.

      I’m not a physician so cannot diagnose you, but please print and bring this 2017 research paper from Zaruba and Wilson with you to show to your physiotherapist (and to your PCP).

      And if you haven’t done so already, go back and click the links to the two videos that New Zealand’s Steve August sent to me in this blog article. Best of luck to you…


      • Denise December 30, 2018 at 5:47 pm #

        Many, many thanks for your response and again for all the info found herein. I have already watched the Steve August videos and after checking reviews and several testimonial videos re the ‘backpod’ I have ordered it. I will most assuredly be armed with the Zaruba and Wilson paper upon my visit to the physiotherapist, and follow-up visit with my PCP.

        I will keep you posted, and here’s to hope for a healthy and pain free 2019 for us all!!

        Liked by 1 person

        • Carolyn Thomas December 30, 2018 at 8:00 pm #

          Thank you, Denise. I hope you will keep me posted – I’m very curious about why more non-New Zealanders seem to suffer for years with awful costo symptoms with nothing but drug prescriptions, while people who live in New Zealand are being treated with a non-drug, hands-on back treatment to “unlock the rib hinges in the back” as Steve suggests.


          • Steve August December 31, 2018 at 12:28 pm #

            Hi Carolyn. Happy New Year!

            Good question. I had no idea until I was deluged by queries after I put up the original YouTube video on how we’d view and treat costochondritis that most of the rest of the world didn’t also see it as a straightforward, readily fixable problem driven simply by rib cage tightness.

            I did luck in, because I had costo myself for seven years after a climbing fall. I fixed it after coming through physio school in New Zealand, so thereafter had a personal feel for the problem.

            I think the answer is probably egalitarianism. There is a core of good manual hands-on physio expertise in NZ and Australia, but also we talk to each other so ideas get around. I’m asked to lecture in this area at various NZ medical conferences, so there’s a two-way exchange of information between the docs’ and physio expertise. Everyone benefits.

            I don’t think this happens so much elsewhere, especially not in the UK and US. I’m a physio. One of my fishing mates is the Prof of Rheumatology in my city. I’m reliably informed by a GP (family doctor) friend from Oxford that this would not happen in England.

            So you get the docs elsewhere trying to solve costo using only the concepts and techniques in their doc toolbox, and failing, when all they have to do is look over the fence into the physio area for a much better fit.

            So I guess the non-wordy answer is – we are good, but we also talk to each other. How’s that for an aim for 2019?

            Best wishes, Steve August.

            Liked by 1 person

            • Carolyn Thomas January 1, 2019 at 9:44 pm #

              Hello Steve and Happy New Year to you too.

              I’m neither a physician nor a physiotherapist – and I do not suffer with costochondrititis – but it seems clear to me that you are making a lot of sense when you write this:

              “…you get the docs elsewhere trying to solve costo using only the concepts and techniques in their doc toolbox, and failing, when all they have to do is look over the fence into the physio area for a much better fit.”

              It’s heartbreaking for me personally to read dozens and dozens of reader comments in response to this blog post over the years – about suffering that apparently continues because of what North American medicine continues to cling to in their “doc toolbox”.

              Here’s hoping that other healthcare professionals elsewhere will become open to “looking over the fence” in the pursuit of reducing suffering.


              • Carol Hughes March 11, 2019 at 7:22 am #

                I live in Eastern Canada and my sister who lives close has frequent bouts of costo! I know she only gets NSAIDS and rest from her Dr. here. I have frustration about why so many “fixes” are known in this world and so few Dr.s use them!!!

                Liked by 1 person

                • Carolyn Thomas March 11, 2019 at 6:30 pm #

                  It IS frustrating, Carol. It seems to be quite common for patients with costochondritis to suffer for a long time with very limited relief. I think, as New Zealand physiotherapist Steve August says (above) “…you get the docs trying to solve costo using only the concepts and techniques in their doc toolbox, and failing, when all they have to do is look over the fence into the physiotherapy area for a much better fit.”

                  Ask your sister to contact some local physiotherapists to ask if any are treating costo like New Zealand physios are doing (have her print and bring this 2017 research paper from Zaruba and Wilson to show them).


          • Gay Adair March 17, 2019 at 6:26 am #

            For several years, in the middle of the night, I’ll roll from my right side to my left and get a stabbing unbearable pain right where my heart is. Last night it lasted longer than usual. I am able to breathe through the “event” but not last night; I yelled!

            I have told my doctors about this and no one seems concerned. I am very fit, slim healthy diet and low blood pressure. It is scary.
            Thank you.


            • Carolyn Thomas March 17, 2019 at 8:29 am #

              Gay, this is not normal. We should be able to roll over in bed without yelling in “unbearable” pain. Something is causing this unusual symptom. Make an appointment to see a physiotherapist and go from there.


        • Steve August December 31, 2018 at 12:08 pm #

          Hi Denise. Pleased you thought I made sense. Well done on thinking for yourself. The odds are very good that (1) your costochondritis pain is just coming from rib joints on your breastbone overworking because the rib hinges round the back have become tight, and (2) your doc will not get this.

          There is a home test you can do for this rib tightness – it’s on the Costo page of the Backpod’s website http://www.backpod.co.nz

          Cheeringly, it’s usually not particularly difficult to sort out. Better check with your doc re osteoporosis first, but the Backpod’s only a graded stretch of the joints anyway; no jolting.

          I have noticed from my first year as a physio the tendency for patients to be pigeon-holed as old. Straightforward musculoskeletal problems that would be readily sorted out in a younger person often don’t get treated because the patient with them has been dumped in the too-old-that’s-all-you-can-expect box. Usually it’s simply not accurate. Get irritated.

          Try a sports massage or two as well, for the muscle between and overlying the tight rib cage, including the pecs.

          Best of luck.
          Steve August


    • Deb February 2, 2019 at 2:48 pm #

      I am with you, Denise! I had a routine mammogram with good results about six weeks AFTER having bronchitis. I have had pain in my upper right back, upper arm, right breast and back of my neck. My ribs are even sore to the touch.

      A PA told me yesterday that she thought it might be gallstones. I am scheduled for an ultrasound to rule it out. However, the more I read, the more I’m convinced it is costochondritis!


  6. Jacqueline Kenney October 24, 2018 at 5:30 pm #

    I’m Jackie,
    My GP has prescribed lasaprazole.

    He said my chest pain is acid reflux
    Causing me this horrible pain
    I’m so miserable .
    It’s present on the right breast . Then later this week it will be all over my chest .
    If I dare to sneeze I suffer severe crushing chest pain .
    Dread waking up tomorrow to suffer this again.

    Thanks for reading 🔮


    • Carolyn Thomas October 24, 2018 at 5:49 pm #

      Hi Jackie – I’m not a physician so cannot comment specifically on your situation, except to say generally that “severe crushing chest pain” during a sneeze is not typically a symptoms of acid reflux. If your lasprazole is not effective at doing its only job (treating acid reflux), please report this back to your physician. Right now you simply don’t know what is causing these distressing symptoms. Try keeping a Symptom Journal (date/time of day/what were you doing/eating/feeling an hour or so before symptom starts?) Often doctors can see a pattern emerging that may help solve the mystery. Good luck to you…


  7. Steve August July 8, 2018 at 1:15 pm #

    Hi Carolyn,

    I know you like good evidence, as do I. Here’s a link to a paper from Zaruba and Wilson in the US in 2017.

    Essentially they fixed all their cases of costochondritis by freeing up the tight rib and spinal joints around the back which cause the overuse strain and pain at the rib joints on the breastbone. This is exactly the New Zealand manual physiotherapy understanding and treatment approach I’ve been presenting.

    Now it’s only a case series of eight patients, but the point is this is the BEST evidence for how you fix costochondritis that exists. No one has ever done a clinical trial to see if anti-inflammatories or steroid shots into the rib joints on the sternum actually help. ALL the other bits of evidence are case studies of one or two patients. And that’s it.

    That means that every other approach to fixing costochondritis is pretty much guesswork, regardless of what you’ve been told. That’s where this “mysterious inflammation” nonsense comes from. Thanks for mentioning my YouTube video on fixing costo on your page.

    I am trying to get a little bit of validated common sense about costo out there.

    Best wishes,
    Steve August

    Liked by 1 person

    • Carolyn Thomas July 8, 2018 at 4:04 pm #

      Steve, I am very happy to read this published paper. In fact, I am now considering re-writing much of this 2013 blog post to reflect more of what you and the study authors have been doing and less of the anti-inflammatories/heat/ice/steroid injections content that is widely relied upon here in North America.

      I see this as a two-pronged challenge, however:

      You have to 1. reach the family physicians who are usually the first diagnosers of costo, and then 2. you have to find out if other physiotherapists are as experienced as you in treating this as a musculoskeletal mechanical issue of the back.

      Thanks so much for sending this study on to me. I recall that my first response to your persistent early blog comments here (scroll waaaaaay down to August 2015, below) was to hope you would just quietly go away. 😉

      So thanks also for not going away… You have really helped me and my readers over the years in answering tricky questions (scoliosis, Vitamin D, coughing, etc etc) and understanding more about a tricky and painful diagnosis.



      • Steve August July 8, 2018 at 8:08 pm #

        Thanks, Carolyn. Yep, I generally get shocked looks when I point out to doctors that the standard medical view of costochondritis and how you treat it is NOT evidence-based. I know – I’ve been back and actually looked at the research evidence.

        There’s another aspect of costo that is highly relevant to your own concerns. Up to 50% of thoracotomy and especially sternal open heart operations leave ongoing pain and/or costochondritis in their wake.

        This is an appallingly high proportion, but it isn’t surprising, as the stretch on the rib joints around the back and the muscles between the ribs is massive, let alone the scarring tethering afterwards. I’ve talked about this and what we do for it in the ‘Pain After Surgery‘ section of the Backpod website.

        And of course it’s distressing for the patient over and above the pain as every time they get a twinge, they think it’s the heart problem coming back.

        Steve August.


  8. Pamela harrison June 4, 2018 at 7:53 am #

    I suffer with costachondritis off & on for for yrs. Breast bone really all the time but this time something new. After taking the dog out, the dog pulling on the lead, when I got in I had a spasm on the chest, thought I was having a heart attack! I went to the doctor, he didn’t check me over he just said it was spasms! I went the hospital a week before the spasm. Had a full EKG etc, the dr said it was definitely the costochondritis, has any one else experienced the spasm? Plz could you give me some feedback?

    Liked by 1 person

    • Carolyn Thomas June 4, 2018 at 1:22 pm #

      I’m sorry you’re suffering these new symptoms, Pamela. I am not a physician, but it sure sounds like there was a likely ’cause and effect’ impact of this incident (no spasm until the dog pulled hard on the lead, then a big spasm after that) which of course makes your doctors assume the link that makes the most sense. Please watch physiotherapist Steve August’s video all about condochostritis and see if any of it seems to apply to your own experience.


    • Steve Wallace November 4, 2018 at 11:03 am #

      I got a spasm cleaning out the washer this weekend. I have gotten them walking and running, lifting light weights. I have had costo so long that almost anything I do gives me spasms along the right side of my breastbone. What is scary is that I have aortic valve stenosis that is close to severe and a GERD problem as well so I never really know where that pain is originating from.

      When I mention this to doctors, they never seem to take me seriously…just say to rest and take ibruprofen. Anyone know if there are chiropractic solutions or treatment for costochondritis?


  9. Sarah August 21, 2017 at 12:08 pm #

    Hi, I’m female 35 single from Iran. I have been suffering from pain in my sternum for a couple of weeks, now previous to that I had weird kind of palpitation and a weird sense all round my neck plus cracking sounds in neck and stiff neck, stiff itchy palm and fingers!

    I was diagnosed Vitamin D deficient by blood test (3 months ago, the vitamin D was 9 and last week 14). I am underweight and do not drink milk. Also due to long black covers we have to wear in my country I have been afflicted with this plague. Symptoms abound from severe yet chronic pain all around the neck especially the front part plus throbbing muscles around my neck and sense of burning in the palm etc…. You did not mention Vitamin D deficiency in your article so I thought it might be of some help to your readers. PS. just did the rheumatology blood work and the results were all negative. Also took the x-ray photos (cervical as well as breast) yet haven’t got the results out yet. Also bouts of breast and armpit pain – itchy feeling.

    Liked by 2 people

    • Carolyn Thomas August 22, 2017 at 5:53 am #

      Hello Sarah – I’m not a physician so can’t comment specifically on your experience, but your story made me wonder if Vitamin D deficiency is more common in countries/cultures where women whose bodies are covered don’t get the daily sun exposure that aids Vitamin D absorption. Turns out that Vitamin D deficiencies linked to full body coverage aren’t unique to women as this interesting Scientific American article suggests. Adults need 600 IU of Vitamin D daily, which is what’s in most multiple vitamin pills. It sounds like your Vitamin D deficiency is under control now, and I hope your other mysterious symptoms are being addressed, too.

      Liked by 1 person

  10. Jamila Ōkami March 14, 2017 at 8:25 pm #

    I’m only 15 with Costochondritis, does the age matter for risk of what was mentioned?

    Liked by 1 person

    • Carolyn Thomas March 15, 2017 at 7:32 am #

      Yes Jamila, costochondritis turns out to be a common cause of chest pain in children and adolescents. More info here:

      Liked by 1 person

  11. Jeremy K February 19, 2017 at 6:37 am #

    i’ve had costocondritis for years. What helps is a healthy green smoothie every night – kale, spinach, green apple, coconut water/water. If i do that the symptoms completely subside. Coffee can also make it worse. Dumbbell chest flys can aggravate it too.

    Liked by 1 person

    • Daisy Shepherd April 2, 2017 at 2:34 pm #

      Thanks, Jeremy that makes a lot of sense. I was having a green smoothie every day then got busy and missed a couple of days and the pain that restarted was unbearable. Have restarted again today,

      Liked by 1 person

  12. swtpusit February 16, 2017 at 10:13 pm #

    I’m having the same symptoms right now. ..I’m told heart and lungs are clear. Will see a chiropractor in the morning to see if they can fix it. Hope you all are having or have had relief with your symptoms


  13. Jacquelyne Janaro January 26, 2017 at 5:32 pm #

    I have been diagnosed with Costochondritis a month ago I have had symptoms off and on for 6 months. I think this is paired with anxiety my dr. is still trying to rule things out but several ekg’s and a stress test on my heart showed that it was fine.

    I am not reacting to any of the steroids they gave me for inflammation. My Dr just started me on an anti inflammatory for the next ten days. I have also noticed discomfort when breathing, in my back, and in my left arm. I also often check my pulse and it always seems normal. I notice that the pain in the chest moves around sometimes on the left or right and sometimes in the sternum. I notice more pain when I am bending over or leaning forward on my elbows. My dr. thinks this may also be due to large breasts.. Is this a possibility? I just want the pain to go away. The next step is to be treated for anxiety.

    Liked by 1 person

    • B February 7, 2017 at 8:04 pm #

      I also have struggled with costochondritis since I was 22, I am now 52. It just shows up .. about three times a year .. when it gets where I can’t handle it anymore … I go for acupuncture… the only thing that has ever helped ….. and mine is both sides, front and back, top to bottom. Best of luck.


    • dogkisses December 30, 2017 at 6:19 am #

      Anxiety does not cause costochondritis, but the pain from costochondritis can cause anxiety. Physiotherapy sounds like the best solution. Personally, I would be suspicious of a speculation that large breasts may be a cause of costochondritis or similar (intense) pain.


  14. Sharee Clarke January 20, 2017 at 2:27 pm #

    I have. I feel everything you just described. My cause is unknown. My flare ups are not as painful as they were but they do come every tinne with my menstrual and causes aches, tenderness & fatigue. I’ve tried pain medicine and non- pharmacological measures. I’m going to try acupuncture next.

    Liked by 1 person

  15. Debbie Schultz December 14, 2016 at 12:11 am #

    I was diagnosed in 2013 with costochondritis after experiencing chest pain that just steadily got worse over a few hours time … the cardiologist on call looked at every test which was a complete cardiac work up all the tests I said my heart was fine he then asked what I did for a living I told him I pushed carts he pushed on my ribs …sternum it hurt …he diagnosed it as costochondritis 😞 Tonight I suddenly woke up with chest pain that went from front to back into my jaw…teeth and ear not sure what to make of it.


  16. Suzie November 26, 2016 at 4:58 pm #

    I got taken to hospital straight from a doctor’s appointment when I went to ask about pain relief for a pulled muscle behind my right chest! It was affecting my breathing as I have functional neurological disorder (FND) conversion and my SATS were low! Doctor and paramedics thought I had a pulmonary embolism. I kept telling them I had pulled muscles. After medication, X-ray and scans they said it was due to rheumatoid arthritis FND and pulled muscle!

    This costochondritis sounds exactly like it! I no longer feel like a hypochondriac! Thank you x


  17. Kayleigh Reid, UK November 22, 2016 at 1:06 pm #

    I’ve been diagnosed with Costochondritis today by the Dr. My ribs do not hurt to touch. I’m getting sharp pains on and off right around the heart area. Sometimes it feels like a trapped nerve which is excruciating. Other times it feels like great palpitations with pains. The pain is only in this area. Dr listened to lungs, abs said was all clear. Also used one of those things on my finger to check heart rate. Apparently all normal. I’m 9 weeks pregnant so all they could advise was take paracetamol for the pain and I’m to be reviewed in 2 weeks again. The pain scares me. I can’t sleep as I feel I’m going to have a heart attack or something. Are these normal symptoms of this? I used to get the pain few months back. Thought it could be my lungs so I quit smoking. Wasn’t a heavy smoker anyway maybe 3 a day. Was more a habit when driving. The pain stopped. Now it’s back again for last few days. Just scaring me now. But I’m reading so much into it. Maybe I’ve been misdiagnosed. How do I know until it’s too late? Maybe I’m just panicking.


    • LuAnne Ostby January 6, 2017 at 10:25 pm #

      I hope you are feeling better by now. I understand the fear you describe I went through that for months before talking to my Dr. She was able to give me something to help my fears get under control short term. Then I just kept telling myself that it wouldn’t kill me because I had already lived through it many nights. I know you can’t take meds right now but maybe remembering that downsizing these attacks will help you to get through it a little easier. Good luck!

      Liked by 1 person

      • Megan May 24, 2017 at 2:56 pm #

        LuAnne, What did doc give to help for the short term?


  18. Cristela November 9, 2016 at 5:30 pm #

    I’ve been diagnosed with costochondritis and I also have fibromyalgia. But I found a small lump, on the (rt) chest side, back in August 2016. It was small then. Now it’s about the size of maybe close to a quarter. I think it’s something else. I’m a breast cancer survivor (2013-2015). Triple Negative.


    • Carolyn Thomas November 9, 2016 at 6:00 pm #

      Hello Cristela – any breast cancer survivor who discovers a lump should get it checked by a physician. Best of luck to you…


  19. Connie September 28, 2016 at 12:29 pm #

    I went for my annual breast sonogram and when the tech pressed down on my right breast and center chest I saw stars. This never happened to me before so I made an appointment with my GI doctor for an endoscope. He took a biopsy and found I had h pylori. I took the antibiotics called pylera. He didn’t see any gastritus or ulcers and never said anything else about the pain. Could h pylori cause costochondritis? It also feels like my ribs on the right chest are swollen, inflamed and very sore. At the end of the bottom rib near the center of my chest it hurts in one spot when I press on it. It seems that when I exercise I feel a little better while doing the exercise. Could this be costo?
    I would really appreciate any comments.

    Liked by 1 person

    • Carolyn Thomas September 28, 2016 at 2:00 pm #

      Hello Connie – I’m not a physician so can’t comment specifically on your case or whether your h. pylori bacteria are linked to costochondritis. Here’s a good resource to learn more about the h.pylori bacteria.

      Liked by 1 person

      • Connie September 28, 2016 at 4:59 pm #

        The one thing I don’t understand is I get pain in my right chest under breast bone and center chest. With h pylori the pain is in the stomach. I was just wondering if anyone had h pylori and developed costochondritis after that.

        Liked by 1 person

        • David Velozzi January 3, 2017 at 6:35 pm #

          Connie I just stumbled upon this post and I have chronic costochondritus as a result of h. Pylori and there are many others out there. No doctor will believe you though. Please email me and I will discuss further with you if you like at davidvelozzi (at) gmail (dot)com

          Liked by 1 person

  20. Mel August 31, 2016 at 11:58 pm #

    Hi I am just wondering if a physiotherapist can diagnose costochondritis or only a medical doc in NZ?


    • Carolyn Thomas September 2, 2016 at 11:01 am #

      I don’t live in New Zealand, but my guess (after everything Steve August has written and said) is YES. Am I right, Steve?

      Liked by 1 person

    • Steve August September 2, 2016 at 3:08 pm #

      Hi Mel and Carolyn. The answer’s yes.

      It’s really a diagnosis of exclusion. In practical terms, anyone with chest pain should see a doctor first – no question. It might be heart, or there are some other dire possibilities. A doctor, with all the medical resources available for testing, is certainly the first port of call. However (and I’ve checked this out with several doctor friends of mine here in New Zealand) if everything comes back normal (so it’s not the heart or anything else dire), the tendency is for the doctor to then relax, stand down from all the emergency stuff they were poised to do, and reassure the patient that it’s not life-threatening, it’s just costochondritis, take these anti-inflammatories if needed, and it’ll settle down.

      This is quite understandable. The doctor’s focus, training and resources are all aimed at the major possibilities that could be causing the chest pain, and fair enough too.

      Unfortunately, costochondritis often doesn’t settle down, and can be a major source of pain, fear (it’s chest pain! Maybe the doc was wrong and it is heart!), and disability (can’t work, exercise, or even breathe in fully).

      Also, irritatingly, the medical understanding of costochondritis is that it’s pain and inflammation where the ribs hinge onto the breastbone (correct), and so treatment should be aimed at suppressing that (sounds reasonable but misses the point entirely which is why it usually doesn’t work).

      The reason the rib hinges on the breastbone are painful and irritated is because the joints at the other ends of the ribs where they hinge onto the spine are jammed. So the more delicate breastbone hinges have to do all the movement required for breathing all by themselves. So they get strained, irritated, then inflamed – and there’s your costochondritis.

      As a physio (in New Zealand, and we’re good at this stuff here), this is so easy to diagnose. I can feel whether the specific ribs are moving or not; I can do other movement tests to check for restriction; I can jiggle or manipulate the hinges and retest immediately afterwards to see whether the patient can now breathe in fully, or can rotate further – this is all basic manual physio as practised in NZ. It’s also not difficult.

      So I can tell whether stuck ribs are causing chest pain, nearly every time. But I can’t tell whether the heart is also causing chest pain, so I do want the patient to also see a doctor.

      Most doctors aren’t going to pick the stuck ribs. It’s not their area or focus, but mostly they’re just not thinking of costochondritis as a problem in those terms. It’s a tiny fraction of what they have to learn through medical school, whereas in physio we get get to concentrate almost entirely on musculoskeletal systems, problems and treatments. Of course we’ve got a better handle on this stuff. I lecture to the medical conferences in New Zealand on it. Of course costochondritis isn’t a mystery and of course it’s fixable.

      Lastly, (sorry about long reply!) physio practitioners vary, just like plumbers and hairdressers. NZ and Aussie physios tend to be good on this practical hands-on approach; it’s our particular area of expertise. I’m not saying all physios everywhere will have the same level of understanding, and very clearly most doctors don’t. You could ask any doctor or physio to have a look at my YouTube videos on costochondritis here and here – this is a perfectly reasonable request.

      Hope that helps!
      Steve August

      Liked by 2 people

      • TERRI WOODS September 16, 2016 at 7:48 pm #


        Liked by 1 person

        • Carolyn Thomas September 16, 2016 at 8:00 pm #

          Sorry you are having these horrible symptoms (plus duelling opinions from the specialists you’ve seen so far!) Before you have surgery or an invasive nerve procedure, consult a physiotherapist (watch Steve’s video for more background). Best of luck to you, Teri. (PS Please don’t use ALL CAPS when you write; it’s hard to read).


        • Corazon B Bedillion September 28, 2016 at 6:47 pm #

          I have been seeing doctor after doctor with many different diagnoses. I have unrelenting burning pain in ribs, back, stabbing at my heart. Costochondritis, shingles, possible pleurisy. So scared and frustrated. Been in bed for 2 months. On pain meds and steroids but still unsure what this is.
          Terri, Are you Carmen’s cousin?


      • Jane January 11, 2017 at 9:03 pm #

        My costochondritis has been chronic for over 15 years. I’m happy to look at your video. I appreciate your in-depth notes here. Tonight more of a question of, is this focal right-of-sternum pain today, cardiac? Cardiologist will be seen, but meanwhile… your video.


        • Jane January 11, 2017 at 9:14 pm #

          I withdraw my comment on the basis of the straight-out selling of the pod.


      • dogkisses December 30, 2017 at 7:30 am #

        I’ve had symptoms of costochondritis, on and off, for over a decade, but even in my late twenties, certain exercises would cause pain like an ice pick went thru my right chest to the back.

        I now have several diagnoses (53 years old), including fibromyalgia, chronic fatigue syndrome, arthralgia, degenerative disc disease, post Lyme and twice had RMSF that caused CFS and chronic joint pain, and now a rather generic diagnosis, “pain syndrome.”

        Most recently, I was diagnosed with Nutcracker syndrome that caused pelvic congestion syndrome. Wow right?! Sigh… I also have COPD. Lichen Sclerosus. Skin lupus. Arthritis. Bladder spasms. Blood in urine (Nutcracker), and of course, anxiety and depression.

        Alas. This costochondritis pain is getting the best of me!

        I saw a cardiologist, but failed to follow up with an echo test. Most doctors see my diagnosis of fibromyalgia and they are blind to all else, which leaves me with skepticism about them.

        I am supposed to have a Venogram and arteriogram to check level of compression on my renal vein from the Nutcracker. I am terrified of things in my veins and have been neglecting these tests, but the pain we are calling costochondritis is scaring me and disabling.

        I can’t do anything with my arms without causing the thoracic pain, front, back and sides. Mornings are scary. I can’t breathe in without knife like pleurectic pain. Thank goodness I have pain medication. I recently started PT but my level of confidence in the therapist is low.

        Pardon my long comment. I am concerned regarding possible costochronditis because although I have the symptoms, it’s my thoracic spine that feels like a mule kicked me. I hear you speak to the chest and ribs but right in the center of my spine is a spot; a rather small area, that starts burning and then comes the chest and rib pain. Now my neck, jaw, throat and ears are involved. Still, the thoracic spine seems to be the prevailing symptom. It burns and that spreads.

        A few years ago I took high dose of an antiviral drug. I was convinced I had shingles in my spine. I did get relief. I used to have outbreaks on my ribcage leaving me with post-herpetic pain.

        Too much…


  21. Ellie August 23, 2016 at 9:45 am #

    I got diagnosed with costo 2 months ago, I had an xray done – but it was clear. I have been to four doctors and they haven’t sent me to get further tests such as EKG, blood work to rule out cardiac problems etc. They think I’m fabricating my pain and basically think I’m a hypochondriac – one doc said that the pain is all in my head. My symptoms are – hurts to touch lung/sharp pain, rib pain, shoulder pain, arm pain (tingling, heaviness and hurts to touch/put pressure on it), pain under the breast bone and both sides of sternum and spasms on the left side of chest and my chest feels achy when I breathe in and out. I’m constantly checking my pulse because I think I’m having a heart attack. I had chest pain back in May, it subsided and returned in June. It is now August and I feel weak, constantly in pain and a state of anxiety.


    • Carolyn Thomas August 23, 2016 at 3:58 pm #

      Hi Ellie – I’m not a physician so cannot comment on your specific experience, but I can say in general that a patient already diagnosed with condo is hardly a hypochondriac. The doc that initially diagnosed you must have offered a treatment plan. Two of the symptoms you mention are rarely if ever heart-related (hurts to touch and hurts breathing in and out) and do point instead to a muscular/joint issue. Try starting a symptom journal, tracking what you were doing/eating/feeling in the hours before to see if there’s any kind of pattern. And most importantly, stop checking your pulse repeatedly as that will simply worsen your anxiety and will NOT tell you anything about your heart health. Best of luck to you…

      Liked by 1 person

    • Steve August August 23, 2016 at 4:31 pm #

      Hi Ellie, Amber, Ashly and Carolyn.

      I’m the New Zealand physio Carolyn’s mentioned in some of her replies to you. I’m just catching up with her blog and thought some comments might be useful. Of course, the absolute number one first response to chest pain is see a doctor to get it medically checked out in case it’s heart or something else dire. But you’ve all done that.

      Ellie – an X-ray is a still photo, so it can’t tell whether the hinges around the back where the ribs join onto your spine are moving or frozen solid. An MRI can’t tell that either – same reason. Jammed up rib hinges at the back cause most costo, because the more delicate rib hinges at the front have to then do all the work of breathing, so they strain, get irritated, then inflamed – and there’s your costo. That’s why the pain’s so specific, and also why it often hurts to breathe in fully. I sympathise with the anxiety – chest pain is scary stuff! But you can be anxious, and still sprain your ankle, or jam up your rib joints – it’s not ALL anxiety..

      Amber – I’ve often seen costo on young, breastfeeding mothers. All that bending forward over the baby can compress the rib hinges around the back enough that they jam, and the costo follows from that. Easy to fix – just free up the stuck hinges.

      Ashly – coughing doesn’t sound like much but it gives a surprisingly strong percussive impact on the rib hinges. It’s a common source of them freezing up, and the costo follows from that.

      For all three of you, your costo really sounds exactly like what I’ve been describing in a couple of YouTube videos – which makes it logical and readily fixable, not mysterious. If you’d like to have a look, the links are here and here. (I’m getting more technically adept with this stuff,Carolyn!)

      Steve August.

      Liked by 2 people

      • Carolyn Thomas August 23, 2016 at 5:50 pm #

        Thanks once again Steve. I sure would feel a lot better about recommending physiotherapy as you New Zealanders are routinely doing IF I knew that physios throughout North America were as familiar with/experienced in treating costochondritis as you and your colleagues are in NZ…. Please keep me posted if you hear of Canadian or American physios who are!

        Liked by 1 person

        • dogkisses December 30, 2017 at 7:34 am #



      • amberheal August 24, 2016 at 7:50 pm #

        Hi, my biggest confusion is the different locations costochondritis affects. Ive seen a few videos and has got me to understand more, but i keep searching and there are very few explanations of where else you can feel the pain. All the videos i have seen are comparison to just chest pain where the sternum is. Though i have pain in my ribs that are on my side radiating to back and side of my breast or under them.

        Liked by 1 person

      • Ellie August 26, 2016 at 9:35 am #

        Hi Steve, I understand. I’ve watched your videos explaining costo and they’re very informative… I’m going to ask my physiotherapist on Tuesday. Is it possible to get arm weakness/tingling with costochondritis?

        Liked by 1 person

        • Steve August September 10, 2016 at 4:07 pm #

          Hi Ellie. I just spotted your question. Sure – you can get arm symptoms, especially tingling, in association with costochondritis.

          It’s called T4 syndrome. The sympathetic trunk (big nerve bundle) sits around the fourth thoracic vertebra (T4) – about the middle of the upper back. If that patch of moving joints is gummed up/adhesed, the nerve bundle can be tweaked, and send symptoms off down the arm. Usually, these are tingling, dull ache, maybe a bit of mottling down the arm. (Not usually loss of strength though – muscle power is controlled by motor nerve wiring to the arm which comes out of the spine more at the neck level.)

          How it ties in with costochondritis is that jammed up rib and spinal joints at the T4 level can cause the inflammation and pain at the other ends of the ribs where they hinge onto the breastbone – called costochondritis. If the sympathetic nerve trunk next to the hinges at the back is also tweaked, that can send the tingles off down the arm. So you can fairly frequently get both problems from the same gummed up hinge origin. The answer, of course, is to free up the stuck hinges causing both problems.

          Hope that fits – you can get arm weakness/tingles from a neck problem also, of course; and also with a heart problem – but you’ll have been checked out for that. Cheers, Steve August.

          Liked by 1 person

          • Corazon B Bedillion September 24, 2016 at 3:59 pm #

            I haven’t been diagnosed with costochondritis yet but have been suffering with all the burning, stabbing pain in sternum, heart constantly now for 2 months. Haven’t been able to leave far from my bed. I also have reflex sympathetic dystrophy in feet but this is new. Had chest x-ray and ultrasound and blood test. All normal. Doc says not costo since he can push with not much pain. Next move is neurologist. Does this sound like costochondritis to you?


      • Linda October 22, 2016 at 8:42 am #

        First time in 3 years I have Hope!!!!

        Liked by 1 person

  22. Amber Partain August 22, 2016 at 5:29 pm #

    Hi – going on for 5 months now, I’ve been having pain in my chest that tends to move around. At first it started with my breasts so I thought either my bra was tight or it was just cyclical. But after a while, I started getting anxiety attacks because my sternum would really hurt so I’ve already gotten two x-rays and one ultra sound and all came out clear.

    I have a 17 month old daughter so I use to do a lot of lifting and exercises, but now I haven’t picked up my daughter in a few months because the doctor first said it was inflammation in my ribs and chest. They gave me antibiotics which didn’t seem to work and I’m starting to get real depressed. My pain lately tends to feel a tad better if I do absolutely nothing but one little exertion that I do, I’m in terrible pain the next day. I don’t know what’s going on with me.

    Every now and then it gets so severe it feels like it’s the ring underneath my breasts especially my RIGHT breast. And at the moment it’s my ribs and breast radiating to my right arm and back of shoulder. I keep worrying so I tend to press down where I feel tender because it kind of helps me feel at ease to know it could be costochondritis.

    Liked by 1 person

    • Carolyn Thomas August 23, 2016 at 12:12 pm #

      Hello Amber – that’s heartbreaking to think that you haven’t been able to pick up your daughter for a few months. My grandbaby is about the same age and I can’t imagine how sad I’d feel not to be physically able to scoop her up in my arms. I’m not a physician so cannot comment specifically on your symptoms, but I can say generally that it does sound like your doctor is leaning towards an inflammation diagnosis like costochondritis. Please read Steve August’s comments below and watch his video to learn more about how physiotherapy might help. Best of luck to you…


  23. Ashly July 25, 2016 at 4:18 pm #

    I was diagnosed with costo a little over 3 months ago due to severe coughing from bronchitis. Although it’s not as severe as it was, I still have touch & go pains all through my sternum, above both breasts & lower left ribs & upper back most days. In the beginning, it was most certainly tender to the touch under my left breast but now isn’t. A lot of what I read said that tenderness to the touch is a constant thing with costo so that has me worried and thinking about going in for more tests. I’ve had an EKG, chest X-ray & blood work all came back normal. I’ve been anxiety-ridden the last 9 weeks & feel I’m kind of getting a handle on things, but that tad bit is concerning me.

    Liked by 1 person

    • Carolyn Thomas July 25, 2016 at 6:32 pm #

      Hi Ashly,
      I’m not a physician so cannot comment specifically on your symptoms, but I can say that in general, the onset of serious costo symptoms coincides with something like your severe coughing episodes. You can of course, reach out to your physician for further tests, but I’m guessing that docs seem to pay more attention when we say pain is getting worse, not when we’re worried that it’s getting better. Re-read the comment by physiotherapist Steve August and watch his video to see if it might apply to your case. Best of luck to you…


      • Ashly July 25, 2016 at 8:38 pm #

        I’m hoping getting better is the case, I just wasn’t sure if since the tenderness to the touch is gone but continued chest pain is there it could still be costo! Thank you for the reply!!


    • Steve August July 25, 2016 at 7:46 pm #

      Hi Ashly. I’m just supporting Carolyn’s comment. Coughing doesn’t sound like much but it has a surprisingly strong percussive impact on the rib machinery – muscles and joints. I’ve seen fractured ribs from coughing, and not just in elderly patients, either. So it’s certainly strong enough that repeated impact on the rib joints around the back can leave them glued stuck because of adhesive fibrosis (part of a repair process). Once they’re jammed, the joints at the front have to work overtime just to let you breathe – so they get sore and often inflamed. Easy enough to sort out if it doesn’t settle fast and completely.
      Cheers, Steve August, physio.

      Liked by 1 person

      • Carolyn Thomas July 25, 2016 at 8:00 pm #

        Thanks Steve – I can personally attest to the immense power of a cough! Last month, I was knocked out for about 10 days by a brutal chest cold accompanied by SEVERE and protracted coughing episodes. I woke up one morning after the first week of this and could not believe how every muscle in my upper back, shoulders, sides and abdomen ached horribly. I could hardly move. It took me a while to finally figure it out: must have been due to those crazy coughing attacks, day after day after day. But luckily no chest pain! 🙂


        • Ashly July 25, 2016 at 8:21 pm #

          Thanks guys I really feel for everybody that has dealt with this for so long.. I hope everybody finds a way to get through the pain! Mine started in just the left side & arm which is why I started getting to anxiety ridden but it’s spread to my right side, upper back & neck pain here and there.. Normal? I always find myself thinking it’s more then costo but try to keep myself calm about it all.. Thanks again reading, it has really helped me feel less crazy!

          Liked by 1 person

  24. Rohan Strathie July 19, 2016 at 6:41 am #

    I’ve had a lot of different pains for about 7 months now. I get throbbing pains in what feels like my veins, dull pain under by breastbone, stomach pain and feel like I have a fever a lot of the time. I’ve seen several doctors who said it’s costochondritis but they are not sure. I’m 17 and feel like they don’t really care as I am young and healthy. 7 months ago I had a really unusual headache and I also had work that day as well as walking 4 miles. That night I was laying in my bed and my heart starts to beat really fast so I go to the hospital and they said it was a panic attack (first one I’ve ever had). The next day I feel like my chest is in agony and for the past 7 months I have experienced multiple pains around my chest. I have been unable to keep fit and have missed a lot of school. The tests I have had so far – Chest x-ray, blood tests x3 (both came back fine). Still waiting to see the cardiologist.


    • Carolyn Thomas July 19, 2016 at 3:54 pm #

      Hello Rohan – I’m not a physician so of course cannot comment specifically on your symptoms, but I can say that it would be highly unusual at your age to have a heart-related condition. I’m not saying you don’t, just that it would be rare. If it IS costochondritis, ask for a referral to a physiotherapist who is familiar with costo (and see Steve August’s comments/video below about his work treating costochondritis patients in New Zealand). Best of luck to you…


  25. Peter Williams June 12, 2016 at 4:33 am #

    Does anyone else here believe or feel there is an association between Scoliosis and costochondritis?


    • Carolyn Thomas June 12, 2016 at 7:00 am #

      Hi Peter – I’m not sure if there is an identified scientific link between the two, but I’ve heard patients say anecdotally that they have experienced both.


      • Peter Williams June 12, 2016 at 8:08 am #

        Thanks Carolyn – I know there are probably different causes for costochondritis: inflammatory, mechanical. I often hear therapists say it’s associated with ribs that are fixated at their connection with the spine. I believe having a significant bend in the spine at this level would possibly predispose exacerbate or maybe even cause the condition. As an engineer, it’s difficult to believe that scoliosis wouldn’t at least cause extra stress at the costachondral junction.

        Liked by 1 person

        • Carolyn Thomas June 12, 2016 at 8:58 am #

          It makes sense to me, too, Peter. Watch the video (in the post) with New Zealand physiotherapist Steve August talking about the non-drug, non-invasive physiotherapy methods that he and other NZ physios have been using to treat the costovertebral rib joints for 30+ years.


          • peter williams June 12, 2016 at 9:27 am #

            Thanks again Carolyn will do.


    • Steve August June 12, 2016 at 10:29 pm #

      Hi Peter and Carolyn. Yes, absolutely there’s a link between scoliosis and costochondritis. You’ve summed it up as an engineer and I’d see it in exactly the same way as a physio. I’ve seen it plenty of times in patients, and of course it makes structural sense. You’re not alone – see the comment from Thomas Ward only five days ago and my reply on my YouTube video ‘How to fix (most) costochondritis and Tietze’s Syndrome chest pain‘ Part (2)

      The twist in the thoracic spine with scoliosis distorts the whole rib cage, to some extent. It has to, if you think about it. The hinges where the ribs join onto the vertebrae of your backbone (a.k.a. the costovertebral (CV) joints), and also the hinges where the other ends of the ribs join onto your breastbone (a.k.a. the sternocostal joints) have to move somewhat asymmetrically to still have your chest facing reasonably forward, even though the the spine is twisted towards one side.

      Of course this puts abnormal loading on the rib and spinal joints on one side – a bit like leaning back in your chair and getting the whole load onto the back two legs. So unsurprisingly, if you have scoliosis then the CV joints are predisposed to locking. (I’m not sure of the mechanism – either simple compression, or irritation leading to inflammation leading to adhesive fibrosis gluing and then freezing the movement – but I’ve seen the results more than often enough to note it as a pattern.)

      My view as a New Zealand physio is that once the CV rib joints at the back have locked, then the SC joints at the breastbone have to do all the rib cage joint movement just to let you breathe, so they get irritated, then inflamed, then it’s called costochondritis.

      Not all scoliosis leads to costochondritis, and you can also have costochondritis from a normal non-twisted spine, but there’s definitely a tendency for the two to overlap. My view on both (mild) scoliosis and costochondritis is that if you get the spinal and rib hinges moving okay, then you don’t get pain or restriction from either of them.
      Steve August

      Liked by 1 person

  26. SH April 18, 2016 at 11:40 am #

    I am in heart failure but my pulmonary DR thinks I have this; my chest pain has had me in the hospital for years they’d discharge say nothing was wrong with my heart, look at me like I was lying. I had high BP so I went to a cardiologist, had an echo done and was told I have heart failure. My cardiologist doesn’t see any connection of pain with my heart either – ekgs ecgs all ok, blood work fine. I do have a tissue mass in my mediastinum so I think the pain is coming from this, how can I tell the difference? I had pain in my arm they still told me it had nothing to do with my heart, could it be the mediastinal mass?


    • Carolyn Thomas April 19, 2016 at 6:19 am #

      I’m not a physician so of course cannot comment specifically on your case, but I can tell you generally that a mediastinal mass can cause chest pain. If you’ve been diagnosed with this mass, what treatment plan do your doctors have in place for you to treat it? Ask for a second opinion – best of luck to you.


  27. Brett March 29, 2016 at 12:24 pm #

    Costochondritis is often a result of a vitamin D deficiency. I had bouts with costo every spring for several years. It would always happen just as the weather would be on the verge of becoming nice enough to get outside again after a long winter. The costo would last anywhere from a few days to several weeks. Eventually I realized that it would go away after I started to get exposure to sun and my vitamin D level would rise.

    Incidentally, the first time I had a costo attack, I went to the ER for chest pains, certain that I was having a heart attack. I had just about every test done, including EKG and a dye injection CT scan. The doctors never diagnosed anything, but simply sent me away telling me it wasn’t anything to worry about.

    These days I have to be extremely careful about my vitamin D levels since I don’t spend as much time outside. If my levels drop at any point I could have a costo episode. Fortunately, I’ve learned to not panic when I feel a tight chest. I might have to take some ibuprofen for a few days while I build my D level back up. But I can carry on with my normal routine without much difficulty.

    Also, since costo is essentially an inflammation problem, curcumin, garlic and other anti-inflammation supplements can be of help. Just be aware that they also tend to thin your blood.


    • Carolyn Thomas March 29, 2016 at 4:11 pm #

      Brett, if your theory is correct (a vitamin D deficiency due to lack of sunshine was the cause of your springtime attacks of costochondritis), why wouldn’t your costo symptoms kick in during the winter instead of in early spring?


      • Brett March 30, 2016 at 9:34 am #

        Your vitamin D reserve should be somewhat high at the beginning of winter since it is stored in body fat and the liver throughout summer and fall. But the sunlight in the northern states where I live isn’t strong enough to maintain or replenish levels much at all throughout winter. Vitamin D levels gradually drop and are at its lowest point at the end of winter, regardless of how dark the days are in between. At least in my area. I would say that my costo episodes happened at ‘the end of winter’ rather than ‘the beginning of spring’. A small distinction, but probably easier to understand that way.

        It’s a bit like gas in your car. You fill up your tank and drive for quite a while as your gas gauge drops and you’re fine. But once you hit a certain threshold your gas low warning light comes on. Even filling up a gallon or two here and there won’t help beyond a certain point. Costo is sort of my low vitamin D light.

        I can’t speak for other people (and I’m not a doctor), but I know for a fact that there is a direct relationship between my costo episodes and vitamin D since I can eliminate all my costo symptoms by increasing D supplements.

        One thing to note… your body uses up magnesium when converting D supplements to a useable form. So you should take magnesium along with vitamin D or you might end up with other equally unpleasant symptoms if your magnesium levels drop too much (as I’ve learned).


        • Steve August July 25, 2016 at 7:36 pm #

          Hi Brett and Carolyn.

          This is a really interesting discussion. Since I put up my two YouTube videos giving my New Zealand manual physio view of costochondritis and got swept into the “What causes costo?” arena, I’ve been trying to resolve obviously clear and accurate reports like yours, Brett, with my own knowledge and experience of fixing costo by freeing up the stuck rib joint machinery at the back (which causes the overuse pain and inflammation at the other ends of the ribs where they hinge onto the breastbone). I can do this!

          Essentially, I think the stuck rib origin I’ve described CAUSES the localised breastbone/rib joint inflammation of costo for obvious mechanical reasons. However Vitamin D (and probably Omega 3 also) help your body to fight and suppress inflammation generally, so they can take the pain away if the joint locking isn’t too bad. It’s similar to taking anti-inflammatory medications or turmeric for it – they’ll suppress the inflammation if it isn’t too bad. But in most cases, and probably almost all chronic cases, none of these meds or supplements will actually FIX the costo. That’s why it keeps coming back when you stop taking the stuff.

          (To be completely accurate, if the costo is recent and not too bad, and you take away the pain by Vitamin D or whatever – a good thing !- then your own unguarded movements have got enough leverage to pull free the bit of posterior rib joint restriction that’s causing the chest pain.

          So you could say the costo is fixed then. But this is NOT the case when things are tighter, as they will be in chronic cases – that’s WHY they’re chronic. A thoroughly jammed up rib hinge cannot be freed up just by doing exercises – it’s a matter of leverage. You HAVE to use an external force. Without that, they’ll tend to just stay jammed. Hence costo lasting many, many months and years.)

          Finally, a reality check. It just doesn’t make sense that a very specific pain only where your ribs join onto your breastbone and nowhere else in your body is actually caused by low levels of Vitamin D in the body generally. My New Zealand explanation of the rib hinges at the back being jammed is the only one that accounts for such a specific pain. But absolutely, Vitamin D is highly useful in helping your body deal with the pain and inflammation – I reckon while you’re sorting out the frozen machinery round the back which is driving it. The best treatment is probably combining both approaches.

          My New Zealand manual physio view of costo and how to fix it is on two YouTube videos. Links are: https://www.youtube.com/watch?v=uvJbQFDeyO and https://www.youtube.com/watch?v=r7ve6nNVdWc

          Steve August

          Liked by 1 person

          • Carolyn Thomas July 25, 2016 at 7:51 pm #

            Thanks for this, Steve, especially your reality check (“…doesn’t make sense that a very specific pain only where your ribs join onto your breastbone and nowhere else in your body is actually caused by low levels of Vitamin D in the body generally”) You’re so right.


  28. dogkisses March 14, 2016 at 9:25 pm #

    I think I have this condition. I have chronic fatigue fibromyalgia syndrome. I’ve had this sore aching chest pain on and off for years. I was supposed to have heart tests years ago, but I got scared, and depressed, so I left hospital without the procedures done. Now, I feel I must have the heart tests performed.
    I like your blog. Very helpful information! Thanks!

    Liked by 1 person

  29. Madeleine Dussault March 14, 2016 at 4:02 pm #

    I’ve been having this type of pain for 2 and a half years. It started about 4 months after my mom put my family on a strict gluten-free diet. The odd thing is, that I only have chest pain when I’m on my period, or when I’m using hormonal contraceptives.

    I’ve seen a gynecologist about this (as well as some other issues) and been to the ED a few times, but my x-rays and physical exams have all been clear. A few doctors have suggested that I could have endometrial tissue in the area, but that’s apparently rare, and should be resolved by the hormonal contraceptive use. My gynecologist is extremely hesitant to do any kind of surgery because I’m 19. I also want to discontinue the contraceptive use because of the severe mood effects, but I’m going to hail mary with an IUD in a few months, so that I can say I’ve exhausted all options.

    I had an ECG before I went to the children’s hospital the first time two and a half years ago, which showed ST segment abnormalities, but further ECGs were clear. I also went for an echo (which was clear), but never a stress test. I never received a formal diagnosis at the hospital or at urgent care, I was simply told to “keep coming back” until someone could figure it out, but my parents refused to take me, I’m not able to get their on my own, and I really don’t think I should be going to the hospital for something that’s non-life threatening that could be tested and taken care of non-urgently.

    I’m autistic, and I’m also looking into possible rheumatoid issues (family history) and neurological issues related to a potential TBI 6 years ago with my GP, and I’m also seeing a chiropractor about some of the same issues.

    Do you know of any differentials/tests/treatment options that I could discuss with my GP, gynecologist, or doctor of another specialty that may be of help? Thank you for having taken the time to read all of this, and for your response.

    Liked by 1 person

    • Carolyn Thomas March 14, 2016 at 4:51 pm #

      Hi Madeleine – I’m not a physician so cannot advise you on your specific case. I can say that, generally, it would be unusual that new chest pain would be associated with adopting a gluten-free diet (in fact, likely just the opposite). There are not, to my knowledge, specific diagnostic tests that would confirm a costochondritis diagnosis. So much of medicine is just trying to rule out what the problem ISN’T – ruling out one possibility after another to solve the mystery. In your case, it sounds like you have a medical history that’s varied and complex – so it’s much more challenging for your physicians to connect the dots. Try keeping a symptom journal to show your doctor (e.g. what were you doing/eating/feeling in the hours leading up to a pain episode). You may be surprised by some of the patterns or clues that come up. Best of luck to you…


  30. dogkisses February 28, 2016 at 7:09 am #

    Excellent post!

    Liked by 1 person

  31. Silvia February 21, 2016 at 9:38 am #

    It really breaks my heart 💔 to read about all of this pain so many of you are suffering from. I suffered with this pain on and off since I was about 10 years old. But beginning in the summer of 2009 I was in pain everyday. I had every exam and blood work done that you can imagine. I had steroid injections, I was hospitalized for almost 3 weeks to control the pain that only dilaudid could control.

    My pain management dr referred me to a surgeon that told me he believed that removing my xyphoid would take care of my pain. At this point I didn’t care what he removed. All I wanted was to rest from the pain. In April of 2010 I had it removed. When I woke up from surgery I couldn’t believe that excruciating pain was gone. THANK GOD!! I was obviously in some pain due to the surgery but I could tell the difference. I recovered quickly. I had the surgery on a Thursday and I was back at work the following Tuesday.

    I pray every one of you finds a Dr who will take you seriously and that every one of you finds relief SOON!!!!
    *hugs to all of you *

    Liked by 1 person

    • Carolyn Thomas February 21, 2016 at 9:54 am #

      That’s an amazing story, Silvia! The 2009 medical textbook General Thoracic Surgery does recommend surgery like yours for appropriate costo patients, calling the xyphoid a “partially cartilaginous structure that may promote bilateral spread of the infection”. But each case seems to be uniquely puzzling; glad that your remedy worked for you after all those inexcusable years of pain.


    • Donna Soderlund November 26, 2016 at 11:15 am #

      I really need to know to know more details of your surgery PLEASE I have had my Costochondritis since 16 and I am now 50 and have tried everything. I am at my wits end. Can you tell me what kind of surgeon it was, his name, where he is located, what is the kind of doctor you went to to find this surgeon please give me as much information as you can PLEASE I’m begging you.
      Thank You So Much,
      Donna Soderlund


      • Carolyn Thomas November 26, 2016 at 1:21 pm #

        Hello Donna — If Silvia has subscribed to these comments, she may respond to your questions, but if not, she won’t. Meanwhile, here is some basic info: the kind of surgery that Silvia had is called a xyphoidectomy, which just means removing a part of the breastbone. A thoracic surgeon (a surgeon who operates on organs located in the chest) is the kind of surgeon who would typically perform this procedure. Please view Steve August’s videos (Links are: https://www.youtube.com/watch?v=uvJbQFDeyO and https://www.youtube.com/watch?v=r7ve6nNVdWc) before pursuing any kind of surgery. I’m not a physician but I have heard from readers who did have this surgery for costochondritis but still have chronic pain post-op. Every patient is different.


  32. Rebecca Ward Hudson February 20, 2016 at 7:19 pm #

    I’ve RA, OA and Fibromyalgia. I have had several bouts of Costochrondritis over 30+ year period. I have controlled HBP, otherwise my good and bad cholesterol, and other blood work are excellent. My rheumatologist believes the pain I experienced is definitely associated with this very painful condition. I cannot take oral NSAIDS, but have had good luck with Voltaren Gel.

    Liked by 1 person

    • Carolyn Thomas February 20, 2016 at 9:58 pm #

      Hello Rebecca – thank goodness you seem to be finding relief with the Voltaren. While you’re here, check out Steve August’s video on physiotherapy to treat costochondritis, as mentioned in this article. Best of luck to you…


  33. Lucia Adler January 30, 2016 at 9:05 am #

    I was recently diagnosed with costochondritis, though I’ve been in varying degrees of pain for 4 years. I have had every workup possible except cardiac (aside from echos) x-ray, MRI, full body scan, endoscopy, colonoscopy, abdominal ultrasounds and my blood work is always prefect (aside from elevated amylase – that’s why they did the abdominal ultrasound.

    I have had constant pressure and dull ache under my left lower rib and in December I had an episode of severe pain while I was doing leg presses. Since then I stopped working out completely. My back is now in constant pain because I stopped working out – it’s the only thing that helped me with back pain. It was suggested that I have a steroid shot in the ribs, but I HATE steroids and even more so because I’m not quite convinced that it is costochondritis.

    Is it possible for costochondritis to last this long? I’m contemplating doing the steroid injections just to rule out costochondritis, but even if I do rule it out I have no clue where else to turn. I’ve seen countless physicians and some told me they have no clue, some said I should wait until something else happens that might help give them an idea and some said I should just live with it.

    I’m 52 years old and have always been in excellent health and I’m also not overweight. Any idea at all what I should do next? I have also not been able to sleep on my back since the onset of this problem and I do get chest pains but only at night usually around 3am. Many times the chest pains wake me up but I was just given anxiety medication for that, which I don’t take. I’ve been taking tumeric/curcumin/coconut oil paste for the past 2 weeks thinking that if it is an inflammatory process I might be able to affect it somewhat but nothing changed – some days the pain is better some day it’s not. I still cannot pinpoint a particular reason why that is! I’m getting depressed at the thought of having to live with this forever!


    • Carolyn Thomas January 30, 2016 at 12:35 pm #

      Hello Lucia – four years is a very long time to be in pain before a diagnosis! Sometimes there is no sudden specific event or reason that pain can start, and sometimes there is. I’m going to suggest that you revisit Steve August’s link (and his video) about how physiotherapists in New Zealand are approaching costochondritis and see if this makes sense to you. It’s very different from our North American views. Best of luck to you…


  34. Amanda January 22, 2016 at 6:26 pm #

    I was just diagnosed with costo today. I hurt my lower back last month and was in my second week of physical therapy for it and last night I was doing my stretches and heard and felt something pop in my chest. I thought a rib moved or something, but it’s the most painful thing ever. I can’t even breathe or sit or lay down or anything without pain… They did an x-ray and I guess my ribs are fine, but that’s what the doctor diagnosed me with. I was crying earlier because it hurt so badly. I can’t handle this!

    Liked by 1 person

    • Carolyn Thomas January 23, 2016 at 6:19 am #

      This sounds awful, Amanda. What treatment did the doctor who diagnosed you recommend? As Kelly Young (who has had several bouts of this condition) recommends in this article, many costochondritis patients find relief with ice or heat and anti-inflammatory medications; in her own experience, “the inflammation subsides to a more manageable level in a few days” if it is costo. I hope this will also be true for you!

      You are in very early days yet, but make an appointment to see your family physician as soon as possible for further recommendations. You might also ask your physiotherapist too (watch Steve August’s video for more about how physiotherapy can also help). Good luck to you…


    • Steve August January 23, 2016 at 10:52 am #

      Hi Carolyn and Amanda.

      Amanda, what you’ve just described would fit squarely into the explanation of costochondritis I’ve put on a couple of YouTube videos on CC which Carolyn has kindly referred to and linked.

      That sharp pop and the feeling that the rib moved is a classic mechanical pain presentation – not an inflammatory one. The rib joint(s) around the back where they hinge onto your spine will be jammed – maybe from whatever you did to hurt your low back, especially if it was a fall. Then when you stretched, the frozen rib hinge(s) round the back couldn’t move, so the rib joints around the front where the ribs hinge onto the breastbone had to try and do all that movement. They’re more delicate, and one of them strained and ‘gave’ – hence the pop and the very sharp instant pain.

      Don’t panic, it’s easy to sort out.The key is, logically, to free up the stuck rib hinges around the back. Have a look at two YouTube videos ‘How to fix (most) costochondritis and Tietze’s Syndrome chest pain’ – Part 1 and Part 2. Ask your physio to view them also. This is a perfectly reasonable request – I’m a physio myself (in New Zealand).

      Carolyn, this is a perfect example of how I think most CC turns chronic and inflamed. Imagine if Amanda’s costovertebral rib hinges at the back don’t get freed up. I’m not being alarmist, just accurate – my own ones stayed stuck for seven years, after my climbing fall. Then the continuing extra strain on the sternocostal rib hinges around the front (which are now trying to do ALL the work of breathing and movement) means they get continually strained and irritated, and then inflamed.

      Cheeringly, Amanda’s ribs haven’t been jammed for very long, so should be easy to free up. Not too difficult even if it has been years – just takes longer.
      Best wishes,
      Steve August

      Liked by 1 person

  35. Shanelle January 12, 2016 at 12:10 pm #

    I was diagnosed in Oct 2015 with Costochondritis and it’s been a living hell ever since. I first started experiencing the pain after smoking. My chest tightened up and I had a “full” feeling over my chest and throat. I rarely hear people describe it going up their throat but that’s where I feel it most and it frightens me. They ran so many tests on me as my brother passed away 5 years earlier from a pulmonary embolism and wanted to rule it out.

    I can’t stop worrying that maybe they got it wrong. Does anyone feel that way? Feeling an odd feeling in their throat and perhaps this is anxiety but I have to remind myself how to swallow while breathing. The Aleve medication helps but so much…. I don’t experience the soreness at all…it’s just an “My chest is too full, too tight, and it hurts and scares me”.

    Am I alone in this feeling regarding costochondritis?


    • Carolyn Thomas January 12, 2016 at 12:33 pm #

      Hi Shanelle – I’m not a physician so can’t comment specifically on your case, but I’d advise you to seek a second opinion focused on your throat pain if you are still experiencing it as a “living hell”. As you know, smoking irritates the throat, causing it to become dry, red and inflamed, so if you’re still smoking, that could also be contributing to your symptoms.


      • Shanelle January 12, 2016 at 1:00 pm #

        Oh I quit smoking immediately after being diagnosed. The pain comes and goes but I do have to admit with other replies left here it is a scary feeling to feel your chest tighten up so much and only being prescriped generic aleve or naproxen. Wish there was more information on this diagnosis on the web. Everywhere it states the same thing as if it’s no big deal!


        • Adrienne February 1, 2016 at 6:35 pm #

          Shanelle, I am experiencing the exact symptoms. For several weeks I have seen more than six doctors and even went to the ER. I was told it was costochondritis but I also have a subluxation on my sternoclavicular joint. I have radiating pain to my throat under chin. This is a condition not treated by many doctors. You have to find someone who knows and will listen! I am still looking and having relentless pain. Good luck!


      • Alise January 12, 2016 at 1:53 pm #

        I’ve had costo problems; I’ve had the pain that also traveled up to my throat. My rheumetologist diagnosed me with costo but he also suggested the possibility of anxiety as a result of fear that naturally occurs. I also see a cardiac doctor (I have atrial fibrillation, yet my heart and valves are in good condition). I have an irregular heartbeat at times. But when I’m in pain that lasts longer than 15 minutes, I usually go to the ER primarily to rule out angina which also can cause chest pain. As a side point: if chest pain is relieved by NSAIDS (ibuprofen, etc.) it’s probably not cardiac problems. (EDITOR’S NOTE: see FDA warning in my response below) Go to your doctor and request a work up to rule out cardiac problems; it will alleviate much of the anxiety issues. Remember: knowledge is power!


        • Carolyn Thomas January 13, 2016 at 5:49 pm #

          Just a cautionary reminder here for my readers: last summer, the FDA strengthened its prior consumer warning that NSAIDS pain medications (nonsteroidal anti-inflammatory drugs) like brand-name Motrin, Advil, Aleve, Celebrex, Voltaren (or generic ibuprofen, naproxen, celecoxib, or diclofenac) increase the risk of having a heart attack or stroke, and may also elevate blood pressure or cause heart failure. The risk is greatest for people who already have heart disease, according to this Harvard bulletin.

          Aspirin is also an NSAID, but apparently does not pose a risk of heart attack or stroke, and is not covered by this new warning.


    • Mary February 21, 2016 at 9:35 am #

      I also get tightness and pain crawling up my neck and throat. It continues up my face and feels like all my teeth are being pulled out. It’s terrible, sometimes I pray that I could just die, the pain is so bad. The attacks usually last 1-2 hours and repeat 3 or 4 times over the next few days. Afterwards my face hurts for days.

      I have never smoked.


  36. Susan January 6, 2016 at 7:52 am #

    I’m 24 and have had this recurring chest pain for over 7 years now. It lasts for a minimum of a month if I’m lucky and the ERS says this is what it is. Now it is spreading to my neck and back and my chest is breaking out which it never does, and personally it’s starting to freak me out.


    • Carolyn Thomas January 6, 2016 at 8:09 am #

      Hi Susan – I’m not a physician so cannot comment on your specific case, and I’m not sure if you mean you’ve been diagnosed with costochondritis or not. If you have, you should have some type of treatment plan in place. Seek a second medical opinion, or conversely consider a physiotherapy consultation. Seven years is a long time to withstand distressing symptoms!


  37. Stacy December 8, 2015 at 2:22 pm #

    This has helped me a lot. It seemed as if my doctor wasn’t concerned, but the chest pain was alarming. I have lost 5 people of my age in the last year. I now feel a bit more comforted knowing I am not the only female feeling this discomfort, especially when wearing these underwire bras, which make it worse.

    Liked by 1 person

    • Carolyn Thomas December 8, 2015 at 3:29 pm #

      Stacey, life is just too short to ever wear an uncomfortable underwire bra! If your chest pain continues, seek medical help, okay?


      • Steve August December 11, 2015 at 2:41 am #

        Hi Carolyn.

        I’m the New Zealand physiotherapist who made comments about how we’d see and treat costochondritis (CC) over here back on August 27. (Essentially we’d see it as a straightforward musculoskeletal problem where the costovertebral rib joints at the back are jammed, requiring the anterior rib joints around the front to work excessively to compensate, leading to irritation, then inflammation of them.) You graciously allowed the post, even though it includes mention of a device we make which I do find genuinely appropriate for the problem – thanks for that.

        We’ve put up a YouTube video which probably explains what I was going on about much more clearly than my long verbose email to you. It’s titled ‘How To Fix (most) Costochondritis and Tietze’s Syndrome Chest Pain.’

        I’m not at all saying this is the answer to all CC. But clearly the standard medical view (e.g. Mayo Clinic) that it’ll probably settle down in a few days or weeks is simply not correct for the numerous patients who’ve had it for years – as evidenced on any of the CC blogs. I would like to put forward this standard NZ manual physio view of CC – patients can decide if it seems like a fit with their particular problem.

        You had asked for research evidence of my stance. Happy to report I’ve found Martin Ian Rabey ‘Costochondritis: Are the symptoms and signs due to neurogenic inflammation. Two cases that responded to manual therapy directed towards posterior spinal structures‘ in ‘Manual Therapy‘, Vol.13, Issue 1, Feb.2008, pp 82-86. This is exactly what I’ve been talking about – I’m delighted to find something on it in print.

        Best regards,
        Steve August

        Liked by 2 people

        • Carolyn Thomas December 11, 2015 at 9:16 am #

          Steve, this is what I was talking about. Evidence! Also, your YouTube video is excellent: simple, clear explanations and suggested remedies. Thanks for these two resources. I’m going to include a link within the text of this article (speaking of which, always include URL links to journal articles/videos when recommending them – it saves the blogger from having to look them up!)

          Liked by 1 person

          • Steve August December 11, 2015 at 11:19 am #

            Hi Carolyn. Thanks for that! And roger, wilco re the URL.

            Re evidence, there’s a recent article in ‘The Lancet’ on troponin levels indicating that two-thirds of acute admissions to hospitals with chest pain are not having a heart attack.
            Even allowing for some further admissions with chest pains from respiratory and other medical problems, that’s a lot of people (maybe half?) walking out again with a costochondritis label and wondering what to do about the pain.

            Steve August

            Liked by 1 person

            • Carolyn Thomas December 11, 2015 at 1:21 pm #

              Thanks Steve – we have long known that the vast majority of the chest pain that brings us to the ER is not heart-related, as I wrote in January here (which includes a number of other reasons for this distressing symptom. I spend much of my time, however, hearing from women whose heart attacks have been misdiagnosed by Emergency Department physicians – yes, even like my own, when chest pain is a dominant symptom.


    • Lerato Marsh January 22, 2016 at 10:41 pm #

      Oooh I feel the same I’m no longer wearing underwire bra, if I will try, two minutes is enough.

      Liked by 1 person

  38. Cherie Davis November 27, 2015 at 10:58 pm #

    Exactly 1 week ago I had a mammogram; it was done twice and was very abrupt and hurt a lot more than usual. The pain kept getting worse, radiating down my arm, severe pain at the sternum (felt like a heart attack), sharp pain in the back, can’t cough, hard to breathe- feels like a broken rib under the breast.

    Today I go to Urgent Care and am told that I have Costochondritis and it is not related to the [hard] mammogram (I’ve have numerous done- so I know this one was different). Given a anti inflammatory shot, told to get a rib brace and take ibuprofen (problematic due to acid issues). Hard to believe that this coincidentally occurred at the same time. The back, neck and shoulder hurt. Everything I read seems very likely this came from the minor but twice repeated trauma of the mammogram. Thoughts?

    Liked by 1 person

    • Carolyn Thomas November 28, 2015 at 8:35 am #

      Hi Cherie – ouch!! I haven’t heard specifically about a mammogram causing costochondritis, but the literature does mention that this inflammatory response is often linked to “injury” as a known cause (minor trauma, a blow to the chest, physical strain, overuse of the arms, heavy lifting, strenuous exercise – even severe coughing). See your doctor if you have trouble breathing, a fever, or worsening pain despite your ibuprofen. Best of luck to you….


      • Cherie Davis November 28, 2015 at 11:53 am #

        Thank you. God bless you for providing comfort and information to others. Jesus said that which you have done for the least of these, you have done for me. Matt 25:40

        Liked by 2 people

    • Marian Howard January 1, 2016 at 11:37 am #

      I have spent almost 3 years in pain and discomfort visiting GPs, physiotherapists, osteopaths, having ultrasound, MRI scans, blood tests, ECG and more to find the cause of my constant pain.

      Like Cherie, my pain also occurred not long after I had my first mammogram which was also done twice. I remained in the uncomfortable position I had been placed in while waiting for the operator of the machine to take another image as there had been a problem with the first one. I am not sure if the cause was the mammogram or my excessive heavy gardening duties at the time.

      I have gone from a happy, healthy, fit 50 year old to an overweight, unhealthy 53 year old who struggles to carry out simple everyday tasks due to the immobility and pain from costochondritis.

      My family have no idea how frightened I have been when I feel I am having a heart attack when I exert myself or carry anything heavy.

      I have trawled the internet in a quest to find help as I am certain the damage to my body can be repaired… but how?

      Today I have finally found the help I have been seeking for 3 years. I have watched Steve August on YouTube and I now have hope that I can turn my life around and regain my health and fitness.

      I long to be able to run, ice skate, swim and take huge lung fulls of air again. I will update on my progress.

      Thank you Carolyn and Steve for your helpful information.
      Best wishes to all contributing to this discussion.


  39. Taryn October 4, 2015 at 3:35 pm #

    Carolyn — thank you for this post. I just found it. I was misdiagnosed for 3 weeks with costochrondritis by 2 primary care doctors and ended up having a heart attack during this period. 😦 I am a 51 year old woman whose only cardiac risk factor was being overweight. I eventually had a stent placed, but have had many problems since — it has been like falling off a cliff — I survived the fall, but I am being battered around by the rocks underneath. I really love your blog and appreciate the time and energy it takes to maintain it. Thank you!!!

    Liked by 1 person

    • Carolyn Thomas October 4, 2015 at 5:59 pm #

      Hi Taryn – “falling off a cliff” is a really good description of how many of us feel (except often it seems like we were pushed off that cliff!) Unfortunately, it can also be common for cardiac problems to be misdiagnosed as costochondritis (or indigestion, or anxiety, or gall bladder, or . . . ) Hope you continue to feel better as time goes by.

      Liked by 1 person

  40. Magdalena September 30, 2015 at 10:26 pm #

    I live with fear, this “costochondritis” is not curable.. the medicine, home remedies, etc., is not enough. I wish there was a cure to this condition; to me all of this recommendations are just like putting on a bandaid. It is hard to live like this.


    • Carolyn Thomas October 1, 2015 at 5:09 am #

      Costochondritis seems like a mystery. Much of the medical literature claims it’s “benign” and goes away within a few weeks or months on its own, but even the comments here show that this isn’t always the case. Best of luck to you…


    • Amanda January 22, 2016 at 6:58 pm #

      It’s so much pain.


  41. Amanda Barnes September 22, 2015 at 1:59 pm #

    A little over two years ago I woke up one day with severe chest pain. I was diagnosed with JRA at the time so they upped my prednisone and tried a different biologic. Since then, I’ve been to every doctor imaginable and through every test to rule out everything which left me with a dx of costochondritis. They did discover I have lupus now and I’ve started infusions for that, but even though I’ve had multiple sets of cortisone injections in my chest, prednisone shots, take anti-inflammatories, ice multiple times a day, and am on an incredible amount of horrifying narcotics, nothing seems to help.

    In fact it seems to be getting worse and it’s hard to function when it hurts to move and is difficult to breathe. I’m astounded at how many people there are suffering from this for years with no answers or relief when everything says it should clear up within a few weeks. Sorry for the long post – I just get frustrated especially when doctors can’t help, or worse – tell you to just accept it and give up like my pain doctor.

    Liked by 1 person

    • Carolyn Thomas September 23, 2015 at 5:45 pm #

      Yikes. Your pain doctor told you to “just accept and give up”? I’m not a physician so cannot comment specifically on your symptoms, but I can tell you that generally lupus can sometimes affect the heart through inflammation of the pericardium, the sac that surrounds the heart. This may feel like a sharp pain in the chest. Best of luck to you…


    • Tracy January 19, 2016 at 12:18 pm #

      I had a rapid heart rate 160 and extreme fatigue for 2 months, went through all kinds of testing. Then woke up and had pain on and off all day ended up in the ER, admitted for bilateral pulmonary embolism ( blood clots) – in the hospital for 2 months for pain control. I had to have fluid taken out of lung walls. And have resolved clots, now a year later and still have the same pain not as bad as when I had clots. I have minimal scarring in my lungs. And still have chest pain. Was diagnosed with microvascular heart condition. And that pain is higher in my chest. They have no clue why I still have pain in the same exact spot of my clot pain!!! So they say it must be this condition.


      • Carolyn Thomas January 20, 2016 at 5:49 am #

        Hi Tracy – what a year you have had! My understanding is that, although most patients recover well after PE, recurring chest pain can persist with others (scar tissue? Chronic Thromboembolic Pulmonary Hypertension, especially in women?) This University of North Carolina resource recommends that if there has been no significant improvement at 6-9 months after PE, or if improvement has reached a plateau at an “impaired functional level”, ask for a medical referral just to rule out pulmonary hypertension. Best of luck to you…


  42. Sreekanth September 20, 2015 at 10:48 am #

    I am 34yr old male. Having pain over the left side chest muscle. sometimes it hurts when I touch near the heart. Went to multiple cardiologists and have had 4 ECGs, 3 2d echos and 2 lipid profile tests. Every report came normal. I also had a treadmill stress test 15 months ago – came back normal.

    Cardiologists diagnosed the problem as anxiety neurosis, prescribed me a few muscle relaxants and antidepressants to use. As long as I use those medicines I will get some relief. When I stop taking those pills again, I feel chest pain and will become anxious about my heart health.

    For 18 months, I am suffering from this problem. And I am also suffering from strong palpitations. Don’t know how to convince my brain and relax with this problem. Please help me out, this is like an on-and-off situation for me. Need a permanent solution for this….


    • Carolyn Thomas September 20, 2015 at 11:02 am #

      These are distressing symptoms, Sreekanth. I’m not a physician so cannot comment specifically on your case, but I can say that generally, heart-related chest pain does not feel worse if you press on it. I’d suggest you keep taking the meds that seem to be helping you, and perhaps discussing costochondritis with your physician. If you can make an appointment with a physiotherapist or someone who specializes in musculo-skeletal issues, that might also be useful. Best of luck to you…


    • htjadhav November 29, 2015 at 9:28 pm #

      Sreekanth, I have a similar problem. My email is htj.rit at gmail dot com


  43. Kimberly Riggs September 6, 2015 at 2:34 pm #

    I was diagnosed with costochondritis in 2002. Thought I was having a heart attack. ER ran tests and EKGS. Came back normal till x rays of my sternum. I had broken my sternum in 1992 in a car wreck. It was exactly 10 years to the day. I have to get injections in my sternum area to relieve the pain at times. Winter months are terrible.

    Liked by 1 person

    • Carolyn Thomas September 6, 2015 at 5:51 pm #

      That’s fascinating, Kimberly. Ten years to the day! A blow to the chest is sometimes associated with costochondritis – but I wonder if it usually takes a full decade for symptoms to develop! Best of luck to you – stay warm!!

      Liked by 1 person

  44. Steve August August 27, 2015 at 11:30 am #

    Hi Carolyn and the others. I’m a New Zealand physiotherapist – have been treating spines for 30 years. I do sympathise with you guys. There just doesn’t seem to be an awareness in the UK or USA of what causes costochondritis (CC) or how to fix it. It’s really logical and easy to treat – truly!

    Sure, it’s irritation and inflammation of the front ends of the ribs where they join onto the breastbone (sternum). But you have to stand back and ask WHY they’re inflamed in the first place. The answer is almost always that the rib joints at the back ends of the ribs where they hinge onto the vertebrae of your middle back (they’re called costovertebral joints (CVs)) are jammed up. You have to have movement of the rib hinges just to let you breathe and move around. If the CV hinges at the back are frozen, the rib hinges at the front where the ribs join onto the breastbone have to work overtime to compensate. So they get irritated and then inflamed.

    The front chest pain can be really severe and debilitating, and it’ll last as long as the CV hinges around the back are frozen, and that can be pretty much indefinitely. It’s NOT an injury taking time to heal – it’s a locking hinge problem, and they can just stay stuck until you get enough leverage onto them to free them up.

    Cheeringly, this isn’t difficult.

    There’s a New Zealand home device we use for it called the Backpod. It’s a high-tech fulcrum you lie back on at home, which uses your own upper body weight to stretch out the tough shortened material (called collagen) which holds a frozen rib hinge immobile. Just exercises on their own don’t have enough specific leverage to work the stuck hinges free – you have to use a strong localised external force. Once the CV hinges are freed up, the hinges at the other end of the ribs where they join onto the breastbone don’t have to work overtime simply to let you breathe, so they just settle down and stop being sore. It really is as logical and easy as that. Just treating the inflamed rib hinges around the front misses the point and doesn’t work.

    The Backpods are available off this website We built the Backpod for the usual hunching upper back problem in front of computers but they work excellently well for this specific rib problem. Best of luck – it’s truly a readily fixable problem.

    Steve August (B.A.,Dip.Physio.)

    Liked by 1 person

    • Carolyn Thomas August 27, 2015 at 1:20 pm #

      Hi Steve – I usually don’t publish comments related to selling a specific product, but given how little is available to patients living with costochondritis, I’m running your comment and contact info in case any of my readers would like to research and follow up. READERS TAKE NOTE: publishing Steve’s comment here does not suggest personal endorsement of the backpod.


      • Steve August August 27, 2015 at 2:50 pm #

        Hi Carolyn. Thank you! I really am trying to help – am not a car salesman! I’ve been reading some of the costochondritis (CC) blogs from the UK and the US and am sort of appalled at how much the problem just isn’t understood in those countries.

        New Zealand (and Australia) are good at practical musculoskeletal answers and CC simply isn’t difficult to sort out once you realise that it’s just the frozen hinge movement at the spinal end of the ribs that drives the acute irritation pain around the front. That really isn’t an inflated “I-am” claim: we certainly don’t get everything right but CC is one of the most straightforward logical conditions that we get to treat. I like seeing them presenting at my practice because they respond so well and logically.

        There are standard NZ hands-on physio techniques for freeing up the frozen rib hinges and sorting out the problem. But it seems like UK and especially US physiotherapists aren’t generally aware of them. So I think for anyone in those countries getting hold of a Backpod is a pretty good personal answer. The disclosure is that, yes, I am the inventor – but we developed it out of my expertise on spines: 30 years of treating patients and lecturing. I thought there was a need for something patients could use at home to free up frozen thoracic spinal and rib joints. Given the comments on the blogs, this is demonstrably the case!

        The Backpod website covers its main use in treating the common hunched upper back (usually over laptops, tablets and smartphones) driving neck pain and headache. The user guide that comes with it has specific instructions on how to use it for the tight rib hinges driving costochondritis. I’d have emphasised this latter use more if i’d realised how poorly the problem is understood outside NZ and Australia. Don’t give up – it’s readily fixable!

        Cheers, Steve August (B.A.,Dip.Physio.).


        • Carolyn Thomas August 27, 2015 at 3:21 pm #

          Steve, can you send us some links to recent studies on the link between this “frozen hinge movement” and costochondritis?


          • Steve August August 28, 2015 at 8:45 pm #

            Hi Carolyn.

            What I’d like to get across is just how mainstream and accepted the approach I’ve been talking about is inside New Zealand manual physiotherapy. It must be decades since I’ve looked for specific research on it. The explanation and treatment approach was worked out long ago – we’ve just been getting on with it and using it to fix the problem. I didn’t even realise it was a big problem outside NZ – let alone a mysterious and intractable one – until I strayed by chance into a costochondral blog.

            Happy to discuss this. I can see it’s a bit startling from your viewpoint. From my perspective it’s a bit weird also – feels like I have to assert and justify that, yes, the sun actually does rise in the east.

            Steve August


            • Carolyn Thomas August 29, 2015 at 1:02 pm #

              Hi Steve – you don’t have to assert or justify anything to me. But if you’d like me (and my readers here) to take your word for it, help us out by providing links to the science. This could be the best thing since sliced bread, but if you read any of my blog posts at all, you’d already know that I like evidence, whether we’re talking abut statins or stents or frozen hinges! UPDATE: Readers, see Steve’s video explanation of how New Zealand physiotherapists treat costochondritis.


    • Deone January 26, 2016 at 4:46 pm #

      Steve: What about exercise related CC? I’m relatively certain that’s what kicked mine off as I was doing dips (really deep, and likely with bad form), and felt some pain.

      The pain is really high up though, between my pecs. Does this sound like costo (I had begun to think I cracked my sternum as the pain worsened and became sharp upon going back to pipeline work where I have to carry 75lbs+ regularly).


  45. Carolina August 21, 2015 at 1:11 am #


    I’m a fifteen year old female and during mid July I started experiencing chest pain that felt like my chest was closing in, there was a lot of pressure, I had difficultly breathing and felt like I couldn’t get enough air. At first I didn’t make a big deal of it because it went away a few hours later.

    Days passed and the pain would come back occasionally, where some days it would get worse. Even when I do everyday things (walking, running, standing, laying down, sitting etc) I would lose my breath and have a little bit of pain; then two days ago it came back and my mother who was concerned brought me to the hospital to see if it was anything serious. The doctor had diagnosed me with costochondritis and recommended me to take some Advil. However it does help the chest pain but it doesn’t help when I have trouble breathing. I don’t know if anyone else experienced this either? The doctors said it’s stress but to be honest I have no stress whatsoever. It happens everyday when I feel like I’m losing my breath, not getting enough air, and coughing a lot.


    • Carolyn Thomas August 21, 2015 at 6:44 am #

      Hello Carolina – sorry to hear you have these distressing symptoms. If this is costochondritis, it’s not uncommon for pain to increase when taking deep breaths, hence the shallow breathing problems sometimes reported (not so much that you can’t breathe, but that you can’t do so without experiencing more pain). Sometimes symptoms flare after a cold or other upper respiratory infection; rest seems to be an important therapy. If your symptoms continue, do not hesitate to seek further medical help. Best of luck to you…


  46. Alise August 15, 2015 at 7:00 am #

    My Rheumatologist hasn’t decided whether it’s costochondritis or rheumatoid arthritis. The pain that I get seems to begin in my throat, it feels like an anxiety attack starting. I’ve had a stress test, an EKG and the X-ray that comes with it and found that my hyper anxiety is 90% as my stress increases. So I know and can relate to what everyone was discussing. Even as I’m typing this, my chest wall feels sore again.

    I do know that while I was in school carrying a heavy backpack of books not long after a head injury, I’d been having this pain. But now my anxiety level has increased to the point of having caused a fit. As my stress increases so does the anxiety and as the anxiety increases so does the costo. Sometimes I feel like I’m in a no-win situation.

    I’m going to my cardiologist in a couple of days because I need him to explain the difference or how to tell the difference between costo, angina, and panic attacks.


    • Carolyn Thomas August 15, 2015 at 7:30 am #

      You have hit upon the real question here, Alise: how to tell the difference between three possible diagnoses that can all show very similar symptoms. Best of luck to you in your appointment…


  47. Hannah June 14, 2015 at 9:53 pm #

    I’m fifteen years old and was diagnosed with chronic costochondritis two years ago.

    I was doing dishes when I suffered my first attack. It was sudden; I hadn’t moved anything heavy, no quick movements that could’ve caused injury. It was an abrupt mixture of a burning, throbbing, and tightening pain right under my breasts on my ribcage; the pain radiated to my stomach and my back. It felt like someone had stabbed me underneath my sternum. My father quickly took me to the nearest hospital, where I was diagnosed with it and was sore for months, as well as trouble getting a proper inhale.

    My symptoms and flareups have eased considerably over the last couple of years. I still experience flareups around my menstrual cycle, random stabs of pain usually in a few of my left ribs or left breast, right over my heart. It’s a bit scary considering I feel tremors and tightness over such a critical area, and reading this article has definitely expanded my awareness. My breasts are sore and tender as well as my back and the pain sometimes runs through my arms and legs. Even under my armpits are extremely tender. The only way I can describe the discomfort is like a spear going through my back at any angle where the pain is: pain starting from one side directly to the other in the same spot. It almost feels like my chest is covered in bruises or starting to bruise.

    The odd thing about my condition is that my father suffered with the same thing starting around my age, peaking in his early twenties and then slowly dying down. He’s now forty-five, saying that he still has slight pain but has become accustomed to it. However, there is no scientific link to costochondritis being genetic.

    Is there any way to calm the pain and ease the severity of flareups without NSAID’s? I take Aleve but it usually does nothing. My mother suggested cortisone shots as well. I feel like the pain will never die down, nothing seems to work anymore.

    Liked by 1 person

    • Carolyn Thomas June 15, 2015 at 4:30 am #

      Hello Hannah and thanks for sharing your story here. I’m so sorry you have had to go through all of this pain, especially at your age – but it’s interesting that your Dad also suffered the same symptoms. Some scientists suggest there may indeed be a genetic predisposition. I’m not a physician so cannot comment specifically on your case, but I can tell you that there have been some studies suggesting a link between costochondritis and other inflammatory conditions (arthritis, fibromyalgia, irritable bowel syndrome, for example) and possibly even Vitamin D deficiency. If there is a Pain Clinic near you, consider asking your physician for a referral (pain self-management is an important skill taught by most pain specialists). Best of luck to you…


    • paul June 17, 2015 at 1:19 pm #

      Here is my recommendation of what to do, having gone through the same symptoms after a heart attack.

      Muscles develop a memory and just need a little jog to forget the spasms they create. Like driving a car your legs muscles do the work automatically or riding a bike, so the more pain they create the more normal the muscles believe it is correct.
      Find a Musculoskeletal Doctor, write a list of all your symptoms and give it to them to read, as they will start asking questions which can drag you off track and you will forget to mention things.

      When you are about to go to the appointment, get a pen or some small Band-Aids and mark or put them on the sore spots. Tell the doctor you want a local anesthetic injected into all the hot spots that you have found and the muscles around the area, including the muscle between the shoulder blades and the muscles that come down from the side of you neck to the top of your shoulders, they usually have knots in them which can also cause light headedness.

      Then wait till the next morning and it should have helped, once the muscles have relaxed your state of mind will relax and so will the body. You may have to go back for a little tweaking from time to time. You won’t need to take any drugs, which I found nothing worked anyway.

      Good Luck


      • Carolyn Thomas June 17, 2015 at 9:43 pm #

        Paul, it’s important to remember that costochondritis is generally unrelated to cardiac pain following a heart attack, so what worked for you (local anaesthetic) may have nothing to do with costochondritis.


  48. Steve Davis June 13, 2015 at 5:48 am #

    I used to workout in cable crossover machine in the Gym and one day I pulled little heavy weights. After 2 days I felt chest discomfort so bad that I ran to ER. There was nothing in the EKG and doctor gave me a few medicines including Aspirin. The other day I felt chest discomfort again in the office. I ran to the ER a second time but nothing came up in the EKG.

    After that I went to a cardiologist; he ran many tests like stress test, heart ultrasound, heart CT Scan. The result was 0% blockage of arteries with mild heart valve leak. Cardiologist said it’s normal. Cholesterol level was high to 225 and LDL 130 so he put me to 20 mg Lipitor medication.

    After 2 months of Lipitor I started feeling low blood pressure. I was not able to exercise after that and getting shocks in chest in movement. I complained to the doctor and he reduced the Lipitor dose to 10 mg with CoQ10 medicine. Doctor said there is no heart issue.

    But I remained as it is with chest pain in center. I cannot bend down to lift any object or weight from ground because I feel heavy pain in whole chest from center. In the morning I cannot wake up and roll over in bed as my chest gives me unbearable pain in center when moving my position and waking up from my bed. I am not sure where to go to find the cause and which doctor will do the treatment. I am left with chest pain forever.


    • Carolyn Thomas June 13, 2015 at 6:25 am #

      Steve, I’m not a physician so cannot comment on your specific case. But I can tell you generally that when symptoms strike suddenly after what looks like a specific incident in the gym, that seems a good place to start investigating – especially since all of your tests don’t seem to indicate a cardiac source for pain that is affecting your daily quality of life. Consult your family doctor right away for referrals to solve this mystery. Something is causing your symptoms – you and your doctor need to find out what that is. Best of luck to you…


  49. Susan P May 26, 2015 at 11:20 am #

    I’ve been diagnosed multiple times with costochondritis and/or pleurisy. I have an aching, sore feeling in my chest along my bra line under both breasts – but more prevalent under my right breast. I’ve had multiple EKG’s and my gallbladder has been tested, so it isn’t either of them. I do have fibromyalgia and some sort of internal inflammation (my doctor hesitates to call it rheumatoid arthritis yet), but this chest pain has lasted for almost a year, off and on. It is very frustrating because nothing seems to be being done.

    Liked by 1 person

    • Carolyn Thomas May 26, 2015 at 1:07 pm #

      Hi Susan – my understanding is that if this were costochondritis, treatments that work include rest, ice/heat, anti-inflammatory/pain medications, or even (as Kelly Young has found) steroid injections for severe cases. Go back to the doctor who diagnosed you for a comprehensive treatment plan. Do not accept “nothing can be done” for an answer!


    • Carole July 29, 2015 at 11:40 pm #

      I haven’t been able to wear a bra without pain for over 40 years. I know how you feel. The pressure from the band under the bra is too much. I was labeled with fibromyalgia in 1989, but suffered years before that. Luckily I am only a B cup and found ways to wear clothes in the winter to disguise my missing bra, but summer is harder. I never tried cortisone shots along bra line, because I never thought of it. They did help immensely in other areas. You might want to try it. I may check it out for myself now! 🙂 Good luck!

      Liked by 1 person

      • Carolyn Thomas July 30, 2015 at 6:11 am #

        40 years of pain is a long time, Carole! Thanks for sharing your experience here, and best of luck to you…


  50. Marsha May 11, 2015 at 10:47 pm #

    Year 2013, my doctor told me that I have costochondritis, and the pain was there. My doctor give me pain relievers and after that the pain would come back and radiate in my right upper back. Year 2014, I go back to the doctor and he told me that I have scoliosis as seen in my x-ray… The pain is there… what can I do?


    • Carolyn Thomas May 13, 2015 at 7:50 am #

      Marsha, please make an appointment with your doctor to review a full treatment plan for your symptoms – no matter what the diagnosis. Do not leave that appointment until you understand all the details of your diagnosis. Best of luck to you…


  51. Shoshanna April 23, 2015 at 3:38 am #

    I’m only 15 and I’ve had Costochondritis since I was 8 and they diagnosed me with it last year…

    It’s very painful, for me it’s like mini heart attacks and it aches and sometimes the pain radiates to my stomach or back but it usually is under my left or right breast bone. However the pain actually has hurt pretty much everywhere around my breast bone, sometimes the pain is attached to my breathing though. I went to the doctor after being in severe pain for a whole week straight and he ended up popping my bone back in place. I stopped drinking caffeine and I stopped working out my arms because they both make my Costo hurt bad… Inhaling smoke is really bad too, and I just don’t do workouts except cardio that doesn’t include my arms at all.

    Liked by 1 person

    • Carolyn Thomas April 23, 2015 at 5:25 am #

      Hello Shoshanna and thanks for sharing your story here. Seven years is a long time to wait for an accurate diagnosis! You’ve modified a few strategies that work to relieve symptoms (caffeine, workouts) but next time, do NOT wait a full week before seeking medical care for severe pain. Best of luck to you…


  52. Janine December 17, 2014 at 2:52 pm #

    I have now been living with infectious costochondritis for the past 3 months,after getting gastritis.

    I am in so much pain practically every day, it really is debilitating, I can’t do much in a day, I have to rely on my family a lot, I have been off work now for 4 months and fear I may have to give up my job, as have been told this is a long term illness for me.

    One doctor said it’s the worse case of costochondritis he has ever seen in all his 25 years as a doctor. I am at my surgery every other week, as the painkillers stop working after a while. So I go back for stronger ones. If I have 2 good days then it comes back with a vengeance. Am also on antidepressants to help me cope with the pain, but it’s not letting up. I honestly think the doctors are running out of things to do for me. And my 13 year old daughter is fed up with having a mum who is in chronic pain.

    It just seems like not a lot is being done research wise. Not that I would but I can seriously understand why people who live with chronic pain take their own lives.


    • Carolyn Thomas December 17, 2014 at 4:29 pm #

      Thank you Janine for sharing your costrochondritis story here. It is not surprising at all that you are depressed – few people understand that living with pain can change your entire personality. If you have access to a pain clinic near you, please ask your doctor for a referral. Meanwhile, I’m keeping fingers crossed that your symptoms will start to ease up very soon.

      Liked by 1 person

    • Stephanie September 21, 2015 at 4:42 pm #

      I have had the same symptoms as you for three years. I also get vertigo too. I’m so fed up with pain, don’t know what to do any more.


      • Stephanie September 21, 2015 at 4:45 pm #

        Can I ask does anyone with these problems have food intolerance like diary gluten etc?


  53. Amy November 2, 2014 at 4:25 pm #

    I was diagnosed with costochondritis Feb 2013. After 10 months of trying different medications and therapies I finally had it controlled enough to go back to work. It continued to bother me but I was able to tolerate the pain.

    Then today I ended up in emergency department with what felt like a heart attack. After 3 1/2 hours on heart monitors and heavy pain meds, they ruled it to be my costochondritis. Everything I read says that this condition only lasts days or months. Where can I find more information on this condition and what things I could encounter with it? It doesn’t look like it is going away anytime soon for me.


    • Carolyn Thomas November 2, 2014 at 4:38 pm #

      Amy, I’m so sorry to hear your story. This sounds just awful! You were smart to go to Emergency – as you never want to assume that symptoms are “just” costochondritis. Here’s what I’d do if you haven’t done so already: do a search on the WomenHeart online support community – just type in costochondritis into the search box called Search This Community in the upper right corner. You’ll get dozens of discussion topics on this subject. Best of luck to you…


      • Amy November 2, 2014 at 4:41 pm #

        Thank you I will certainly check that out. =)


  54. Jo October 14, 2014 at 7:02 am #

    I have 8 stents in. Lately, I have symptoms of what I think is “costochondritis.” It feels more like sore chest wall pain rather than the chest pain I had before when I had my heart attack. It actually hurts when I try to speak long sentances. My chest starts squeezing and hurting as I speak and until I take a breath it is like a crescendo of pain-soreness. Today it was rather bad so I just ate 3 junior baby aspirins. If there is a doc out there, I wanted to know, is there such a thing of chest wall pain from the stents I may have? Has this ever been discussed or recorded. Sometimes the pain is sharp and sore in my chest. I keep thinking it is the actual stents hurting….is this possible?


    • Carolyn Thomas October 14, 2014 at 7:36 am #

      Hello Jo – I’m not a physician so of course cannot comment on your specific symptoms. But I can tell you that in general, something docs call “stretching pain” is common in recently-stented patients. If your stents were implanted some time ago, however, please see a doctor about your pain.


  55. Ralph Beckett, MD December 30, 2013 at 10:12 am #

    When I went to medical school 35 years ago, the teaching was to be very careful with the diagnosis of costochondritis. Because 50% of the time, chest pains are actually something else. This should be an expected piece of knowledge in any health care providers’ brain.

    On the other hand, I have seen many patients who have undergone extensive (and unnecessary) cardiac evaluations without the slightest consideration of something besides heart problems. Two cardiac caths before the diagnosis of costochondritis is inexcusable. This problem cuts both ways.

    Liked by 1 person

    • Carolyn Thomas December 30, 2013 at 12:35 pm #

      Good point, Dr. B: in either case, non-cardiac issues can cause chest pain – and cardiac issues can have no associated chest symptoms at all.


  56. Anne December 26, 2013 at 7:22 am #

    Good article. Heart patients need to check in with their cardiologist before using NSAIDs as they raise the risk of coronary damage.


    • Carolyn Thomas December 26, 2013 at 7:38 am #

      Thanks for this reminder, Anne. Studies have found that, among those who had already had one heart attack, people who took the painkillers called NSAIDs (non-steroidal anti-inflammatory drugs) such as Vioxx, Bextra, Aleve, Advil, Motrin, etc. were at >40% higher risk of having a second heart attack compared with those who did not take them.


      • Magda December 26, 2013 at 8:33 am #

        Good article. In addition to heart disease, I also have this from a car accident where I was injured by the seatbelt. I often have swelling and pain, but no doctor has diagnosed it. I had to learn to tell the difference since doctors often dismiss it and tell me to take an anti-inflammatory. I usually suffer through or use ice, since I don’t want to take risks with the NSAIDs.


        • Carolyn Thomas December 26, 2013 at 9:26 am #

          Thanks Magda – I hope your symptoms improve over time.


          • Dr. Barbara Keddy December 26, 2013 at 7:13 pm #

            I have both – heart disease and chronic costochondritis. I have lived with the latter for many decades because of fibromyalgia. Because this can mimic a heart attack it causes me great anxiety. My HA presented as the classic chest pain and it was a few minutes before I realized this was different than what I had been living with for many years.

            However, flare-ups are anxiety provoking! Almost a year now and the constant pain in my chest, neck, jaw stirs up the same questions: is it fibro? costochondritis? another HA? I’ve come to the conclusion I have to live with the uncertainty- the challenges of daily living! 😦


            • Carolyn Thomas December 26, 2013 at 7:42 pm #

              Hello Barbara and thanks so much for sharing your unique personal experience. When I was writing this post, I was so surprised to learn that 60% to 70% of those with fibromyalgia may also have symptoms of costochondritis, too. One report suggests that such people might find themselves “with an ice pack on your chest and a heating pad on your back at the same time.”



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