Costochondritis (Tietze’s Syndrome)

Costochondritis - Tietze's syndrome

Costochondritis is also referred to as Tietze’s syndrome. It is a painful condition that occurs at the joints between the ribs and the sternum (breastbone). Here we explain the symptoms, causes and treatment for Costochondritis.



  • Symptoms include chest pain, specifically at the front of the upper chest, where the ribs attach to the sternum.
  • Pain either develops, or gets worse with activity, especially, from breathing deeply.
  • Pressing in over the area in the middle of the chest, where the ribs meet the sternum will be especially tender.
  • Diagnosis is usually based on the patient’s history and a physical examination.
  • Further tests such as blood tests and x-rays may be undertaken to rule out other conditions.

What is Tietze’s syndrome?


Costochondritis or Tietze’s syndrome is inflammation of the attachment of the ribs to the sternum in the middle of the chest. It is thought to be caused by overuse which results in repetitive micro-trauma. The sternum and ribs are cushioned by cartilage inside the joint. It is the cartilage which is damaged and becomes painful and inflamed.

Tietze’s syndrome describes inflammation of usually just a single joint, although the sternoclavicular joint may also be involved.

Costochondritis anatomy ribs sternum

What causes Costochondritis?

This condition is most common in younger people and is in overuse injury. It has also been linked to rowers and can occur following car accidents. Costochondritis may also result from viral and bacterial infections. The 4th, 5th, and 6th ribs are the most common joints for costochondritis to occur.


  • Treatment for Costochondritis consists of rest. In particular, avoiding all aggravating movements activities. This may mean just changing your training for a while, or it might be that you need a period of complete rest to allow the inflammation to settle down.
  • Cold therapy applied directly to the chest may be beneficial. This will help reduce pain and inflammation. Cold can be applied every hour for 10 minutes, reducing frequency as your symptoms improve. Do not apply ice directly to the skin as this may cause ice burns. Wrap in a wet tea towel or use a commercially available cold pack.
  • A doctor may prescribe anti-inflammatory medication such as ibuprofen. This will help reduce pain and inflammation. However, always check with a doctor before taking medication. Also, do not use the pain killing effects to mask your injury so you can resume training or exercise.
  • Joint mobilizations may also be beneficial in recovering from Costochondritie. A professional therapist, Chiropractor, or Osteopath can help with this.

References & further reading

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