Costosternal chondritis, also known as chest wall syndrome or costosternal syndrome and costosternal chondritis, is an inflammatory disease affecting the cartilages connected to the ribs of the rib cage. Symptoms can resemble those of a heart attack, so at the first sign of pain in the chest it is always necessary to consult a doctor to rule out that it is a heart attack. They may also offer some advice on how best to relieve pain during the healing process.
Steps
Part 1 of 3: Seeking Medical Assistance
Step 1. See your doctor right away or call emergency services if you experience chest pain
The doctor will be able to determine if it is a heart attack or something less serious, such as costochondritis.
- Know what to expect from your doctor's visit. Your doctor will likely feel (examine with your fingers) the breastbone to figure out where the painful spot is and to assess the severity of the inflammation. If during the physical exam he can stimulate the area in a way that arouses pain, it is probably costochondritis and not a heart attack. They may also ask you if you have recently been in an accident to find the cause.
- They may order tests to rule out other conditions commonly associated with chest pain, including osteoarthritis, lung disease, gastrointestinal disease, or joint infections. In these cases, he will ask you to undergo an x-ray, CT scan, MRI scan, or electrocardiogram.
- Tell your doctor if you have heart, liver or kidney problems, high blood pressure, ulcers, or have suffered from internal bleeding in the past. This information will help him develop a personalized pain management plan based on your needs.
Step 2. Take antibiotics if prescribed by your doctor
If your case of costochondritis is caused by a joint infection, your doctor will likely prescribe you taking oral or intravenous antibiotics.
These medicines are not always intended to be administered because infections rarely cause costochondritis
Step 3. Discuss drug options with your doctor
If the pain does not go away after a few weeks and non-steroidal anti-inflammatory drugs have not been effective, your doctor may suggest something stronger to help you manage the pain. Here are some possibilities:
- Stronger non-steroidal anti-inflammatory drugs (NSAIDs), similar to the action of ibuprofen (Brufen, Moment). If you have to take them for a long time, do it under medical supervision as they can harm your stomach and kidneys.
- Medicines containing codeine, such as Vicodin, Percocet, etc. They can be addictive.
- Some antidepressants or contraceptives are also effective in managing chronic pain.
Step 4. Consider the most invasive procedures to combat pain
In most cases, costochondritis heals on its own over time. However, if the pain continues and is unbearable, the doctor may suggest:
- Injecting a corticosteroid and anesthetizer directly into the painful joint.
- Transcutaneous Electrical Nerve Stimulation (or TENS, which stands for TransCutaneous Electrical Nerve Stimulation). It is a procedure that by means of weak impulses prevents the nerves from communicating pain to the brain.
Step 5. Discuss surgical options for removing or repairing damaged cartilage if no treatment has been effective
Sometimes it is necessary, especially if the cartilage tissue has been severely damaged by an infection.]
- Results are usually excellent in combination with antibiotics.
- Once you've recovered, get regular annual checkups to make sure your joint is healthy.
Part 2 of 3: Dealing with Pain in the Home
Step 1. Rest to give the body time to heal
In other words, you will have to abstain from the most strenuous sports for several weeks. Usually, costochondritis is due to activities that stretch the cartilage and muscles of the chest. The first advice prescribed by your doctor is to rest or avoid practicing exercises that contribute to aggravating the malaise. Usually, the pain goes away after a few days to a few weeks, but in some cases it could last for several months.
- Rest until the pain passes completely
- Slowly resume physical activity so that the body has time to recover muscle power and endurance;
- Pay particular attention to activities that require sharp, sudden movements, place a strong impact on the chest muscles, or increase the risk of getting blows to the chest. Among these sports, consider tennis, baseball, golf, basketball and karate.
Step 2. Apply heat to the painful area
Promotes increased blood circulation and relaxes contracted muscles.
- Use a hot water bottle or thermal blanket;
- Do not apply the heat source directly to the skin. If you use the hot water bottle, wrap it in a towel to avoid burning yourself.
- Apply the heat for a few minutes, then remove it to give your skin a chance to cool off.
Step 3. Put an ice pack on the affected joint
It is where the pain radiates from and where the breastbone connects to the ribs. Ice will help reduce swelling and relieve inflammation.
- You can get a cold pack quickly and easily by wrapping a package of frozen peas or corn in a towel;
- Do not apply it directly to the skin;
- Remove the ice pack after 15-20 minutes to give your skin a chance to warm up. Repeat this three to four times a day.
Step 4. Stretch the tight muscles around the joint
Do this exercise slowly and gently, and only if your doctor has given your consent. The latter may refer you to a specialist to find out which exercises are most appropriate for your injury.
- Start calmly, stretching your chest muscles as you breathe slowly and deeply;
- When you feel ready, start stretching your pecs. A simple technique is to rest your forearm against a door and then slowly lean forward until you feel the muscles under and around your shoulders pulling.
- Yoga poses combined with deep breathing are excellent for relaxing and stretching. Try the position of the sphinx. Lie with your abdomen on the floor and lift your torso with your elbows on the ground. Spread your shoulders, arching your back, and return to the starting prone position.
- If the exercises are painful, stop immediately to avoid hurting yourself.
Step 5. Try different sleeping positions until you find the one that eases the discomfort
Try to avoid those that put pressure on the aching joint.
Sleeping on your stomach will probably not be very comfortable
Step 6. Improve posture to reduce chest tension
If you are hunched over when sitting or standing, you risk aggravating costochondritis and increasing discomfort.
- Try to sit, stand and walk with a book balanced on your head.
- Concentrate on widening your chest and bringing your shoulders back.
Step 7. Try over-the-counter pain relievers
Non-steroidal anti-inflammatory drugs are likely to be more effective. Ask your doctor if you can take over-the-counter pain relievers. They can give you some relief.
- If you are already on drug therapy for this malaise or any other condition, consult your doctor before you start taking any self-medication. He will be able to tell you if there is a risk of unwanted interactions.
- Follow the instructions in the package insert and consult your doctor if you need to take them for more than a few days. Do not arbitrarily increase the doses.
- If you have heart disease, high blood pressure, kidney disease or liver disease, or are prone to stomach ulcers or internal bleeding, talk to your doctor before using these medications, including over-the-counter medications.
Part 3 of 3: Knowing the Symptoms and Causes
Step 1. Learn to recognize the symptoms
Costchondritis can cause severe discomfort. Patients describe pain in the following ways:
- Sharp, oppressive pain or limited pressure on the sides of the breastbone. Typically, it is located on the fourth, fifth and sixth ribs.
- The pain can also radiate to the stomach or back;
- The pain can affect more than one rib and be aggravated by coughing or deep breathing.
Step 2. Be aware that since the main symptom is chest pain, it is not easy to distinguish costochondritis from a heart attack
The fundamental difference is that, in the case of costochondritis, the painful area is generally sensitive to touch and that, therefore, the palpation carried out by the doctor can awaken the pain. However, in all cases of chest pain, it is advisable to consult your doctor immediately to rule out that it is a heart attack.
- The pain is often localized on the left side as in the beginning of a heart attack. It can be strong and worsen when you breathe deeply, turn your chest, or move your arm.
- Heart attacks usually cause dull pain and may be accompanied by numbness in the arm and jaw.
Step 3. Learn about the causes of costochondritis
The etiological factors are different. The most frequent are:
- Injury to the cartilages that connect the ribs to the rib cage. It can be produced by a blow or sustained effort while carrying heavy objects or in the case of a severe cough. A respiratory infection of the upper respiratory tract can also trigger costochondritis if it causes a strong cough.
- Arthritis affecting the joints. Osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis can cause chest pain.
- Joint infection, such as tuberculosis, syphilis or aspergillosis. Sometimes, the cause of costochondritis goes back to a bacterial infection that affects the joints after surgery.
- Tumor located near a joint.
- In some cases, the cause cannot be determined.
