Costochondritis is a painful inflammation in the front of the chest. It is in the cartilage that attaches the ribs to the breast bone.

Tietze’s syndrome is similar inflammation in upper ribs. Neither of these conditions is a serious issue. However, their symptoms are similar to dangerous conditions, like a heart attack . It is important to confirm what is causing your symptoms.

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

  • Injury, overuse, or trauma to the area
  • Recent or current vigorous coughing

Other times it may be due to abnormally tight or loose joints in the area.

Risk Factors

Factors that may increase your chances of costochondritis include:

  • Repetitive activity of upper body
  • Conditions that cause vigorous coughing
  • Arthritis, especially:
    • Osteoarthritis
    • Rheumatoid arthritis
    • Ankylosing spondylitis



Costochondritis may cause:

  • Sharp, localized chest pain, which may be made worse by:
    • Sneezing or coughing
    • Deep breathing
    • Twisting motions of the upper body
  • Tenderness or swelling over a joint between the rib and breast bone


You will be asked about your symptoms and health history. A physical exam will be done.

Your doctor may do further tests to rule out other more serious conditions. Tests will help to rule heart or lung issues. Tests may include a chest x-ray or EKG .



Costochondritis will often go away on its own. It may take a few weeks to a few months to pass. Options to help manage the pain include:

  • Hot or cold compresses over the area
  • Over-the-counter medicine such as:
    • Aspirin
    • Acetaminophen
    • Non-steroidal anti-inflammatory
  • Cough suppressant medicine
  • Avoid strenuous activity; Limit or avoid activity that is causing pain

Treatments that may help lingering or repeating pain include:

  • Injection of corticosteroids into the area
  • Stretching exercises
  • Physical therapy to help muscle balance of the upper body


There are no current steps for prevention.

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.

a (Tietze’s Syndrome)


Family Doctor—The American Academy of Family Physicians 

Kids Health—Nemours Foundation 


Health Canada 

The College of Family Physicians of Canada 


Costochondritis. EBSCO Dynamed Plus website. Available at:  . Updated November 28, 2016. Accessed December 18, 2017.

Costochondritis. Kids Health—Nemours Foundation website. Available at: Updated January 2015. Accessed December 18, 2017.

Proulx AM, Zryd TW. Costochondritis: Diagnosis and treatment. Am Fam Physician. 2009;80(6):617-620.