What is the treatment for costochondritis?

Costochondritis usually gets better with time. Clinicians, when diagnosing costochondritis, should be able to rule out serious causes of chest pain. For many people, knowing that their chest pain is not due to a serious illness is enough.

Treatments that can help with the symptoms of costochondritis include:

• Pain relief tablets, such as paracetamol or ibuprofen.

• Pain relief gels, such as ibuprofen or capsaicin.

• Resting and avoiding physical activity that flares up the symptoms.

• Applying a warm compress or a heating pad to the painful area.

• Physiotherapy exercises, such as targeted stretching programmes.

• Steroid injections into the affected joints - rarely, when other things haven't worked.

Another condition, called Tietze syndrome, can cause similar symptoms to costochondritis. It causes pain and swelling of the cartilage joining the ribs to the breastbone (sternum). It's much rarer than costochondritis. The treatment of Tietze syndrome is similar to costochondritis.

A rare form of costochondritis, called infective costochondritis, can develop as a complication of major chest surgery - for example, open heart or lung surgery. This is treated with antibiotics and surgery. This article covers the treatment for non-infective costochondritis only.

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 treatments of costochondritis as, at Patient, we know our readers sometimes want to have a deep dive into certain topics.

Costochondritis treatment

Costochondritis usually gets better with time.

For some people, getting a diagnosis of costochondritis, and knowing that their chest pain isn't due to a serious condition, such as heart disease, is enough for reassurance. They might not need any treatment if the symptoms are mild.

Because costochondritis typically gets better with time, and doesn't cause serious health problems, there actually isn't much good research into its treatment. The following treatment recommendations are mostly based on healthcare professionals' clinical experience of what they think works.

Treatments to help with the pain of costochondritis include:

Over the counter medicines

Over the counter pain relievers are good options for controlling the symptoms of costochondritis. These include:

• Paracetamol tablets or capsules.

• NSAIDs (Nonsteroidal anti-inflammatory drugs) such as ibuprofen - for example Nurofen or Advil. These can be taken by mouth or used as gels to rub directly onto the skin over the affected areas.

  • These might not be suitable for everyone. Speak to your doctor before using if you have a medical history of stomach ulcers, bleeding from the stomach, asthma, or are taking any blood-thinning medications.

• Co-codamol.

Prescription medications

Prescription medications usually aren't needed for costochondritis, but options when other treatments haven't worked include:

• Capsaicin gel or cream.

• Prescription NSAIDs - such as naproxen.

• Higher strength codeine for short term only.

• Lidocaine patches.

Lifestyle changes

Some things that may help with the symptoms of costochondritis include:

• Avoid heavy lifting.

• Avoid repetitive twisting or reaching movements.

• Strenuous exercise is probably best avoided until you have recovered. It isn't dangerous, but might irritate the cartilage, making symptoms worse.

• Try to maintain good posture when sitting or standing.

Other treatments

Other treatments for costochondritis include:

• Using heat packs or warm compresses over painful areas of the chest wall.

• Targeted stretching exercises, usually under direction of a physiotherapist.

• Transcutaneous electrical nerve stimulation (TENS).

• Rarely, for people with long-lasting costochondritis that hasn't got better with other treatments, steroid injections can be given to affected areas.

Patient picks for Chest pain

Chest and lungs

What are the symptoms of costochondritis?

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

by Dr Doug McKechnie, MRCGP

Chest and lungs

Pneumothorax

A pneumothorax (collapsed lung) describes the condition in which air has become trapped next to a lung. Many cases occur 'out of the blue', particularly in healthy young men. Some develop as a complication from a chest injury or a lung disease. The common symptom is a sudden sharp chest pain followed by pains when you breathe in. You may become breathless. In most cases, the pneumothorax clears without needing treatment. The trapped air of a large pneumothorax may need to be removed if it causes breathing difficulty. An operation is needed in some cases.

by Dr Doug McKechnie, MRCGP

Can costochondritis go away without treatment?

Costochondritis usually goes away on its own, even without treatment. It can last days, weeks, or even months.

If you have costochondritis and the symptoms aren't bothering you, you don't need to use any treatments unless you want to.

Complications of costochondritis

Costochondritis doesn't cause serious health complications.

However, costochondritis can come back. Rarely, costochondritis symptoms can stay for a long time - months to years - which can be distressing.