What are the treatment options for costochondritis?
Treatment is not always needed. Sometimes it helps just to be reassured there is no serious cause for the chest pain. Worry can make the pain worse. (Indeed, anxiety is a common cause of chest pain.)
When treatment is needed for costochondritis, all that is normally required are painkillers and anti-inflammatory medications. Often, just simple painkillers such as paracetamol or codeine are needed. Ibuprofen is an anti-inflammatory medication - also called a non-steroidal anti-inflammatory drug (NSAID) - that is often effective for costochondritis. Other NSAIDs are available on prescription, such as naproxen.
With or without treatment, most people with costochondritis get better gradually over time. It is unusual for it to last more than two months.
For severe cases of costochondritis not responding to painkillers and anti-inflammatory medication, injections of steroids or local anaesthetic medicines may be used.
In extreme cases, an intercostal nerve block can be performed (usually by a doctor specialising in acute pain and/or anaesthetics). This involves injection of a local anaesthetic medicine around the painful ribs, to block the nearby intercostal nerve. The intercostal nerves transmit the painful sensation in costochondritis. This sort of injection temporarily disrupts nerve impulses to stop the pain. Nerve blocks can last several weeks or months. In repeated, severe cases of costochondritis, a series of these injections can be given to permanently destroy the nerve causing the pain.
Non-medicinal measures can be tried for relief of pain in costochondritis. Examples of such techniques include:
- Heat pads.
- Ice application.
- Transcutaneous electrical nerve stimulation (TENS).
- Gentle stretching exercises.
- Avoidance of sports or activities that worsen the pain.
- Physiotherapy or chiropractic therapy.
Did you find this information useful?
- Proulx AM, Zryd TW; Costochondritis: diagnosis and treatment. Am Fam Physician. 2009 Sep 15 80(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 1 87(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 Mar 10(1):60-3. doi: 10.1016/j.jcm.2010.10.002. Epub 2011 Jan 21.
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