Condition guide
Costochondritis Treatment: Chest Wall Pain Explained
Important first: any new, crushing or spreading chest pain, chest pain with breathlessness, sweating, nausea or pain into the arm, jaw or back needs 999 straight away. Do not assume it is costochondritis. Once a doctor has ruled out heart and lung causes, costochondritis treatment focuses on calming irritated cartilage where the ribs meet the breastbone and getting you moving and breathing comfortably again. This page is general information rather than a diagnosis, and an assessment is the sensible next step if your symptoms are not settling.
What is Costochondritis?
Costochondritis is inflammation or irritation of the cartilage that joins the upper ribs to the breastbone, known as the costochondral joints. It causes sharp, aching or pressure-like pain at the front of the chest, usually on one side, and the area is often tender to press. It can follow a chest infection with heavy coughing, a strain from lifting or a new exercise, or appear with no obvious trigger. It is not dangerous in itself, but because chest pain has serious causes, the diagnosis should come from a doctor first. A similar condition called Tietze syndrome also involves visible swelling over the joint.
Typical Symptoms
- Sharp or aching pain at the front of the chest beside the breastbone
- Tenderness when pressing on the sore ribs
- Pain that worsens with deep breaths, coughing, sneezing or twisting
- Discomfort when lying on the front or the affected side
- Pain with reaching, lifting or pushing, such as opening heavy doors
Common Causes & Triggers
- Repeated or heavy coughing during or after a chest infection
- A strain from lifting, carrying or an unfamiliar upper body exercise
- A knock to the chest wall
- Sustained stooped postures that stiffen the upper back and ribs
- Sometimes no clear cause can be found
How We Treat Costochondritis at Bluebell
- 1
A careful history, checking that a GP or hospital has already ruled out heart, lung and other medical causes before treatment starts.
- 2
Examination of the ribs, upper back, neck and shoulders, because stiffness in the thoracic spine can add to chest wall pain.
- 3
Advice on reducing aggravating activity for a while, including pacing lifting, pushing and pressing exercises in the gym.
- 4
Gentle breathing exercises and upper back mobility work so the rib cage moves more easily.
- 5
Hands-on treatment to the upper back and surrounding muscles where it helps, followed by a gradual return to normal upper body loading.
Honest Recovery Timeline
Costochondritis often settles over several weeks, although some people have pain on and off for longer. Flare-ups with coughing or a return to heavy lifting are common and do not mean something has gone wrong. Your physiotherapist will explain what to expect in your case and when it would be sensible to go back to your GP.
Why the upper back matters
The ribs join the spine at the back as well as the breastbone at the front, so stiffness between the shoulder blades can change how the rib cage moves when you breathe and reach. Many people with chest wall pain also notice an ache in the upper back. Our page on pain between the shoulder blades explains that area in more detail, and gentle mobility work for the upper back is often part of a costochondritis plan.
Booking an assessment for chest wall pain
Our pain treatment service explains the hands-on treatment, exercise and advice used for persistent pain, including chest wall pain once medical causes have been excluded. Please bring any letters from your GP or hospital. Appointments are at Warren Road, Blue Bell Hill, Chatham ME5 9RD, with free parking, Monday to Saturday 8am to 8pm. You can self-refer online or call 01634 757123.
When Costochondritis Needs Urgent Medical Attention (Not Physio)
- •Chest pain that is crushing, heavy or spreads to the arm, jaw, neck or back, call 999.
- •Chest pain with breathlessness, sweating, nausea or feeling faint, call 999.
- •Sudden sharp chest pain with breathlessness, especially after surgery, a long journey or with a swollen calf, call 999, as it may be a clot.
- •Chest pain with a high temperature or coughing up blood, contact NHS 111 or your GP the same day.
- •Red, hot, swollen skin over the ribs, see your GP promptly.
Costochondritis — Common Questions
How do I know chest pain is costochondritis and not my heart?
You cannot be sure on your own. New chest pain should be checked by a doctor, and crushing pain or pain with breathlessness needs 999. Physiotherapy starts once heart and lung causes have been ruled out.
What does costochondritis treatment involve?
Usually advice on easing aggravating activities, breathing and upper back mobility exercises, hands-on treatment where it helps and a gradual return to lifting and exercise.
How long does costochondritis last?
It often settles over several weeks, but it can come and go for longer. Your physiotherapist will explain what to expect rather than giving a fixed date.
Can I keep going to the gym with costochondritis?
Often you can keep some exercise going, but pressing, pushing and heavy pulling may need reducing for a while. Your physiotherapist will help you adjust your programme.
What affects the cost of treatment?
The main factor is how many appointments you need, which depends on how irritable the pain is. Ask the clinic for current fees when you book, and check cover with your insurer if you have a policy.