What Is Costochondritis?

Costochondritis (kos-tuh-kon-DRY-tis) is a painful swelling of the cartilage that attaches the ribs to the breastbone (sternum). It's one of the most common causes of chest pain in kids and teens, and happens more often in girls than boys.

Costochondritis — also called chest wall pain or costosternal syndrome — can cause a sharp, stabbing pain. Usually, it's harmless and goes away on its own after 2 or 3 days.

What Causes Costochondritis?

Doctors often can't pinpoint the exact cause of costochondritis. But sometimes it's linked to:

  • an injury to the ribs or breastbone
  • physical strain due to heavy lifting or strenuous exercise
  • repeated coughing (as can happen with some infections)

What Are the Signs & Symptoms of Costochondritis?

The main symptoms of costochondritis are pain and soreness in the chest. A sharp pain is usually felt on the left side of the breastbone, but can be on both sides.

The pain can get worse when a child:

  • takes deep breaths
  • coughs
  • moves the upper body
  • presses on the affected area

Pain may ease a little when the child stops moving or takes shallower breaths.

A heart attack is rarely the cause of chest pain in young people. Still, it helps to know how costochondritis pain differs from heart attack pain:

  • Heart attack pain is usually more widespread and felt in other body parts, like the arms and neck. It also feels as if it's coming from under the breastbone.
  • Costochondritis pain usually is felt only in a small area of the chest and feels as if it's coming directly from where the breastbone meets the ribs.

How Is Costochondritis Diagnosed?

To diagnose costochondritis, the doctor will:

  • ask about the symptoms
  • feel for tenderness along the area where the breastbone meets the ribs

The breastbone and ribs are connected by rubbery cartilage at points called costosternal joints. It's in one or more of these joints that the pain is felt.

Costochondritis can't be seen on a chest X-ray, but the doctor may order one to rule out other possible causes of chest pain, such as pneumonia.

How Is Costochondritis Treated?

Costochondritis usually goes away on its own without any treatment within a few days. Sometimes, it lasts longer — from several weeks to months. If you're concerned about pain that's not going away, talk to your doctor.

In the meantime, the doctor will probably recommend giving your child over-the-counter pain medicines like ibuprofen or naproxen to help ease symptoms. Applying a warm compress or a heating pad (set on low) to the sore area also may give some relief.

Until feeling better, your child should get plenty of rest and avoid activities that make the pain worse.

Can Costochondritis Be Prevented?

It's not always clear what causes costochondritis, so you can't completely prevent it. But many cases are caused by heavy lifting, like carrying an overstuffed backpack — especially on one shoulder, which many kids do. So if your child has to carry lots of books, buy a supportive backpack that spreads weight evenly over both shoulders and make sure it's worn over both shoulders.

When Should I Call the Doctor?

If your child has chest pain that doesn't go away, call your doctor or go to a hospital emergency room. Chest pain rarely is serious in kids. But sometimes it can be the sign of an emergency that needs medical care right away.

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Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor. © 1995-2020 KidsHealth®. All rights reserved. Images provided by The Nemours Foundation, iStock, Getty Images, Veer, Shutterstock, and Clipart.com.

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