What is costochondritis?
The upper ribs connect to the breastbone (sternum) through flexible cartilage. These costochondral and costosternal joints move slightly every time you breathe. In costochondritis, these areas become inflamed and tender. Unlike Tietze syndrome, a related condition, costochondritis does not usually cause visible swelling. It is one of the most common causes of chest wall pain seen by doctors.
Where costochondritis pain is felt
- At the front of the chest, beside the breastbone, most often on the left.
- Usually over the second to fifth ribs, and often more than one rib.
- It may spread across the chest or to the back, shoulder or arm on the same side.
- In women, pain may be felt near or under the breast and can be mistaken for breast pain.
- The area is tender when pressed, which reproduces the pain.
Symptoms
- Sharp, stabbing, aching or pressure-like chest pain.
- Pain that worsens with deep breathing, coughing, sneezing and certain movements.
- Pain when lying on the affected side or hugging.
- Pain that may come on gradually or suddenly.
- No fever or swelling in typical cases.
Causes and triggers
- Repeated coughing during colds, bronchitis or COVID-19.
- Strenuous exercise, lifting or new upper body training.
- Minor chest injury.
- Viral infections.
- Arthritis affecting the chest joints, in some people.
- Often no specific cause can be found.
Costochondritis or heart pain?
Costochondritis pain is usually reproduced by pressing on the chest wall and changes with movement and breathing. Heart pain (angina or heart attack) is more often a pressure, squeezing or heaviness that may spread to the arm, jaw or back, comes on with exertion or stress, and can be accompanied by breathlessness, sweating, nausea or light-headedness. Women and people with diabetes may have less typical heart symptoms. Tenderness does not completely rule out heart problems, so doctors often check an ECG and sometimes blood tests, particularly in people over 35 or with risk factors. Other chest wall causes are discussed in chest muscle strain.
Treatment
- Reduce activities that worsen the pain, such as heavy lifting, push-ups and rowing.
- Apply heat for 15–20 minutes several times a day.
- Anti-inflammatory medicines or paracetamol may help if suitable for you; ask a pharmacist.
- Gentle chest stretches, such as a doorway stretch, if they do not increase pain.
- Breathing exercises to keep the chest moving comfortably.
- Good posture and avoiding prolonged slouching.
- For persistent pain, a doctor may suggest physical therapy or, rarely, an injection.
How long does costochondritis last?
Many people improve within a few days to weeks. Some cases last several months, and pain may come and go, particularly with activity or coughing. Persistent or recurrent costochondritis is not dangerous, but it can be frustrating. Gradually returning to exercise, treating any cough and addressing posture help. If pain changes in character, comes with new symptoms or does not improve, see a doctor again. Anxiety about chest pain is very common and can make pain feel worse; our guide to anxiety symptoms may help once serious causes have been ruled out.
Three common situations
- Young woman with left chest pain after a chest infection: pain that is tender to press and worse with coughing fits costochondritis; a doctor’s check is still sensible.
- Gym-goer with sharp chest pain after starting bench press: chest wall irritation is likely; reduce pressing exercises and return gradually.
- Man in his 50s with chest pain on climbing stairs: this pattern needs heart assessment even if the chest is tender.
How it is diagnosed
There is no specific test for costochondritis. A doctor takes a history, examines the chest wall and presses on the rib joints to see whether this reproduces the pain. Depending on your age, symptoms and risk factors, they may check an ECG, blood tests, oxygen levels or a chest X-ray to rule out heart and lung problems. If the pain is typical, the examination is reassuring and tests are normal, the diagnosis is made clinically. Swelling at the painful joint suggests Tietze syndrome, and pain with fever or after surgery may need further investigation.
Gentle stretches that may help
- Doorway stretch: forearms on the frame at shoulder height, step forward gently, 20–30 seconds.
- Corner stretch: similar, with hands on two walls of a corner.
- Diaphragmatic breathing: slow breaths into the belly for two minutes, several times a day.
- Shoulder rolls and thoracic extensions over a chair back, 10 times.
- Stop any stretch that increases sharp pain.
Key points to remember
- Costochondritis is inflammation where the ribs join the breastbone.
- Pain is usually left-sided, tender to press and worse with breathing and movement.
- It is harmless, but heart and lung causes must be excluded first.
- Heat, rest from aggravating activities and time help most people.
Questions about costochondritis
These answers are general information and do not replace an examination or individual medical advice.
What does costochondritis feel like?
Sharp, stabbing or aching pain at the front of the chest, worse with deep breaths, coughing and movement, and tender when you press on the area.
Can costochondritis be on the right side?
Yes, although it is more common on the left. It can also affect both sides.
Is costochondritis caused by stress?
Stress does not cause it directly, but it can increase muscle tension and awareness of pain.
Can I exercise with costochondritis?
Walking and gentle activity are fine. Avoid exercises that strain the chest, such as push-ups and heavy pressing, until pain settles.
Will costochondritis go away on its own?
Yes, most cases resolve without specific treatment within weeks to a few months.
Sources
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.