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Pain in the ribs and breast-bone can be scary!

Pain in the ribs and breast-bone can be scary!

Costochondritis is a condition that causes pain and tenderness in the cartilage that connects the ribs to the breastbone. This condition can be mistaken for cardiovascular disease due to the similarities in symptoms. In this article, we discuss the causes, symptoms, and compare the diagnosis of costochondritis with cardiovascular disease, as they can both present with the same symptoms.

Causes of Costochondritis 

The cause of costochondritis is often unknown, but it can be caused by injury, overuse, or certain medical conditions such as fibromyalgia or rheumatoid arthritis.

From an osteopathic perspective; if the back of the spine is tight and restricted, general movement of the spine and ribs is often reduced, this then prevents the general movement of the spine and ribs from acting as a "shock absorber" with the resultant mechanical forces being transferred, or projected to the front of the chest and onto the junctions of the ribs and the cartilage, creating inflammation; hence the term costo-chondritis.

Symptoms of Costochondritis

The symptoms of costochondritis include pain and tenderness in the middle or either side of the chest. The pain can be sharp or dull and can radiate to the back or arms.

Differential Diagnosis with Heart Disease

Heart or cardiovascular disease refers to any condition that affects the heart or blood vessels and can include conditions such as heart attacks, angina, and heart failure. The symptoms of cardiovascular disease can also include chest pain or discomfort, but the pain is usually described as pressure, squeezing, or fullness. The pain may also radiate to the jaw, neck, arms, or back.

Diagnosing costochondritis

To distinguish between costochondritis and cardiovascular disease, a healthcare professional will typically conduct a physical examination and ask about your medical history. We may also order tests such as an electrocardiogram (ECG) or a chest x-ray to help make a diagnosis.

Treatment for Costochondritis 

Treatment for costochondritis typically involves managing pain and inflammation. This can include taking over-the-counter pain relievers such as ibuprofen or naproxen, using a heating pad or ice pack to reduce pain, and avoiding activities that exacerbate the pain. 

Osteopathic treatment can be very effective in resolving costochondritis, by treating the whole of the thoracic (mid-back) spine and improving rib function by exercises to stretch and strengthen the muscles around the chest.

In some cases, a corticosteroid injection may help reduce inflammation. If the condition is caused by an underlying medical condition, treating that condition can also help alleviate symptoms.


Chest pain can be a symptom of both costochondritis and cardiovascular disease, so it is important to seek medical attention if you are experiencing chest pain. If the pain is severe or accompanied by shortness of breath, sweating, or a rapid heartbeat, it is considered as a medical emergency and should be treated as such. A healthcare professional should be consulted to determine the correct diagnosis and treatment plan. Costochondritis can be treated with pain management, physical therapy, and addressing underlying medical conditions if present. Osteopathic is usually effective in resolving chest pain due to costochondritis.

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