From the Guidelines
Costochondritis treatment should primarily focus on pain management and reducing inflammation, starting with over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen for 1-2 weeks. According to the most recent study 1, costochondritis is the most common cause of nontraumatic musculoskeletal chest wall pain, and it can be readily diagnosed by physical examination without the need for diagnostic imaging.
The treatment approach should include:
- Over-the-counter NSAIDs like ibuprofen (400-800mg three times daily with food) or naproxen (500mg twice daily with food) to reduce inflammation and pain
- Applying heat or ice to the affected area for 15-20 minutes several times daily to help manage discomfort
- Rest and avoiding activities that worsen pain, particularly those involving chest movement or pressure
- Gentle stretching exercises for the chest muscles can help once acute pain subsides
For severe cases, a doctor might prescribe stronger pain medications or inject a corticosteroid directly into the affected area. Physical therapy focusing on posture improvement and strengthening chest and back muscles may be beneficial for persistent cases 1. Most costochondritis cases resolve within weeks to months with conservative treatment. The condition occurs when cartilage connecting ribs to the sternum becomes inflamed, often due to physical strain, repetitive movements, or minor trauma, which explains why rest and anti-inflammatory treatments are effective first-line approaches.
From the Research
Diagnosis of Costrochonditits
- The diagnosis of costochondritis is typically made through history and physical examination, with palpation of the affected chondrosternal joints eliciting tenderness 2.
- In children, adolescents, and young adults, reproducible pain by palpation over the costal cartilages is usually sufficient for diagnosis 2.
Treatment of Costrochonditits
- Traditional treatment of costochondritis involves the use of acetaminophen or anti-inflammatory medications, where safe and appropriate 2.
- Patients are also advised to avoid activities that produce chest muscle overuse 2.
- Reassurance is an important part of treatment, as costochondritis is usually self-limited and benign 2.
Further Testing and Evaluation
- Patients older than 35 years, those with a history or risk of coronary artery disease, and any patient with cardiopulmonary symptoms should undergo further testing, including an electrocardiograph and possibly a chest radiograph 2.
- Additional testing may be necessary to rule out cardiac causes of chest pain, particularly in patients with a high cardiac risk status 2.