Costochondritis: symptoms, causes, treatment and how long it lasts

The NHS says costochondritis may cause sharp pain in the front or side of your chest. The pain may be worse in the situations below.

Because chest pain has many possible causes, including some that are serious, the NHS says it is important to get chest pain checked and not to assume it is costochondritis.

• When you move your upper body.

• When you lie down.

• When you breathe deeply.

• When you press on the middle of your chest, or your ribs.

The NHS describes costochondritis as inflammation where your ribs join the bone in the middle of your chest, the breastbone (sternum). It can cause sharp chest pain, especially when moving or breathing.

NICE CKS lists costochondritis among the musculoskeletal causes of chest pain, alongside conditions such as rib fracture and spinal disorders. It is therefore a cause of pain in the chest wall rather than a problem with the heart or lungs, but a clinician needs to assess you to say so.

The NHS says costochondritis usually gets better on its own, over time. Treatment is aimed at easing the pain while this happens.

The NHS says costochondritis can last for a few weeks to several months. It usually gets better on its own over time.

If the pain is very bad or does not get better over time, the NHS says you may be offered a steroid injection or local anaesthetic. Speak to a GP if pain is not settling or is getting worse.

The NHS says it is not always known what causes costochondritis, but it has been linked to the following.

• An injury to your chest.

• Repetitive upper body movements, like lifting.

• Coughing a lot.

• Infection.

Chest pain has many causes and, as the NHS says, in most cases is not caused by a heart problem. It also says not to self-diagnose, but to see a GP if you are worried, and that you should always get medical advice for unexplained chest pain that does not go away.

The table gives the NHS descriptions of other common causes of chest pain, which is why a clinician needs to consider them before costochondritis is diagnosed.

The NHS costochondritis advice says to get help from NHS 111 if you think you have costochondritis, because it is important to get chest pain checked to rule out other, more serious conditions.

It says to call 999 if you have any of the following, and not to drive yourself to A&E.

• Chest pain that started suddenly, or spreads to your arm, neck or jaw, or your chest feels tight. This could be a heart attack.

• Chest pain with difficulty breathing, your heart beating fast, or coughing up blood. This could be a pulmonary embolism.

• Sudden chest or back pain that can feel like something being torn inside, and causes shortness of breath and problems with walking, vision and speaking.

The NHS page on costochondritis does not describe specific tests. In general terms, NICE CKS says that to find the cause of chest pain a clinician takes a medical history and performs an examination, with further investigations arranged based on the suspected cause. It says emergency admission is needed for clinical features suggesting a serious cause, and that routine referral is appropriate for chest pain of unknown cause that persists despite management in primary care.

Depending on your symptoms and the suspected cause, further tests such as an ECG may be arranged to look for other causes. Do not delay seeking help for new or worrying chest pain.

On the NHS, chest pain is assessed urgently through NHS 111, a GP or, where it could be serious, 999 and A&E. Costochondritis is usually managed in primary care with advice and painkillers, with injections considered if the pain is very bad.

Some people choose a private consultation for quicker access to an examination, ECG or imaging. A private clinic is not appropriate for sudden or severe chest pain, which needs the emergency route. In every case, tell your GP about the result so your records stay complete.