Costochondritis - When to see a doctor

Authored by Dr Mary Harding, 25 Jan 2017

Patient is a certified member of
The Information Standard

Reviewed by:
Dr John Cox, 25 Jan 2017

It can be very difficult to know when to see a doctor if you have chest pain, and how urgently. On the one hand you don't want to waste your own time, or that of your doctor if you have pulled a muscle. On the other hand you know you need to get on with it if you are having a heart attack, or other life-threatening problem. With chest pain, it makes sense to err on the side of caution if you are unsure.

If you feel unwell, breathless, dizzy, or sweaty, or if your chest pain is very severe or spreading to your jaw or left arm then treat it as an emergency. Call 999/112/911 for an emergency ambulance.

If you have a pain in your chest which gets worse as you move your chest wall, and hurts when you press on it then it is likely to be a chest wall cause, such as costochondritis. If you feel generally well, and the pain does not need painkillers, or can be managed with over-the-counter painkillers then you do not necessarily need to see a doctor. Even if you are fairly sure you have costochondritis, if the pain is severe or getting worse rather than better over time then see your doctor.

If you are young and generally healthy, it is more likely that you have a non-serious chest wall pain. Costochondritis is an example of a condition that can cause chest wall pain that is not serious. Because the pain caused by costochondritis can be quite severe at times, many people with it become very anxious and worried that it may be due to something more serious.

If you have other symptoms in addition to the pain then see a doctor. This would include if you have:

  • A cough.
  • A high temperature (fever).
  • Breathlessness.
  • Blood in the mucus you cough up (sputum).
  • Pain which spreads to other parts of the body.
  • A rash.
  • A feeling of having a "thumping heart" (palpitations).
  • Dizziness.
  • Difficulty swallowing.
  • Started to get heartburn or indigestion.

Also see your doctor if the pain gets worse as you exert yourself (for example, on walking up a hill) rather than as you twist your chest around. Pain on exertion is more likely to be due to angina.

See separate leaflet called Chest Pain for more information about the different causes of chest pain.

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 am so disheartened that so many of us poor suffers on this forum are on their own quest to find answers to what can only be discribed for all as a chronic and enduring condiiton spanning so many...

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