The cause is not often known. Sometimes there is a clear cause of irritation to the area such as:

  • Trauma
  • Muscle imbalance
  • Inflammation of the nervous system
  • Recent or current intense coughing

Risk Factors

This problem is more common in women, especially those who are athletes, such as rowers. Other things that may raise the risk are:

  • A spine or joints with an unusually large range of motion
  • Moving the upper body the same way over and over again



A person may have:

  • Sharp pain that may be worse when:
    • Sneezing or coughing
    • Deep breathing
    • Twisting the upper body
  • Tenderness or swelling over a joint between the rib and breastbone


The doctor will ask about symptoms and health history. A physical exam will be done.

The doctor may do tests to rule out more serious health problems, such as heart or lung issues. Tests may include:



This problem will often go away on its own within a few weeks or months. Symptoms can be managed with:

  • Supportive care, such as resting the area and using warm or cold packs to ease pain and swelling
  • Medicines to ease pain and swelling, such as:
    • Over the counter pain medicines
    • Corticosteroids

People who are not helped by these methods may need physical therapy. An exercise program will be created to help with strength, flexibility, and range of motion.


There are no known methods to prevent this health problem.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.