Private costochondritis clinic in London, same-day GP.

What it feels like

• Sharp, aching or pressure-like pain at the front of the chest, usually on the left, over the joints beside the breastbone.
• Reproducible by pressing on the affected joint — the single most characteristic feature.
• Worse with deep breathing, coughing, twisting, lifting or lying on that side.
• Often affects more than one rib joint, and may radiate across the chest or into the arm, which is what causes the alarm.
• Comes on gradually or after unaccustomed exertion, coughing, or a chest infection, and frequently with no identifiable trigger at all.

What causes it

• unaccustomed lifting, gym work, DIY or carrying
• a prolonged bout of coughing
• a recent viral illness or chest infection
• minor chest trauma
• poor posture, or long periods hunched over a desk
• often nothing identifiable

Treatment

• Anti-inflammatories — ibuprofen or naproxen, taken regularly for a week or two rather than occasionally, if they suit you. Topical gel works well here because the joint is superficial.
• Heat — a heat pack or warm shower, several times a day.
• Relative rest from the aggravating activity, but keep moving — complete rest stiffens the chest wall.
• Gentle stretching of the chest and shoulders, and attention to posture.
• Avoid heavy lifting and pushing for a few weeks.
• Where pain is persistent, a local injection can be considered.

How long it lasts

It resolves completely and leaves no damage. It can recur, and a recurrence in someone who has had it confirmed before is usually recognisable — but a change in the character of the pain is a reason to be reassessed rather than assumed.

The anxiety part

Chest pain generates fear, and fear generates chest tightness and hyperventilation, which produces more chest pain. Many people with costochondritis end up in a loop of checking, worrying and repeated attendances. A clear diagnosis, properly explained, breaks that loop far more effectively than another set of normal tests — which is a good argument for having it assessed once, thoroughly.