Costochondritis (Chest Wall Pain): Symptoms, Causes & PT Treatment

Updated July 20261 minute read

Costochondritis is inflammation of the cartilage where the ribs meet the breastbone, causing chest-wall pain that's usually sharp, worse with deep breathing or pressing on the area, and tender to touch. It's benign and self-limiting. But because chest pain can also signal a heart problem, it's essential to be sure: pain with pressure/tightness, breathlessness, sweating, or radiation to the arm/jaw is a medical emergency, not costochondritis.

What is costochondritis?

It's inflammation of the rib-to-breastbone cartilage, producing front chest-wall pain. It is a common cause of chest-wall pain, but it is a diagnosis of exclusion — meaning it is only correct once a clinician has ruled out serious causes.

Symptoms

Common features are sharp or aching front chest-wall pain, tenderness when you press on the area (a key clue), and pain worse with deep breathing, coughing, or certain movements. It can radiate to the upper back.

What causes it / risk factors

A recent illness with coughing, physical strain, repetitive upper-body activity, or minor injury can trigger it; often there's no clear cause.

How it's diagnosed

Diagnosis is clinical — reproducible tenderness over the cartilage — after ruling out cardiac and other serious causes, especially in those with risk factors.

Physical therapy treatment

What a PT does. Once serious causes are excluded, your therapist eases the chest wall and upper back with gentle mobility, breathing, and posture work. Exercises & progression (overview). Gentle thoracic mobility, breathing techniques, and graded return to activity; avoid aggressive stretching that flares it. Recovery timeline. Often settles over a few weeks, though it can linger.

Treatment options compared

Reassurance, activity modification, and gentle PT are first-line. Anti-inflammatory measures help some. The priority is excluding cardiac and other causes first.

Red flags

Call emergency services for chest pain with pressure/tightness, breathlessness, sweating, nausea, or radiation to the arm/jaw, or any concern about your heart — do not assume chest pain is costochondritis.

Frequently asked questions

Sources (2)
  1. MedlinePlus: Costochondritis. — NIH/MedlinePlus
  2. Proulx AM, Zryd TW. Costochondritis: diagnosis and treatment. Am Fam Physician. 2009. — PubMed

This article is for education only and isn't medical advice. Always talk to a licensed clinician about your specific situation.

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