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What causes costochondritis?

What causes costochondritis?

Costochondritis is a common condition. It usually causes sharp chest pain. The symptoms of costochondritis can be similar to other serious conditions, such as a heart attack. Costochondritis, though, isn't serious and gets better with time. Pain medicines, including anti-inflammatory medicines, can help to treat the symptoms.

Costochondritis is a condition where the cartilage (connective tissue) joining the ribs to the breastbone (sternum) becomes inflamed and painful.

It's not always clear what causes costochondritis. Some possible causes include:

  • An injury to the chest wall.
  • Coughing or sneezing.
  • Viral or bacterial respiratory infections.
  • Heavy lifting.
  • Problems with the spine, like scoliosis.
  • Some types of arthritis.

Costochondritis has similar symptoms to a different, rarer condition called Tietze syndrome. Tietze syndrome also affects the area where the ribs and breastbone (sternum) meet. Whereas costochondritis causes pain alone, Tietze syndrome causes pain and swelling. The causes of Tietze syndrome are probably similar to those of costochondritis.

If you think you have costochondritis, find out what to do here.

In this series of articles centred around costochondritis you can read about symptoms of costochondritis, costochondritis treatment, and costochondritis causes - all written by one of our expert GPs.

The rest of this feature will take an in-depth look at the causes of costochondritis as, at Patient, we know our readers sometimes want to have a deep dive into certain topics.

Costochondritis causes

The symptoms of costochondritis are thought to be due to inflammation and irritation of the costal cartilage - the connective tissue that joins the ribs to the breastbone (sternum). This inflammation causes the pain associated with costochondritis.

It's often difficult to find a clear cause in people with costochondritis. Sometimes, though, one of the following things is involved:

  • An injury to the chest wall, such as a direct blow to the chest, or repeated smaller injuries that damage and inflame the costal cartilage.
  • Repeated coughing or sneezing. This can cause small, repeated injuries to the costal cartilage.
  • Viral or bacterial respiratory infections. This is probably because they cause coughing, but might also occur if the inflammatory response to infection affects the costal cartilage too.
  • Heavy lifting. This can strain and injure the costal cartilage.
  • Spinal problems, such as scoliosis. This can change the shape and alignment of the ribs and costochondral joints, causing them to rub against each other.
  • Some types of inflammatory arthritis, such as rheumatoid arthritis, may lead to inflammation of the costal cartilage. Fibromyalgia may also be linked with costochondritis.

Rarely, a type of infective costochondritis can occur as a complication of major surgery to the chest - such as open heart or lung surgery. This is a type of wound infection.

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Costochondritis risk factors

The risk factors for costochondritis include having any of the causes of costochondritis, as listed above.

Other risk factors include:

  • Age. Costochondritis can affect anyone, but most commonly affects adults aged 40 to 60.
  • Gender. Costochondritis is slightly more common in women.

What causes costochondritis to flare up?

It's often difficult to find an exact reason why costochondritis flares up, but some people report that the following can cause costochondritis to flare up:

  • Physical activity, such as heavy lifting or anything else that puts physical strain on the chest muscles.
  • Coughing or sneezing.
  • Repeated twisting movement of the chest.
  • Poor posture.
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