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Alternative Names: Tietze Syndrome, Slipping Rib Syndrome.
Costochondritis is the inflammation of the cartilage where the ribs attach to the breastbone (sternum).
Causes & Development
The cause of this condition is generally unknown but it can be the result of trauma to the rib cage, a viral infection or part of an inflammatory disease.
Costochondritis may be caused by hypermobility of the anterior end of the costal cartilage. Most often, the tenth rib is the source of pain because, unlike ribs one through seven which attach to the sternum, the eighth, ninth and tenth ribs are attached at the back to each other by loose, fibrous tissue. This provides increased mobility, but a greater susceptibility to trauma.
Costochondritis is also more likely to occur in the lower ribs because of the poor blood supply to the cartilaginous tissue and ligaments. Injury to the cartilage tissue in the lower ribs or the sternocostal ligaments in the upper ribs often does not completely heal naturally.
The ribs are attached in the front, as well as in the back of the body. A loose rib in the front is likely also to be loose in the back. Unexplained upper back pain between the shoulder blades and pain in the rib vertebrae are likely due to joint laxity and/or weakness in the associated ligaments.
Signs & Symptoms
Initially the symptoms may feel like those of a heart attack: pain moving from side to side of the chest and to the arms and neck. Some sufferers find it more difficult to breathe, but there is usually no reason for alarm when the cause of these symptoms is costochondritis.
During the acute phase, pain is usually worse and it hurts to breathe, wear a bra or move suddenly. Eventually the pain subsides to a dull, constant ache or tenderness in the ribs. The symptoms often disappear within two months but may take up to a year or even become a chronic condition. When chronic, the pain seems to come and go with sudden movements or lifting heavy objects.
Stress may contribute to the pain because it makes the muscles tense. Other things that hurt are lifting, pushing, pulling, sneezing, coughing, long hours of driving or using the computer, repetitive motions and caffeine. Cold, rainy and humid weather also make some sufferers feel worse. Even sinusitis, with the associated nose blowing can be the initial event that results in this chronic chest pain.
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Signs, symptoms & indicators of Costochronditis:
Recommendations and treatments for Costochronditis: | | | | | Drug |  NSAIDs | Nonsteroidal anti-inflammatory medications (e.g. Motrin, Advil) help decrease the pain and the inflammation, which is the primary problem. Check with your doctor before taking NSAIDs as they have potential side-effects. |
 Conventional Drug Use| | Cortisone shots are one way of reducing the inflammation of costochondritis but repeated injections are not recommended as they are said to weaken the cartilage after extended periods of use. |
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Physical Medicine |
 Rest| | Exercise, deep breathing, and strain on the muscles of the chest may worsen the pain and slow the healing process. |
Cold Applications| | See the link between Costochondritis and Hot Applications |
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Skin |
DMSO Topically| | DMSO applied to the area of pain may reduce both the pain and the inflammation of costochondritis. |
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Surgery/Invasive |
Prolotherapy| | Prolotherapy, by strengthening the ligaments involved, provides definitive results in the relief of the chronic chest pain of costochondritis. |
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KEY | | Strong or generally accepted link |  | | Proven definite or direct link | | | May do some good | | | Likely to help | | | Highly recommended |
GLOSSARY
Acute
An illness or symptom of sudden onset, which generally has a short duration.
Anterior
In the front or forward part of the organ or toward the head of the body.
Anti-inflammatory (Antiinflammatory)
Reducing inflammation by acting on body mechanisms, without directly acting on the cause of inflammation, e.g., glucocorticoids, aspirin.
Cartilage
Specialized fibrous connective tissue that forms the skeleton of an embryo and much of the skeleton in an infant. As the child grows, the cartilage becomes bone. In adults, cartilage is present in and around joints and makes up the primary skeletal structure in some parts of the body, such as the ears and the tip of the nose.
Chronic (Chronicity)
Usually referring to chronic illness: Illness extending over a long period of time.
Fibrous Tissue
The tissue that forms tendons and ligaments.
NSAID (NSAIDs)
Non-steroidal anti-inflammatory drug.
Prolotherapy
A single or series of injections that stimulates the body to regrow, tighten, and strengthen ligaments or tendons. It is unequaled for pain relief and restoration of normal function for any body joint where connective tissue is weak or has been damaged.
Sinusitis
Inflammation of the sinuses, with causes ranging from dust to hay fever. Obstinate cases can be caused by chronic sinus infections or the continued exposure to allergens from food, pets or environmental irritants.
Last updated: Apr 13, 2008
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