Costochondritis, or inflammation of the cartilage connecting a rib to the sternum, can be confused with Tietze syndrome. In Tietze syndrome, swelling in the chest wall is also present. Symptoms of costochondritis include pain where your ribs attach to the costosternal joints or breastbone, pain when coughing or taking deep breaths, and difficulty breathing, as noted by the Mayo Clinic.
While many causes of costochondritis are unknown, some of the recognized causes include an upper respiratory illness, fibromyalgia, infection in the costosternal joint, injury to the chest, and heavy lifting.
Diagnosing chest wall conditions includes eliminating any cardiac event. The area most affected is the second to fifth rib, according to the Baptist Health Systems. The type of pain, which is often described as aching, pressure or sharp, can mimic the same type of pain that accompanies a heart attack. Diagnostic testing may include an EKG, if symptoms or risk factors are suspect for any type of coronary artery disease. A chest X-ray to determine any pulmonary involvement may be ordered.
Physical therapy is a treatment modality aimed at making it easier to perform daily activities. It may be used for pain management, mobility issues, muscle strengthening, coordination and flexibility. Health issues and disease processes such as back pain, rheumatoid arthritis, costochondritis and tendon or ligament issues may improve with treatment by a physical therapist.
Physical therapy is available in a variety of locations, such as a hospital, clinic, school, fitness setting, nursing home or your own home. The physical therapist will do an evaluation to determine a treatment plan that may include core strengthening exercise, ultrasound, manual therapy, electrical stimulation and hot or cold packs.
For costochondritis, the goal is for musculoskeletal chest pain relief and the return to pain-free deep breathing and a full range of motion. Physical therapy for costochondritis will likely include the use of heat packs for muscle and cartilage relaxation and gentle stretching of the chest muscles. A nonsteroidal anti-inflammatory drug to reduce inflammation and pain may be ordered by your doctor.
Costochondritis can affect persons of any age but is most often diagnosed in women and people over 40. According to the Mayo Clinic, costochondritis is usually short-lived but may last for months or longer. Your physical therapist can help you establish a routine for use at home that may reduce the duration and frequency of recurrence. Other measures to reduce the chances of recurrence include:
- Avoid heavy weights on your shoulders such as a purse or school bag.
- Reduce your chances of getting a respiratory infection by frequent and thorough hand washing and limiting exposure to people who are ill.
- Talk to your doctor or therapist about alternates for exercises or activities that trigger rib pain.
Mayo Clinic: Costochondritis https://www.mayoclinic.com/health/costochondritis/DS00626/DSECTION=symptoms
Baptist Health Systems: Costochondritis https://www.aafp.org/afp/2009/0915/p617.html
Mayo Clinic: Costochondritis Treatment and Drugs https://www.mayoclinic.com/health/costochondritis/DS00626/DSECTION=treatments-and-drugs