What is the treatment for costochondritis?

From the Guidelines

Treatment for costochondritis typically involves managing pain and inflammation until the condition resolves on its own, with over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen being the first-line treatment to reduce inflammation and pain. The goal of treatment is to relieve symptoms, maintain or regain functional capacity, reduce inflammation, and prevent structural musculoskeletal damage 1.

Some key points to consider in the treatment of costochondritis include:

• Providing patient education and lifestyle recommendations, such as avoiding activities that worsen chest pain and applying heat or ice to the affected area 1
• Considering physiotherapy and dental examination as part of the treatment plan 1
• Using short courses of oral prednisolone or intra-articular glucocorticoid injections as bridging options, while awaiting the effect of other agents 1
• Avoiding the long-term use of glucocorticoids due to potential adverse effects 1

It's also important to note that costochondritis can resolve on its own with conservative treatment, and most cases resolve within a few weeks to months. However, patients should seek immediate medical attention if chest pain is severe, accompanied by shortness of breath, fever, or spreads to the arms or jaw, as these could indicate a more serious condition.

In terms of specific treatment options, NSAIDs like ibuprofen (400-800 mg three times daily with food) or naproxen (220-500 mg twice daily) are commonly recommended. Rest and avoiding activities that worsen chest pain are also essential, particularly movements that stretch or strain the chest wall. Gentle stretching exercises for the chest muscles may help once acute pain subsides. For severe cases, a doctor might prescribe stronger pain medications or administer a local corticosteroid injection directly into the affected cartilage area.

Overall, the treatment of costochondritis should be individualized and based on the severity of symptoms and the patient's overall health status. By following a comprehensive treatment plan that includes medication, lifestyle modifications, and physical therapy, patients can effectively manage their symptoms and improve their quality of life.

From the Research

Treatment Options for Costochondritis

• The treatment for costochondritis typically involves a combination of medication, physical therapy, and lifestyle changes 2.
• Medications such as acetaminophen or anti-inflammatory medications may be prescribed to help manage pain and inflammation 2.
• Alternative treatments such as acupuncture have shown promise in reducing symptoms of costochondritis in adolescent patients 3.
• External application of herbal medicines, such as Rhizoma Corydalis and borneol, has also been shown to be effective in relieving pain and improving range of motion in patients with costochondritis 4.
• Stretching exercises have been found to be beneficial in reducing pain and improving symptoms in patients with costochondritis 5.
• Oral corticosteroids have been shown to be effective in improving pain and quality of life in patients with Tietze syndrome, a rare form of chest wall costochondritis 6.

Non-Pharmacological Interventions

• Avoiding activities that produce chest muscle overuse is often recommended to help manage symptoms of costochondritis 2.
• Providing reassurance and educating patients about the condition and its treatment options is also an important aspect of managing costochondritis 2.
• Physical therapy, such as stretching exercises, can help improve range of motion and reduce pain in patients with costochondritis 5.

Diagnostic Considerations

• It is essential to distinguish costochondritis from other, more serious causes of chest pain, such as coronary artery disease 2.
• A thorough history and physical examination, including palpation of the affected chondrosternal joints, are usually sufficient to make a diagnosis of costochondritis in children, adolescents, and young adults 2.
• Further testing, such as electrocardiography and chest radiography, may be necessary in patients older than 35 years or those with a history or risk of coronary artery disease 2.