Health Insights · General health & symptoms
Costochondritis: chest pain from the rib joints, not the heart
Costochondritis is inflammation where the ribs join the breastbone. It causes sharp chest pain that is reproduced by pressing on the spot, and it is entirely benign. It is also a diagnosis made only after cardiac causes have been properly considered — because the two can feel similar and one of them matters a great deal more.
Call 999 if chest pain is
- central, heavy, tight or crushing and lasting more than 15 minutes
- spreading to the jaw, neck, back or either arm
- accompanied by sweating, nausea or breathlessness
- accompanied by a sense of impending doom
- sudden and tearing, felt through to the back
- sharp and worse on breathing in with breathlessness or coughing blood
Tenderness on pressing the chest wall makes a cardiac cause less likely but does not exclude one, and the two can coexist. If you have risk factors for heart disease and new chest pain, get assessed rather than reasoning your way to costochondritis. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
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
Tietze syndrome
A closely related condition in which one rib joint — usually the second or third — is not only painful but visibly swollen. Costochondritis has tenderness without swelling; Tietze has both. Tietze is less common, tends to affect younger adults, and the swelling can take months to settle even after the pain has gone. The treatment is the same.
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.
Why come to us. The value here is a proper assessment that settles the question. We can see you the same day, 7 days a week, examine you, perform an ECG and blood tests in-house with results in the same visit, and arrange echocardiography on site or a chest X-ray through our CQC-registered imaging partners if anything warrants it. If it is costochondritis you leave knowing that, with a written explanation and a treatment plan — rather than a normal test result and lingering doubt.
Private costochondritis assessment in East London
Costochondritis is inflammation of the cartilage that joins the ribs to the breastbone, causing sharp or aching chest pain that is often tender to press and worse with movement or breathing. It is harmless, but chest pain always deserves care to make sure it is not coming from the heart. A private GP in East London can examine you, perform an ECG if needed, and reassure you, with physiotherapy and simple pain relief helping recovery. Our musculoskeletal service can help if pain persists. Pain with breathlessness or sweating needs urgent assessment — see our chest pain guidance. Tower Bridge Hospital is on Whitechapel Road in East London, a short journey from Canary Wharf and the City, with same-day appointments and no referral required.
Costochondritis in London: common questions
How do I know it is costochondritis and not my heart?
Costochondritis is typically tender to press and worse with movement or breathing; an examination and, if needed, an ECG help confirm it is not cardiac.
How is it treated?
With reassurance, anti-inflammatory pain relief, gentle activity and sometimes physiotherapy; it usually settles over weeks.
What brings it on?
Often it follows a viral illness, unaccustomed exercise, coughing or minor strain, though sometimes no cause is found.
When should chest pain be urgent?
Chest pain with breathlessness, sweating, or pain spreading to the arm or jaw needs 999; we assess stable, non-urgent chest pain the same day.
Same-day assessment with ECG and bloods
Results in the same visit. 7 days a week. Severe chest pain: call 999.