Costochondritis, also known as Tietze Syndrome, is the inflammation of the cartilage where the ribs attach to the breastbone (sternum).

Initially the symptoms may feel like those of a heart attack: pain moving from side to side of the chest and to the arms and neck. Some sufferers find it more difficult to breathe, but there is usually no reason for alarm when the cause of these symptoms is costochondritis. The cause of this condition is generally unknown but it can be the result of trauma to the rib cage, a viral infection or part of an inflammatory disease.

During the acute phase, pain is usually worse and it can hurt to breathe, wear a bra or move suddenly. Eventually the pain subsides to a dull, constant ache or tenderness in the ribs. The symptoms often disappear within two months but may take up to a year or even become a chronic condition. When chronic, the pain seems to come and go with sudden movements or lifting heavy objects.

Stress may contribute to the pain because it makes the muscles tense. Other things that hurt are lifting, pushing, pulling, sneezing, coughing, long hours of driving or using the computer, repetitive motions and caffeine. Cold, rainy and humid weather also make some sufferers feel worse. Even sinusitis, with the associated nose blowing can be the initial event that results in this chronic chest pain.

Slipping Rib Syndrome, sometimes also called costochondritis, may be caused by hypermobility of the anterior end of the costal cartilage. Most often, the tenth rib is the source of pain because, unlike ribs one through seven which attach to the sternum, the eighth, ninth, and tenth ribs are attached at the back to each other by loose, fibrous tissue. This provides increased mobility, but a greater susceptibility to trauma.

Slipping Rib Syndrome is also more likely to occur in the lower ribs because of the poor blood supply to the cartilaginous tissue and ligaments. Injury to the cartilage tissue in the lower ribs or the sternocostal ligaments in the upper ribs often does not completely heal naturally.

The ribs are attached in the front, as well as in the back of the body. A loose rib in the front is likely also to be loose in the back. Unexplained upper back pain between the shoulder blades and pain in the rib vertebrae are likely due to joint laxity and/or weakness in the associated ligaments.


Signs, symptoms & indicators of Costochondritis

Symptoms - Cardiovascular  

Pain in chest or left side

Counter Indicators
Symptoms - Cardiovascular  

Asbsence of chest or left sided pain

Symptoms - Respiratory  

Chest wall pain

Recommendations for Costochondritis



Nonsteroidal anti-inflammatory medications (e.g. Motrin, Advil) help decrease the pain and the inflammation, which is the primary problem. Check with your doctor before taking NSAIDs as they have potential side-effects.


Conventional Drugs / Information

Cortisone shots are one way of reducing the inflammation of costochondritis but repeated injections are not recommended as they are said to weaken the cartilage after extended periods of use.

Physical Medicine  


Exercise, deep breathing, and strain on the muscles of the chest may worsen the pain and slow the healing process.


Cold Applications

See the link between Costochondritis and Hot Applications


DMSO Topically

DMSO applied to the area of pain may reduce both the pain and the inflammation of costochondritis.



Prolotherapy, by strengthening the ligaments involved, provides definitive results in the relief of the chronic chest pain of costochondritis.


Strong or generally accepted link
Proven definite or direct link
Strongly counter-indicative
May do some good
Likely to help
Highly recommended



Specialized fibrous connective tissue that forms the skeleton of an embryo and much of the skeleton in an infant. As the child grows, the cartilage becomes bone. In adults, cartilage is present in and around joints and makes up the primary skeletal structure in some parts of the body, such as the ears and the tip of the nose.


An illness or symptom of sudden onset, which generally has a short duration.


Usually Chronic illness: Illness extending over a long period of time.


In the front or forward part of the organ or toward the head of the body.

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