What are the treatment options for Costochondritis (inflammation of the cartilage that connects the ribs to the sternum)?

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Last updated: April 21, 2025View editorial policy

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From the Guidelines

Costochondritis treatment should primarily focus on managing pain and inflammation, starting with over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen for 1-2 weeks, as recommended by recent guidelines 1.

Treatment Approach

The treatment approach for costochondritis involves a combination of pharmacological and non-pharmacological interventions.

  • Over-the-counter NSAIDs such as ibuprofen (400-800mg three times daily with food) or naproxen (220-500mg twice daily with food) are the first line of treatment to reduce inflammation and pain 1.
  • Applying heat or ice to the affected area for 15-20 minutes several times daily can help with pain relief.
  • Rest and avoiding activities that worsen symptoms, particularly those involving chest movement or strain, are crucial in the initial stages of treatment.
  • Gentle stretching exercises for the chest muscles can be introduced once the acute pain subsides to improve mobility and prevent further strain.

Additional Considerations

For severe cases of costochondritis, prescription of stronger pain medications or corticosteroid injections directly into the affected area may be necessary, as suggested by expert consensus recommendations 1.

  • Deep breathing exercises and maintaining good posture can help prevent strain on the chest wall and are recommended as part of lifestyle modifications.
  • Patient education on the condition, its management, and the importance of seeking medical attention if symptoms persist or worsen is essential throughout the treatment process 1.

Monitoring and Follow-Up

Most cases of costochondritis resolve within a few weeks with conservative measures. However, if pain persists beyond several weeks, worsens significantly, or is accompanied by other concerning symptoms like fever or difficulty breathing, seeking medical attention is crucial as these could indicate a more serious condition 1.

From the Research

Costochondritis Treatment

  • The treatment of costochondritis typically involves the use of acetaminophen or anti-inflammatory medications, where safe and appropriate, as stated in the study 2.
  • Patients are also advised to avoid activities that produce chest muscle overuse and are provided with reassurance.
  • It is essential to note that clinical trials of treatment for costochondritis are lacking, and the traditional practice is based on the available evidence.
  • The use of nonsteroidal anti-inflammatory drugs (NSAIDs) may be beneficial, but it is crucial to consider the benefits and risks, as discussed in the study 3.
  • The study 3 highlights the importance of individual clinical judgments for each patient, considering the potential risks of NSAIDs on cardiovascular disease.
  • In patients older than 35 years, those with a history or risk of coronary artery disease, and any patient with cardiopulmonary symptoms, further testing may be necessary to rule out cardiac causes, as recommended in the study 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Costochondritis: diagnosis and treatment.

American family physician, 2009

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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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