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Costochondritis  

What is Costochondritis?
Costochondritis is a condition characterized by pain and tenderness along the chest wall, normally very close to the breastbone (sternum). By definition, costochondritis is an inflammation of the juncture of the rib cartilage where the ribs attach to the sternum. While this may seem like a very simple condition, it unfortunately produces extreme pain to the point where individuals feel as if they are experiencing a heart attack or have other internal medical conditions. For this reason, it is not uncommon for individuals to go to the emergency room to rule out more serious conditions.

When other conditions have been ruled out, examination of the chest wall reveals isolated regions of extreme tenderness just off to the sides of the breastbone (sternum). This condition may be made worse with deep inspiration, by compression of the ribcage, or by hard coughing or sneezing. In other words, any event that either compresses or stretches the ribcage may stretch the rib cartilage, thereby producing extra pain.

To make matters more complicated with this condition, costochondritis may stem simply from an inflammation of the cartilage or may be secondary to a mid-back spinal problem. For example, in a growing child who has to wear a heavy backpack, a hunching of the back or a drooping of the shoulders may be seen due to repeated postural alterations. This increased bending of the mid-back may cause compression of the ribs, causing secondary costochondritis. In this instance, chiropractic care to the thoracic spine to increase flexibility of that region, as well as mobilization techniques to the ribs, is of great benefit. At other times, simply stretching the thoracic spine to allow full movement of the rib cage brings sufficient stretch to the rib cartilage to allow the soreness to go away. Sometimes, however, localized soft tissue techniques are utilized over the rib cartilage. Transverse frictional techniques have been shown to be very effective in reducing adhesions or scar tissue that develops in cartilage. Since there is very little blood supply to the cartilage structures throughout the body, it is necessary to break up those adhesions in order for the fibers of that particular tissue to heal.

Whether costochondritis comes from blunt trauma to the chest wall causing localized inflammation, a rib is injured with a twisting incident, or the thoracic spine is involved, chiropractic care normally proves very beneficial in relieving the discomfort. At other times, however, the condition may be very resistant to conservative measures and cortisone injections or anti-inflammatory medication may be needed.