Costochondritis or costo-sternal syndrome is cartilage inflammation that attaches your ribs to the breastbone (sternum). These joining areas are known as costochondral junctions. Costochondritis results in chest pain of mild or severe intensity. In some people, the chest pain can be so intense that it mimics a heart attack. Upon examination, there can be tenderness and swelling in costochondritis.

Costochondritis is caused by trauma, injury, strain, arthritis, respiratory infections, and tumors of the costochondral junction. There is no specific laboratory test to diagnose costochondritis. It is diagnosed based on your symptoms, clinical history, and examination.

Nonsteroidal anti-inflammatory drugs are used to treat most cases of costochondritis. Local anesthetics and steroid injections are used in instances of severe costochondritis. 

Homeopathy helps in managing the symptoms of costochondritis. It helps reduce cartilage inflammation and provide you with symptomatic relief. 

Role of homeopathy in costochondritis

The aim of homeopathic treatment is to reduce the frequency, severity, and duration of the pain. These medicines reduce costochondritis pain and help improve your mobility. 

Top five homeopathic medicines for costochondritis

Arnica montana (Arn.)

Common name: Leopard’s bane

Arnica is known as a homeopathic muscular tonic. It is indicated for costochondritis pain that worsens from breathing, coughing, or movement. This remedy works well in costochondritis after trauma or injury from blunt objects.

Arnica acts by reducing inflammation and lowering stiffness. There is pain in all the cartilage junctions of the chest. The pain feels as if the area is beaten or bruised. A burning sensation in the chest is also present. 

Bryonia alba (Bry.)

Common name: Wild hops

Bryonia alba helps manage costochondritis, where a stitching pain is felt in the chest.There is a sharp and tearing chest pain that worsens from taking deep breaths after rest, touch, and pressure. The affected joints are hot to touch and swollen.

Bryonia helps with pains that increase while coughing, least motion, or turning in bed. The pain radiates from the chest to the back. Soreness in the chest, sensitivity to pressure, heat, or burning sensation in the chest are other indications of Bryonia. 

Belladonna (Bell.)

Common name: Deadly Nightshade

Belladonna is prescribed for costochondritis with painful pressure in the chest extending to the back. It is indicated for sharp, shooting, or stitching pain in the chest while coughing. The person feels a burning pain, especially on the right side of the chest. Belladonna acts by reducing inflammation.

Rhus toxicodendron (Rhus-t.)

Common name: Poison ivy

Rhus tox. Is indicated for costochondritis that arises from muscle strain due to arthritis, overstretching, overstraining a part, or over lifting. Most chest pains indicative of this remedy are left-sided. 

This medicine works well in costochondritis pain that is aggravated from deep breathing, sneezing, sitting bent, after rest, or during the first movement and gets better by hard pressure.  

Ruta graveolens (Ruta)

Common name: Rue bitterwort

Ruta graveolens is considered for chest pain that follows injury. Costochondritis pain after strains and sprains respond well to this remedy. It is indicated when chest pain is aching, biting, or burning in nature. 

Ruta relieves soreness, pain, and aching in the chest region. There is a sensation of fullness in the chest and the sternum feels painful as if from pressure.

Causes for costochondritis

Trauma

Physical trauma to the upper part of your chest can cause costochondritis. Injury to your upper chest from sports, fights, or accidents can contribute to costochondritis.

Muscle strain

Muscular strain due to strenuous exercises and physical activities, like lifting weights or severe coughing can cause costochondritis.

Tumors 

Cancerous and non-cancerous tumors of the costochondral junction can cause costochondritis.

Arthritis

Costochondritis is linked with inflammatory joint disorders like osteoarthritis, ankylosing spondylitis, or rheumatoid arthritis.

Respiratory infections

Costochondritis may occur due to viral and bacterial respiratory infections. Pneumonia, tuberculosis, and pleurodynia are some infections that can cause costochondritis.

Psychogenic illness 

Some psychogenic conditions like anxiety, panic, depression, conductive disorder, and dissociative disorder can lead to costochondritis.

Symptoms of costochondritis

Chest pain

The most common symptom of costochondritis is mild to severe chest pain on either side of your breastbone. The pain can be dull, sharp, stabbing, burning, aching, or constant. In some cases, the pain can shoot down your limbs.

Pressure sensation 

Costochondritis pain can manifest as a pressure sensation in your chest radiating to your back or abdomen. 

Pain gets worse on activity

Costochondritis pain appears like upper chest pain that appears when you move. This chest pain worsens when you take a deep breath, sneeze, cough, stretch, or do any other strenuous activity.

Tenderness 

Tenderness on touch is felt when more than one rib is affected with costochondritis.

Rest amelioration

The costochondritis pain often decreases with rest, slow movement, or slow breathing.

Breathlessness 

Costochondritis pain sometimes is associated with difficulty in breathing or shortness of breath.

Treatment for costochondritis 

Providing rest to your chest and ribcage is the most common way to treat costochondritis. This gives your inflamed costochondral joints time to heal. However, other treatment options include:

Over-the-counter (OTC) medications

OTC medications like nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed to relieve your pain. 

Narcotics

If you have severe costochondritis pain, doctors may prescribe a narcotic medication.

Corticosteroid 

Although rare, your doctor might prescribe corticosteroids to reduce the inflammation if your symptoms aren’t improving after a few weeks.

Antidepressants

Tricyclic antidepressants are prescribed to control chronic pain. It is mostly helpful when costochondritis pain interferes with your sleep.

Anti-seizure drug

In rare cases, epilepsy medication is prescribed to control chronic pain.

Therapies for costochondritis

Stretching exercises

Gentle stretching exercises for your chest muscles can help in relieving costochondritis pain.

Nerve stimulation

Transcutaneous electrical nerve stimulation (TENS) is useful in treating costochondritis. It sends a weak electrical current through adhesive patches applied on your chest near the area of pain. TENS current interrupts or masks pain signals from reaching your brain. This helps in temporary pain relief.

Injection 

Costochondritis is managed by injecting numbing medication and a corticosteroid directly into your painful joint.

Surgery

Surgery is advised in rare cases, when conservative measures don’t work.

Diet and lifestyle changes for costochondritis

Rest

Avoid putting excess strain on your ribs. Ensure to rest after intense physical activity to give your body sufficient time to recover.

Focus on diet

Include foods that are anti-inflammatory in your diet. Food abundant in omega-3 fatty acids like fatty fish, flaxseeds, and antioxidants like fruits, vegetables, help reduce inflammation in costochondritis.

Avoid triggering foods

Identify and stop eating foods that worsen inflammation, like refined sugars, processed foods, and saturated fats.

Maintain hydration

Dehydration can increase muscle soreness and make them prone to cramps. Drink sufficient water to maintain joint and muscle health. 

Incorporate gentle exercises

Include gentle exercises like stretching, walking, swimming, or yoga to strengthen, increase flexibility, and reduce muscle strain.

Correct your posture 

Maintain good posture to alleviate pressure on the chest area, and consider ergonomic adjustments at work or home.

Practice breathing exercises

Deep breathing exercises promote your lung expansion and reduce stress.

Maintain healthy weight

Healthy weight management reduces strain on your chest muscles and rib cage.

Avoid overexertion

Avoid over-exerting yourself to prevent costochondritis pain from worsening.

Sleep hygiene

Ensure you sleep on a good quality comfortable mattress in a proper sleeping position. This helps muscles heal faster.

Conclusion

Costochondritis is an inflammatory condition in which pain and stiffness occur in your chest, making movements difficult and painful. It can happen without an apparent cause or sometimes, trauma, infection, or illness can cause it. Over-the-counter medications and injections can help you relieve pain. 

Along with conventional therapies, you can try homeopathy for costochondritis. Homeopathic remedies can provide considerable relief for the pain and discomfort associated with costochondritis.

References

  • Maurya VK, Kumar S, Kabir R, Shrivastava G, Shanker K, Nayak D, et al. Dark classics in chemical neuroscience: An evidence-based systematic review of belladonna. ACS Chem Neurosci [Internet]. 2020 [cited 2024 Jan 24];11(23):3937–54. Available from: https://pubmed.ncbi.nlm.nih.gov/32662978/
  • Huh YH, Kim MJ, Yeo MG. Homeopathic Rhus toxicodendron treatment increased the expression of cyclooxygenase-2 in primary cultured mouse chondrocytes. Homeopathy [Internet]. 2013 [cited 2024 Jan 24];102(4):248–53. Available from: https://pubmed.ncbi.nlm.nih.gov/24050770/
  • Tobyn G, Denham A, Whitelegg M. Artemisia absinthium, wormwood. In: Medical Herbs. Elsevier; 2011. p. 105–21.Available from;https://linkinghub.elsevier.com/retrieve/pii/B9780443103445000161
  • Schumann JA, Sood T, Parente JJ. Costochondritis. StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532931/ 
  • Barranco-Trabi J, Mank V, Roberts J, Newman DP. Atypical costochondritis: Complete resolution of symptoms after rib manipulation and soft tissue mobilization. Cureus [Internet]. 2021 [cited 2024 Jan 24];13(4). Available from: http://dx.doi.org/10.7759/cureus.14369
  • Davies-Barrett AM, Antoine D, Roberts CA. Inflammatory periosteal reaction on ribs associated with lower respiratory tract disease: A method for recording prevalence from sites with differing preservation. Am J Phys Anthropol [Internet]. 2019 [cited 2024 Jan 24];168(3):530–42. Available from: http://dx.doi.org/10.1002/ajpa.23769
  • Islam N, Tripathy SK, Biswal J. Uncommon causes of chest pain in children: An experience from a tertiary care hospital. Cureus [Internet]. 2023 [cited 2024 Jan 24];15(4). Available from: http://dx.doi.org/10.7759/cureus.37203
  • Schug SA. The role of tramadol in current treatment strategies for musculoskeletal pain. Therapeutics and Clinical Risk Management. 2007;3(5):717.Available from: https://pubmed.ncbi.nlm.nih.gov/18472996/
  • Vyvey M. Steroids as pain relief adjuvants. Canadian Family Physician. 2010;56(12):1295.Available from: https://pubmed.ncbi.nlm.nih.gov/21156893/
  • Thour A, Marwaha R. Amitriptyline. StatPearls Publishing; 2023.Available from:https://www.ncbi.nlm.nih.gov/books/NBK537225/ 
  • Rovetta G, Sessarego P, Monteforte P. Stretching exercises for costochondritis pain. G Ital Med Lav Ergon [Internet]. 2009 [cited 2024 Jan 24];31(2). Available from: https://pubmed.ncbi.nlm.nih.gov/19827277/
  • Wierenga KA, Pestka JJ. Omega-3 fatty acids and inflammation—you are what you eat! Front Young Minds [Internet]. 2021 [cited 2024 Jan 24];9. Available from: http://dx.doi.org/10.3389/frym.2021.601068
  • Tristan Asensi M, Napoletano A, Sofi F, Dinu M. Low-grade inflammation and ultra-processed foods consumption: A review. Nutrients [Internet]. 2023 [cited 2024 Jan 24];15(6):1546. Available from: http://dx.doi.org/10.3390/nu15061546
  • Lau WY, Kato H, Nosaka K. Water intake after dehydration makes muscles more susceptible to cramp but electrolytes reverse that effect. BMJ Open Sport Exerc Med [Internet]. 2019 [cited 2024 Jan 24];5(1):e000478. Available from: http://dx.doi.org/10.1136/bmjsem-2018-000478
  • Yoo W-G. Effects of combined chest expansion and breathing exercises in a patient with sternal pain. J Phys Ther Sci [Internet]. 2017 [cited 2024 Jan 24];29(9):1706–7. Available from: http://dx.doi.org/10.1589/jpts.29.1706