Treatment for Costochondritis

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dr. simi paknikar
Medically Reviewed by dr. simi paknikar, MD
Last Updated on Dec 31, 2019
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Treatment for Costochondritis

Ibuprofen is usually the drug of choice for treatment of mild to moderate pain due to Costochondritis (if no contraindications exist).

Treatment for Costochondritis - Ibuprofen

Flurbiprofen, ketoprofen and naproxen are alternatives.

Once the diagnosis is established, treatment includes:

  • Adequate pain control and reassurance of the patient about the benign nature of the ailment are the prime targets in the treatment of Costochondritis. Pain control requires reduction of inflammation. Nonsteroidal anti-inflammatory drugs (NSAIDs) are useful. Ibuprofen is usually the drug of choice for treatment of mild to moderate pain due to Costochondritis (if no contraindications exist). Flurbiprofen, ketoprofen and naproxen are alternatives for pain relief.
  • Abuse of NSAIDs should never be encouraged. Patient education about the uses and adverse effects of NSAIDs is thus important.
  • Application of local heat is helpful
  • Gentle stretching of the pectoralis muscles (muscles in the front of the chest) two to three times a day may help.
  • Refractory cases (those that do not respond to treatment) may require local infiltration of local anesthetic, steroid, or intercostal nerve block
  • Biofeedback is another modality of management. This is a technique of manipulating certain physiological functions.(5)

References:

  1. Costochondritis - (https://www.nhs.uk/conditions/costochondritis/)
  2. What Is Costochondritis? - (https://www.emedicinehealth.com/costochondritis/article_em.htm#what_is_costochondritis)
  3. Costochondritis - An Overview - (https://www.mayoclinic.org/diseases-conditions/costochondritis/symptoms-causes/syc-20371175)
  4. Costochondritis: Diagnosis and Treatment - (https://www.aafp.org/afp/2009/0915/p617.html)
  5. Prevention of Costochondritis - (https://www.healthdirect.gov.au/costochondritis)
  6. What You Need To Know About Costochondritis - (https://www.rchsd.org/health-articles/costochondritis-2/)

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I'd like to present a New Zealand manual physiotherapy view of costochondritis - because we do not find it mysterious, idiopathic or difficult to fix. One or some of the costovertebral joints [where the ribs hinge onto the spine] are jammed/frozen/hypomobile. This requires the more delicate sternocostal joints (where the ribs hinge onto the breastbone) to work excessively, just to allow breathing. So they strain, get irritated, then inflamed - and there's your costochondritis. Please note this is the ONLY explanation accounting for such a specific pain and inflammation.

Costochondritis is an intense condition of the midsection divider. Costochondritis Treatment normally includes moderate techniques, for instance, the use of ice or warmth in the impacted area as a measure to soothe the manifestations.

mak815

Anti-Inflammatory Medications Nonsteroidal anti-inflammatory medications [e.g. Motrin, Advil] help with two aspects of costochondritis.

Thank you Nithin and Simi - I think this is a succinct, useful summary for a patient or physician to follow. It is appreciated. I think it would be worthwhile adding in a few images and re-inforcing the need to rule out cardiac or aortic or pulmonary causes [ischemia / myocarditis / pericarditis / aotic dissection / Pulmonary emboli] first before making the diagnosis of costochondritis. Some rule out tests such as the ECG (already mentioned) and bloods such as troponin, D-Dimer, C reactive protein, CK would be sensible to add to the article. Best wishes and Keep up the good work. Dr Ameet Bakhai, MBBS, MD, FRCP - London, England www,heartconsultant.co.uk

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