What triggers costochondritis (inflammation of the costochondral junctions)?

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Last updated: March 19, 2025View editorial policy

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From the Guidelines

Costochondritis is most commonly triggered by nontraumatic musculoskeletal causes, with the majority of cases attributed to inflammation of the costochondral junctions without a clear precipitating factor, although physical strain, respiratory infections, and repetitive movements may contribute to its development 1.

Triggers of Costochondritis

The triggers of costochondritis can be varied and include:

  • Physical strain
  • Respiratory infections
  • Trauma to the chest
  • Repetitive movements involving the chest wall
  • Inflammatory conditions
  • Heavy lifting
  • Intense exercise
  • Coughing
  • Sneezing
  • Direct impact to the chest area
  • Stress and anxiety, which may exacerbate symptoms by causing muscle tension in the chest region

Management of Costochondritis

To manage costochondritis, it is recommended to:

  • Avoid activities that worsen pain
  • Apply heat or ice to the affected area
  • Use over-the-counter pain relievers like ibuprofen (400-800mg every 6-8 hours with food) or naproxen (220-500mg twice daily with food) to reduce inflammation
  • Perform deep breathing exercises and gentle stretching to help relieve tension
  • Seek medical attention if symptoms persist beyond a few weeks, worsen significantly, or are accompanied by fever, shortness of breath, or heart-related symptoms

Clinical Presentation

Costochondritis occurs when the cartilage connecting ribs to the sternum becomes inflamed, causing localized chest pain that typically worsens with movement or pressure on the affected area, as noted in a study published in the Journal of the American College of Radiology 1.

From the Research

Triggers of Costochondritis

  • The exact triggers of costochondritis are not explicitly stated in the provided studies 2, 3, 4, 5, 6.
  • However, costochondritis is often associated with inflammation of the costochondral junctions of ribs or chondrosternal joints of the anterior chest wall 3.
  • It is usually self-limited and benign, but can be triggered by various factors such as:
    • Trauma or injury to the chest wall 2
    • Overuse or repetitive strain of the chest muscles 3
    • Viral infections, such as coxsackieviruses, respiratory syncytial virus, influenza, parainfluenza, mumps, adenovirus, cytomegalovirus, and Epstein-Barr virus 4
    • Inflammation of skeletal muscle, which can lead to myofascial pain syndromes 5, 6
  • It is essential to rule out other serious causes of chest pain, such as coronary artery disease, pulmonary embolism, pericarditis, and pneumonia, before diagnosing costochondritis 3, 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Costochondritis: diagnosis and treatment.

American family physician, 2009

Research

Myofascial pain - A major player in musculoskeletal pain.

Best practice & research. Clinical rheumatology, 2024

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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