How does the chest wall work?
To understand costochondritis, you need to know a bit about the way the rib cage is put together. The rib cage is a bony structure that protects the lungs. Bones are hard and solid and they can't bend or move much. Your lungs, however, need to move, so that you can breathe.
When you take a deep breath in, your rib cage expands. (Try it! You will feel and see your rib cage moving.) In order for the ribs to expand, they need something to allow movement. Cartilage allows this. Cartilage is a softer, flexible (but very strong) material found in joints around the body.
Cartilages attach the ribs to the breastbone (sternum) and the breastbone to the collarbones (clavicles). The joints between the ribs and the cartilages are called the costochondral joints. Those between the cartilages and the breastbone are called costosternal joints. Those between the breastbone and the collarbones are called the sternoclavicular joints.
The prefix 'costo' simply means related to the ribs. 'Chondr-' means related to the cartilage and '-itis' means inflammation. So, in costochondritis, there is inflammation in either the costochondral, costosternal or sternoclavicular joints (or a combination). This causes pain, which tends to be worse when you move, or when you press down on the affected part.
'Used with permission of Mayo Foundation for Medical Education and Research. All rights reserved.'
What are the common causes of costochondritis?
The basic problem is inflammation but the cause of this is unknown (or idiopathic) for most people. There are some situations that are known to cause inflammation and they include:
- Chest infections of varying types.
- Large physical efforts, like lifting heavy objects or repeated bouts of coughing.
- Accidents which hit the chest, like falls or car accidents.
- Some types of arthritis.
Further reading and references
Proulx AM, Zryd TW; Costochondritis: diagnosis and treatment. Am Fam Physician. 2009 Sep 1580(6):617-20.
Chest Pain; NICE CKS, April 2015 (UK access only)
McConaghy JR, Oza RS; Outpatient diagnosis of acute chest pain in adults. Am Fam Physician. 2013 Feb 187(3):177-82.
Gijsbers E, Knaap SF; Clinical presentation and chiropractic treatment of Tietze syndrome: A 34-year-old female with left-sided chest pain. J Chiropr Med. 2011 Mar10(1):60-3. doi: 10.1016/j.jcm.2010.10.002. Epub 2011 Jan 21.
I have experienced symptoms of this syndrome for sometime, but have only recently received a diagnosis.As well as symptoms of pain in the chest, neck and arms I have also been experiencing an...Guest
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