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Costochondritis: It’s a pain in the … ribs

Chest pains can be terrifying, and while you should always treat them like an emergency, they don’t always mean the worst. More than 30% of chest pain-related visits to the emergency room are due to a condition called costochondritis—a simple inflammation of the cartilage, which connects your ribs to your sternum aka chest bone.

Costochondritis symptoms

The most common areas of pain are usually on the left side of the body at the fourth, fifth, and sixth ribs. The rib pain increases in intensity when you move, especially turning your torso side to side or taking deep breaths. Pain typically lessens when you stop movement or breathe quietly.

  • Pain is often sharp like an ice pick, but can also be dull and gnawing
  • Exercise (deep breaths and joint movement), coughing, or yawning may increase pain
  • Pain can radiate to the back, upper abdomen, shoulder, arm, neck, and jaw
  • Symptoms can sometimes originate in the back where the rib inserts into the vertebra, which will also feel like a sharp stabbing pain in the back

Heart attack pain vs. Costochondritis

While the pain of costochondritis is often mistaken for angina or a heart attack, there are some significant differences to note:

  • Heart attack pain is often more widespread, where costochondritis pain is usually in a more defined area
  • Heart attack pain usually feels as if it’s coming from under your breastbone, while costochondritis pain seems to come from the breastbone itself
  • Heart attack pain may worsen with physical activity or stress, while the pain of costochondritis remains constant

Costochondritis diagnosis

Costochondritis pain can be very similar to the pains associated with heart disease, lung disease, or gastrointestinal problems. Through a full evaluation we will palpate and press along the breastbone to feel for areas of tenderness and/or swelling. Though costochondritis won’t show up on a chest x-ray or other imaging tests, they may be ordered to rule out any conditions which could be causing the pain.

Home treatments

Costochondritis is a pain in the….rib. We know, we’ve had it. It usually happens after along day of work, lots of chest breathing, overusing those muscles which pull the upper ribs up to breathe. Those ribs get stuck in an upward flexed position causes the stabbing ice pick pain which has dropped me to my knees on more than one occasion. With a chiropractic adjustment, we can help get the rib back into alignment. If you can’t make it in to the office, these simple steps can give you a greater sense of control over your condition:

  • Avoid activities which make your pain worse
  • Exercise gently. Low impact exercise, like walking or swimming, can improve your mood and keep your body healthy. Don’t overdo it, and stop if pain gets worse.
  • Apply low ice to the area several times a day, 20 minutes on, 1 hour off to decrease the inflammation
  • Magnesium can help the muscles relax tension in your body, which will help improve your symptoms.

Chiropractic for costochondritis

Our chiropractic assessment includes:

  • Very gentle joint manipulation.
  • Anterior thoracic adjustments for the soft tissue around the affected area and along the nerve path
  • Mobilization of the collarbone and the AC joint
  • Your prescribed Urban Wellness Clinic homework will include a breathing exercise, a mobility drill, and strength exercises to keep the rib in place.
  • We rule out all the serious conditions like heart related conditions and gastrointestinal problems.

In our experience, the rib pain will lessen 12-24 hours after your visit; once the muscles have calmed down and there’s a decrease in inflammation.

Stretches for costochondritis pain

Stretching can help reduce pain, increase mobility, and encourage healing. Here are some at-home stretches you can perform to stay comfortable:

  • Gently stretch your chest with your arms against a door frame. Stop the stretch before it hurts. Gentle chest-opening stretches relax the muscles around your sternum and ribcage, and allow increased blood flow.
  • Go for short walks, breathing more evenly and naturally. This will also improve blood flow to the inflamed areas.
  • Gentle cat/cow stretches on hands and knees moving with the breath.
  • Our favorite on hands and knees with a neutral spine, long neck and giving yourself a double chin, breathe into your belly and expand your belly 360 degrees. This will help you get out of your chest breathing patterns.

Diet for costochondritis

A whole-body approach to costochondritis is the key to relief and diet is a crucial component in combatting inflammation anywhere in the body. Be mindful of the following:

  • Stay away from gluten, processed foods, and refined sugars. They are known causes of inflammation.
  • Eat plenty of fresh fruits and vegetables. They’re high in antioxidants.
  • Herbs like ginseng, chamomile, fennel, kava kava, ginger, and passionflower are great natural healers and promoters of calmness.
  • Noni fruit and noni juice is helpful in reducing pain—noni is known as the “pain killer tree.”
  • Ginger is a powerful anti-inflammatory agent and pain reliever. In fact, if you only make one dietary change, eat more ginger.

While costochondritis can be painful and disruptive to your everyday activities, understanding the source of the pain is crucial to knowing how to treat it. By utilizing a combination of at home treatments, you’ll be able to lessen the duration, curb the symptoms, and, in some cases, prevent the inflammation of costochondritis altogether.

To find costochondritis relief through chiropractic care, be sure to check out Urban Wellness Clinic as your first step to whole body wellness. Give us a call with your questions 212-355-0445 or email us at

Best in health,

Dr Emily Kiberd