by Carolyn Thomas ♥ @HeartSisters
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.
* Read on to learn about how New Zealand physiotherapists are treating costo with manual (hands-on) physiotherapy to unlock the rib hinges around the back, as explained by expert Steve August.
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.
THE NEW ZEALAND DIFFERENCE
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.” 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.
READER COMMENT: “Thanks for this article. I did have ‘just’ costochondritis, but wound up in the ER four times feeling like I was having a heart attack. Turned out my diabetes medication was inhibiting my body’s production of DAO enzyme, thus giving me histamine intolerance. My body was inflamed head to toe with multiple symptoms. I switched to insulin and went on a low histamine diet and am getting better. Also, most of my menopause symptoms went away too. Take good care!” Melinda (August 15, 2021)
Besides physiotherapy as New Zealand physiotherapists use to treat this condition, possible treatments include heat or ice, and medications like NSAIDs to relieve pain and reduce inflammation. * 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 asking your physician.
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 library or favourite 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 30% 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?
213 thoughts on “When chest pain is “just” costochondritis”
My daughter started having chest pain, mainly in the sternum area, four months ago. The pain started to spread to her ribcage and around her back. She went to her PCP, many specialists, and the ER (3 times) because the pain was worse and constant. Every test was unremarkable or normal and she was continually diagnosed with costochondritis. We were also told that it would go away on its own but over the next 4 months were prescribed a bunch of different NSAIDs, lidocaine patches, steroids (oral and with PT), PT, stretches, ice, heat, rest….nothing worked. I had come across an article (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477585/) about a month after her initial onset of symptoms but wasn’t able to get any of her doctors to read the article or prescribe my daughter Colchicine until after four months of her being in constant pain. After my daughter took 3 low doses of Colchicine she woke up pain-free and has been ever since. I hope this is able to help anyone else out there as it has given my daughter her life back! https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477585/
I have this condition. A lot of heat at the front of ribs at sternum but the pain is mainly at the lower ribs at the side and back. Actually feels as though there is a small lump on the rib.
I’m fourteen years old, female, and about three months ago I had a really bad headache and decided to take a nap. I woke up suddenly with my head still hurting and severe heart palpitations, also nausea. Me and my mom went to urgent care and the doctor did not run ANY tests. She tested me for COVID which was negative and said I was feeling anxiety. I went home and was able to fall asleep again and this time I did not wake up with a fast heart rate, instead it was severe chest pain. It went for about a week the chest pain, on and off, and it seemed to be getting better but we decided to go to the ER.
They took my blood pressure, tracked my heart, and gave me an ECG. They told me everything looked fine and that I had costochondritis and it would go away. So I decided to trust what they said and soon the pain seemed to go away for about a week and then came back extremely suddenly.
We recently decided to go to the cardiologist and the test she ran was just an ultrasound of my heart, once again I was told costochondritis and to drink some water it would go away. I’ve been drinking a gallon a day ever since and my chest pain is still flaring on and off, it goes from mild to severe and changes from left to right. I want to believe the doctors but I just feel like costochondritis isn’t the right diagnosis. I don’t want to waste money on unnecessary tests if costochondritis really is the answer, please tell me what I should do.
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Hello Gabby – I’m sorry that you’ve been experiencing these distressing symptoms, and that you haven’t yet found an answer that seems to fit. I’m not a physician so of course I can’t advise you about what to do. I can tell you generally that there are many non-heart related reasons for chest pain, including anxiety (here’s a link to learn more) One of these might be the culprit in your case.
You’ll be relieved to know that chest pain in people your age is generally not caused by a heart problem. It’s also good that you have had several kinds of cardiac diagnostic tests done so far to help rule out cardiac causes.
Wish I could be more helpful. My only additional comment is to start a Symptom Journal (write down date/time of day/ what you were doing/eating/feeling/coughing/ your posture (sitting? lying down? walking?) and description of the pain (exact location, sharp, dull, stabbing, pressure, how long did it last ?) in the hours leading up the start of your symptoms. Often a symptom pattern will emerge that you can then show to your doctor to help solve the mystery.
I’ve heard of water as a treatment for costochondritis but mostly just as an aid if you’re coughing a lot (which can sometimes aggravate costo).
Good luck to you….
Read this, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477585/. This helped my daughter’s costochondritis after only 3 doses.
Thanks Terri for sharing this example published in the journal, Baylor University Medical Center Proceedings. I’m so glad your daughter’s symptoms seemed to respond so well to this particular treatment.
It’s hard to predict if all patients with costo would respond in the same way, because this was not a study, but one case of an 11-year old boy with COVID-19 who had also developed costochondritis.
I hope other physicians who have had similar success will also publish their findings.
Take care, and stay safe. . . ♥
I suffer with constant chest pain and have had multiple heart tests because I also have tachycardia. The only test that has not been done is a heart cath. My female cardiologist suggested the pain may be anxiety. I have also seen a gastroenterologist and have had an endoscopy, been prescribed antidepressant Effexor and meds for acid reflux but nothing helps. When I mentioned costochondritis to my internist he told me not to go there.
Where else should I go?
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I’m sorry that you’re going through this, Stacy. I would be surprised if you weren’t anxious – given that you live with chest pain. Anxiety is a normal reaction to having multiple (wrong) diagnoses – but no relief. Yet something is causing your chest pain – you just don’t know precisely what yet. Please read physiotherapist Steve August’s response (August 15, 2020, below) for info on doing a simple torso rotation test for costochondritis. Consider a second opinion if that test is positive. Meanwhile, start a Symptom Journal to see if you can identify a pattern. When people describe “constant pain”, a symptom journal (recording the date, time of day, type of pain, what you were doing, eating, feeling in the short time before symptom onset) can often reveal that it’s not actually constant. The trick is to identify what seems to make it worse. Good luck to you in solving this mystery.
Take care, stay safe. . . ♥
I brought my daughter in to see her doctor because I thought she possibly had strep. I had not slept well the night before – was awake, tossing and turning, all night because I couldn’t get comfortable. I felt extremely nauseous, like I had the worst heartburn I’ve ever felt. I was pale and clammy, could not catch my breath. I couldn’t sit up straight.
My daughter’s pediatrician sent me straight over to their urgent care side because she thought I was having a heart attack. I was in my late 20s or very early 30s. The doctor on the other side brushed it off as just heartburn. Gave me an antacid with lidocaine. It did not help.
I have been to three cardiologists; I get told I’m fine. My resting heart rate is around 110-120 normally. It takes nothing at all for my heart rate to jump over 140 – last summer I even got to 181 waking up a steep but short hill. I was diagnosed with inappropriate sinus tachycardia in January.
My grandma died from a heart attack (caused by lupus) when she was 41, but because of my age I can’t have heart issues. I am now almost 37.
I have been diagnosed with costochondritis, fibromyalgia, Sicca syndrome (Sjogren’s without a positive ANA), narcolepsy with cataplexy, migraines, hemiplegic migraines… I’m sure I’m forgetting things.
I have gone to the ER with severe chest pain, nausea, vomiting- told by paramedics it was a panic attack. I had to have my gallbladder removed.
Hello Sara – I’m sorry that you’ve been experiencing so many distressing symptoms (and it seems that none of them have resulted yet in solving the diagnostic mystery). I’m not a physician so cannot comment specifically on your experience but I can tell you generally that each of your many diagnoses, no matter what they are, should also have been accompanied by a potential treatment plan.
For example, if you were diagnosed with inappropriate sinus tachycardia in January, I’m hoping that your doctor also suggested the known treatments for this condition (e.g. eliminating potential triggers like caffeine/nicotine/alcohol, or medications that are known to improve IST symptoms – like drugs in the beta-blockers or calcium channel blocker families) or a referral to an electrophysiologist (a cardiologist who has had extra training in electrical problems in the heart).
Right now, you simply don’t know what is causing your symptoms – which may or may not be heart-related at all. I wish I could help you solve this mystery that is affecting your quality of life so drastically. You might want to start a Symptom Journal if you haven’t done that yet – this can sometimes reveal a pattern that might provide clues to what is causing your symptoms. More info on this here.
Best of luck to you,
Take care, stay safe… ♥
Hi Sara and Carolyn,
Sara, some of your symptoms sound like costochondritis (severe chest pain, couldn’t sit up straight or catch your breath) and the rest don’t. Actually, nothing says you can’t have more than one thing going on, unfortunately.
One good practical indicator that you do actually have costo is the fact that the docs haven’t really definitively diagnosed anything else – generally speaking they’re good on the heart (Carolyn’s area, not mine!) but all at sea over costo.
Have a look at the Costochondritis page on the Backpod’s website, and do the home test for tight rib cage machinery causing costo.
Do it accurately – if your sitting torso rotation towards the side of your chest pain is clearly limited, then you very likely do have the tight rib joints causing the costo strain and pain at your front which the page describes. If so, it’s readily and logically fixable – as explained on the page.
As an anecdote, I corresponded a year or so ago with a woman in the US who’d had severe costo chest pain for five years. I got her husband to do that test on her. Her torso rotation was about 90˚ (full) away from the side of her costo pain, but only 45˚ towards it, which also reproduced her pain – indicating the rib joints round the back were fully frozen. The point is that in five years of docs, medications, steroid shots, cardiologists, rheumatologists, pain specialists and a psychologist or two – nobody had ever done that simple test on her.
She fixed it, using a Backpod to stretch free the tight rib machinery around the back. Completely pain-free and back to normal last time she contacted me. Simply, you have to do the right thing to fix the problem, and our New Zealand understanding of costo is supported by the medical research, whereas the standard popular medical view of it in the US and UK as a “mysterious inflammation” is not. Yes, this is mad.
Carolyn, as one who likes research, you’ll be cheered to know we’re working towards a doc and physio RCT in New Zealand comparing the standard medical anti-inflammatory approach to costo with our NZ manual physio approach of freeing up the frozen rib joints. Progress is glacial, but when it happens it’ll be the only RCT ever done on any aspect of costo.
I’ve been lecturing on costo to various NZ medical conferences and EDs, with an overwhelmingly positive response, e.g. from the head of the ED in my home city of Dunedin: “We’re swamped with this stuff daily, and that’s the first time in 30 years anyone has ever made sense of it for me.”
Stay safe over there!
Steve August (B.A.,Dip.Physio.)
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Hello again Steve and thanks for weighing in. I’m glad you are following the comments coming in to this post.
I am VERY excited to hear about this upcoming Randomized Control Trial on drugs vs. manual physio. If this unfolds as your practical clinical experience suggests it will, maybe then North American clinicians will take note!!
Take care, stay safe…
To Sara: a few of your mentions, such as fibromyalgia, Sjogren’s (an autoimmune disorder with/without a positive ANA), migraine – my 35 yr old daughter has them also–and a few others as time has marched on since her early through late 20’s search for causes.
She developed hypothyroidism in her early 20s; by mid twenties we were afraid we were slowly losing her, as she lacked energy to function normally, or even stay awake. She looked pale, with dark under-eyes. She was chronically fatigued, and part/parcel, depressed. Temperature disregulation–complained of both heat and cold. She had a long history of migraine, as do I.
She also had a history of what was believed to be a seizure disorder–grand mal type. Finally, when endocrinologist was unable to further aid in recovering her former health, and blamed diet for her list of complaints, I called a highly praised Dr where we live who once saw her as a child after a physical exam indicated a delayed heart rhythm.
I was curious about whether her lengthy and growing list of physical ailments might warrant another study and the opinion of another medical specialty. I thought of him. I was blessed to be able to speak with that Dr directly, at the end of a long work day before he’d gone home and asked when I called if he’s ever interested to follow up with former pediatric patients once they’ve reached adulthood. After describing the above, he said ‘sure, we can help you out’. We were soon put in touch with partners beginning research on dysautonomia. I’ll leave it to you to look up more about it, but would recommend https://rarediseases.info.nih.gov/organizations/3297, or http://www.dysautonomiainternational.org/page.php?ID=2 if you (or anyone else) want to learn more.
The first test someone should get to determine if dysautonomia is an issue, is a tilt-table test. I’ll leave you to look that up also. A positive tilt-table test indicates likelihood of dysautonomia. Dysautonomia is an umbrella term for a whole constellation of issues people with it could run into more so than the general population, including to the point of it becoming a significant quality of life impairment/disability.
My daughter’s test was positive. She did *not* have a seizure disorder, hence the reason anticonvulsant meds didn’t work and she occasionally still had seizure episodes following abrupt pain. Turns out her blood pressure would plummet immediately, as it does for anyone, but didn’t as rapidly ‘recover’ as does for most. Next it would cause a secondary response, which was a grand mal seizure. She was newly diagnosed with neurocardiogenic syncope, and is now treated with the correct class of medications for the problem, and no longer the *wrong class* of medication for a problem/seizure disorder she was misdiagnosed as having.
MIgraines are often related to dysautonomia, Sjogren’s (myself possibly included now) and other autoimmunities are thought to share some relationship with dysautonomia. My daughter’s new endocrinologist believes that even though she didn’t get a positive test result for Hashimoto’s (autoimmune) thyroid, that she actually does have it given her array of other autoimmune problems.
Only the *right* diagnoses lead to best treatments and outcomes, whereas in our case we spent a couple of decades chasing the right one while mistreating for the wrong one(s) Daughter also has erratic heart rhythms from time to time–often depending of whether sitting or supine.
These stressful times we’re in right now are taking a frequent toll in that way, too. You might check yourself lying down as well as sitting up, not close to when you’ve eating, or taken any med that can affect your rhythm and blood pressure.
Sorry this got long. Don’t know where you live, but dysautonomia specialists are few and far between across the country. Many people have to travel long distances for an evaluation. A special tilt table test that can monitor the response of the sympathetic and parasympatheic nervous systems during the test is really a must, but often the Dr has to argue with insurance to cover it.
In our case, indicating one diagnostic code vs. a different one made the difference in our initial denial being reversed. Drs to seek out are cardioelectrophysiologists and neurologists. Good luck to you–I hope you get the best help you need.
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Sara – The doctor told you you can’t have heart issues because of your age?
I had a heart attack at 36. I’ve never been considered at risk for one. My nephew had open heart surgery when he was 3. My cousin died of heart related issues when he was 27. You can absolutely have heart issues in your younger years. Your heart doesn’t care how old you are.
Best of luck. I hope you’re further along in your journey in a positive way.
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At this exact moment I am (hopefully) getting over Costochondritis.
It came on in a span of 8 hours and it first presented itself on September 25th. I work at a meat locker and regularly lift and carry 50 lbs so I have a fairly muscular build. I gotta tell ya, that these have been some of the most painfully agonizing days I have ever, in my entire life, had to deal with and for so long! I have never had to take off so much time for an illness!
It feels as if my muscles are actually being pulled off my bones every time I make the slightest move! I couldn’t even hold my cellphone. There was no way to even manage the pain, it was so constant and intense that nothing touched it! I haven’t ever cried…no, bawled! So much for so long either.
I finally went to the hospital Monday morning. They checked for heart issues but I feel did a good job making the correct diagnosis. However, I’m a little miffed because getting any pain pills at all is just a pipe dream now thanks to the opioid crisis.
I finally went back to my job on Friday but physically I should be nowhere near anything that weighs more than a loaf of bread. Please pray that it leaves as fast as it came! God help me, please!!
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Christine, this sounds like it’s been a nightmare for you! I do hope the symptoms ease up for you. I hate to imagine you going back to lifting 50lb weights, though. Heavy lifting and/or strenuous exercise is a known culprit in costo. Continued lifting cannot be good for healing.
Meanwhile, make sure you watch the videos from physiotherapist Steve August in this article (this one includes some recommendations for some gentle exercises you can do at home).
Best of luck to you… hang in there.
What if costochondritis is often accompanied by mild fever, phlegm, and transient red painless welts on hands and feet?
I’m not a physician, Mary, but my understanding is that, except when costochondritis occurs as a result of infection after surgery – when you might be more likely to see redness, swelling, or discharge at the incision site – that the symptoms you mention – fever, phlegm, red welts – would not be typical of costochondritis.
See your physician for a medical opinion…
I have had sudden chest pains diagnosed as costochondritis all my life. The doctors said I would grow out of it. For as long as I could remember, the chest pains would reoccur every 1-2 months. The pain would be located either either on the left or right side of my chest. When the pains trigger, it makes it difficult to breathe. Breathing when I have these chest pains only makes things worse. I have no clue if it’s legitimately costochondritis or another condition.
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Hello Aliah – I don’t know how old you are now, but if you’ve been having these symptoms ALL YOUR LIFE, it appears you have NOT grown out of them. I think it’s time to get a second opinion.
Thank you for this post on costochondritis. I learned a lot.
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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.
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Good luck with your doctor’s appointment on Tuesday, Linda.
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
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.
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.).
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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…
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.
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