| What We Treat
Costochondritis
Chest pain that is reproduced by pressing on the ribs is reassuring, but only once the important causes have been excluded.
Overview
What It Is
Costochondritis is inflammation where the ribs meet the breastbone through their cartilage. It produces sharp, localised chest pain that is worse on deep breathing, coughing and movement, and is characteristically tender when pressed. It is benign and self-limiting, but chest pain always warrants proper assessment first.
Rib Cartilage Inflammation
Sharp, localised pain where the ribs meet the breastbone, reproduced by pressing on the affected joint.
Symptoms
How It Tends to Feel
These are the features that point towards this diagnosis rather than another:
Sharp, Localised Pain
Usually over the left or right side of the breastbone, at one or two specific points.
Reproduced by Pressing
Firm pressure over the affected joint recreates the pain. This is the key feature.
Worse on Deep Breathing
And on coughing, sneezing or twisting.
Worse With Arm Use
Pushing, pulling and overhead reaching load the area.
No Systemic Features
No breathlessness, sweating, nausea or radiation into the arm or jaw.
Fluctuating Course
Settles and flares over weeks, often with no clear pattern.
Causes & Risk Factors
What Drives It
The usual contributors, in rough order of how often they turn out to matter:
Unaccustomed Loading
A new gym programme, heavy lifting or a house move.
Prolonged Coughing
A chest infection is a very common precipitant.
Direct Trauma
A fall, a seatbelt injury or contact sport.
Postural Load
Sustained flexed sitting increases loading through the anterior chest wall.
Idiopathic
In a substantial proportion there is no identifiable trigger.
How We Can Help You
Treatment & Management
Treatment is built around what the assessment finds, but generally follows this shape:
When to Seek Help
Red Flags — Don’t Ignore These
Most presentations are straightforward. These features are the exceptions, and warrant prompt assessment:
⚠ Seek Medical Advice If You Notice
- Central crushing chest pain, or pain radiating to the arm or jaw — call 999
- Breathlessness, sweating, nausea or feeling faint
- Coughing blood, or fever with chest pain
- Pain that is not reproduced by pressing on the chest wall
If any of these apply, contact your GP or seek urgent medical care rather than waiting for a physiotherapy appointment.
Common Questions
Frequently Asked Questions
Is it my heart?
Costochondritis is reproduced by pressing on the chest wall and is worse with movement and breathing. Cardiac pain is not. If there is any doubt at all, seek urgent medical assessment first.
How long does it last?
Weeks to a few months, often with flares. It is self-limiting but can be persistent enough to be genuinely wearing.
Can I keep exercising?
Yes, with modification. Reducing heavy pressing and pulling for a period usually helps, but complete rest is not necessary or useful.
Not Sure If This Is What You Have?
An assessment will tell you what is actually going on and what to do about it. I see everyone myself, and you will leave with a plan rather than a leaflet.
Book Your Initial AssessmentThis page is for general information only and isn’t a substitute for individual medical advice. If you’re experiencing any of the warning signs above, contact your GP or seek emergency medical care as appropriate.