Costochondritis: inflammation of the ribs (treatment)

intercostal neuralgia

Have you ever suffered from pain in the chest area, especially when lifting weights or performing movements that strain the intercostal muscles? You may have costochondritis.

What does this condition refer to? What are its causes ? How does it manifest? How to make the diagnosis? Can we treat it? Discover in this article all you need to know about this pathology.

Definition and anatomy of the ribs

In order to understand the costochondritis, it is important to know the anatomy of the ribs.

La rib cage of the human being is made up of 12 pairs of ribs. These are divided into 3 main types:

  • The "real" ribs: the first 7 ribs, each of which is connected directly to the sternum (flat bone elongated in the middle of the thorax) by cartilage.
  • The “false” ribs: they are not attached directly to the sternum, but rather to the costal arch of the seventh rib located just above them. The 3 ribs are attached to the costal arch by a common cartilage.
  • The “floating” ribs: these are the last two ribs. They are not connected to the rib cage.

La costochondritis means inflammation of the costosternal cartilage, the structure that attaches the ribs to the sternum.

The causes of costochondritis

Even though exact causes of costochondritis are poorly understood, there are a few risk factors that can favor it, such as:

  • carrying heavy loads;
  • intense physical exercises involving the upper limbs;
  • repetitive movements;
  • severe coughs;
  • history of chest injuries;
  • surgery on the thorax;
  • a fall affecting the chest;
  • trauma to the chest;
  • the different forms of arthritis (rheumatoid arthritis, psoriatic arthritis, etc.);
  • certain bacteria, viruses and fungi (candida, salmonella, syphilis, etc.).

In short, the sources of costochondritis can vary from person to person. It can also be of psychological origin (stress, anxiety, etc.).

This disease mainly affects adults over the age of 40. 70% of patients who suffer from costochondritis are women.

Symptoms of inflamed ribs

La chest pain is the hallmark symptom of costochondritis. It is a shooting, burning pain in the chest.

The pain is often felt when coughing or sneezing. It may increase as you move hard or take deep breaths.

The painful symptom associated with costochondritis often manifests on the left side of the chest. But, it can occur sometimes on both sides.

What differs from Tietze syndrome it is that the costochondritis rarely causes redness and swelling in the chest area.

Some patients feel pain extending to the abdomen, back and all over the torso. In more critical cases, the person may have difficulty breathing. For this reason, the symptoms of costochondritis are often mistaken for that of a heart attack.

Only the examinations and the evaluation of a health professional will be able to confirm it to you. It is therefore advisable to consult a doctor as soon as you perceive atypical pain in your chest.

The diagnosis of costochondritis

Before confirming the diagnosis of costochondritis, the doctor first tries to rule out other potential causes of chest pain. Some conditions are very similar to costochondritis, including arthritis of the shoulder or nearby joints, slipping rib syndrome, chest cancer, or shoulder injuries.

To know about various causes of chest pain, see the following article.

To better guide the diagnosis, specific tests can be performed. It will also rule out differential diagnoses of costochondritis.

  • An electrocardiogram (ECG): this records the rhythm and activity of your heart.
  • A blood test: it helps to detect signs of underlying inflammation.
  • A chest x-ray.

If no other disease is suspected, the diagnosis of costochondritis can be made.

In the meantime, the doctor continues the consultation with questions regarding the origin and characteristics of your pain as well as the personal and family medical history.

The doctor will then give you a physical exam to check for tenderness in your chest cartilage. During this exam, the specialist also assesses pain by touching the upper part of your chest, around the costochondral joint. If you have a heart condition, your chest cartilage should not be tender to the touch.

Other clinical examinations are also performed, such as a neurological examination and auscultation of the heart and lungs. You will also need to examine the skin. The goal is to look for any signs of affection.

Signs of costochondritis are not usually observable on X-ray or other imaging techniques.

The treatment of costochondritis

In general, the treatment of costochondritis corresponds to conservative treatment. There are several ways to treat this condition: medicinal or natural.

Medical treatment

A number of medications may be recommended when you have costochondritis. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen and aspirin are the most indicated. An injection of corticosteroids into the painful area is also an alternative in some cases. It is an anti-inflammatory for a wide range of conditions.

If the source of your illness is psychological, the doctor may prescribe antidepressant medications such as amitriptyline, or refer you to a mental health professional.

nerve stimulation

If the pain persists for several days, electrical stimulation (TENS) may be useful, again with the aim of relieving the pain.

In this procedure, a device will be placed on the skin near the painful area, through adhesive plates. This device sends a weak electrical current to prevent pain signals from reaching the brain.

Surgical intervention is indicated only in the event of deterioration of the cartilage linked to an infection.

Lifestyle change

Certain exercises that use the intercostal muscles promote costochondritis. To effectively treat this disease, it is therefore necessary to change your lifestyle with regard to sports habits. If you are used to practicing intense sports several times a week, you will have to adapt your training (type, frequency, intensity, etc.).

Un physiotherapist (physiotherapist) can help you return to sport safely and properly. Relative rest may be recommended initially (especially if the pain is incapacitating).

The application of ice and/or heat will also control symptoms and speed healing.


To know the difference between heat and ice (and which modality to choose), see the following article.

Therapeutic and adapted exercises will also be prescribed by a physiotherapist. This may include muscle stretching, progressive strengthening, mobility exercises and/or breathing.

Tools and accessories

In addition to the treatments mentioned above, there are several products and accessories available on the market to relieve lower back pain related to costochondritis. It should be remembered that these tools generally provide temporary relief, and should be used sparingly. Among the products recommended by our professionals, we have:


This therapy mainly uses plants with analgesic and anti-inflammatory properties. to treat costochondritis. For example, we can cite arnica. Due to its ability to relieve pain and reduce inflammation, it is one of the herbs used for the treatment of costochondritis.

Indeed, arnica is rich in flavonoids, which are a powerful anti-inflammatory very effective in the treatment of various musculoskeletal problems. It is also beneficial for relieving pain in joints, ligaments and other soft tissues. Arnica essential oil is frequently used in herbal medicine.

In addition, here is a non-exhaustive list of plants and essential oils effective in controlling pain and inflammation. The products are available on the site Country. Use promo code LOMBAFIT15 if you wish to obtain one of the following products, or any remedy aimed at relieving your symptoms and improving your quality of life:

  • Turmeric. Thanks to its antioxidant and anti-inflammatory powers very powerful, turmeric is one of the most used plants in a culinary and therapeutic context. The composition of turmeric is essentially made of essential oils, vitamins (B1, B2, B6, C, E, K) and trace elements. But it is to its composition rich in curcumin and curcuminoids that we owe them and calm skin of this spice.
  • Ginger. In addition to the special flavor it brings to the kitchen and its aphrodisiac properties, ginger is a root well known for its anti-inflammatory powers. the gingerol gives it its anti-inflammatory action. It is an active component acting on the inflammatory pain related to chronic joint inflammatory diseases, including rheumatoid arthritis, lupus, rheumatic diseases, etc. It has been proven that this active element is also effective in acting on the inflammation linked to arthritis and sciatica. Ginger also has other benefits thanks to its high potassium content and its richness in trace elements (calcium, magnesium, phosphorus, sodium) and vitamins (provitamin and vitamin B9).
  • Omega-3s. Omega-3s are polyunsaturated fatty acids that play a very important role in the functioning of our body. They are provided by food in three natural forms: docosahexaenoic acid (DHA), alpha linolenic acid (ALA) and eicosapentaenoic acid (EPA). Beyond their action on the brain and the cardiovascular system, omega-3s prove very effective against inflammation. Indeed, they have the ability to act on the inflammatory mechanisms in osteoarthritis by slowing down cartilage destruction, thus they reduce the intensity of osteoarthritis pain. Sciatica, being most often linked to an inflammation secondary to a herniated disc, it can also respond to omega-3 provided it is consumed regularly. 
  • Lemon eucalyptusEucalyptus is a plant most often used in the form of herbal tea or essential oil. She would have anti-inflammatory effects which give it the ability to act on the bone and joint pain in general and the pain of sciatica in particular.
  • wintergreen. Wintergreen is a shrub from which a very interesting essential oil is extracted. It is one of the most used essential oils in aromatherapy. This oil extracted from the shrub bearing the same name, is used in massage to relieve sciatica and act like a analgesic. Indeed, it provides a heating effect thanks to its ability toactivate blood circulation locally.

Finally, remember that costochondritis is a mild disease that can easily be treated if discovered in time. However, it is advisable to consult a health professional in order to eliminate differential diagnoses which are potentially serious (heart attack, pulmonary problem, etc.).

Are you looking for solutions to relieve your pain?

Discover the opinion of our team of health professionals on various products available on the market (posture, sleep, physical pain), as well as our recommendations.


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