What Is This Chest Pain? Learn More About Costochondritis and Tietze Syndrome

Chest pain with psoriatic arthritis might be a sign of another condition.

What is costochondritis?

Costochondritis is chest pain caused by inflammation of the cartilage around the sternum. The sternum is the area in the body where the ribs connect to the breastbone. Cartilage is the tissue that connects the joints between bones. It typically acts as a shock absorber by cushioning the joints. But when the sternum cartilage becomes inflamed, it can lead to symptoms such as:1,2

  • Chest wall pain
  • Pressure
  • Sharp pain
  • Aching pain

In costochondritis, the inflammation can occur in several areas on both sides of the sternum but is usually only on one side.1,2

Certain things can increase the pain, such as movement, exertion, or deep breathing. Pain can also increase with a certain posture, like lying down, pressure on your chest, or coughing and sneezing.1,2

What is Tietze syndrome?

Costochondritis is often confused with another similar condition known as Tietze syndrome. Both conditions can cause pain and inflammation around the sternum. But Tietze syndrome also includes swelling, which is a key feature. Swelling does not occur with costochondritis.1,2

People with Tietze syndrome may also have redness, tenderness, and warmth around the sternum. The pain can be sharp and is sometimes confused with a heart attack. However, a heart attack usually causes more widespread pain and additional symptoms, like breathlessness, nausea, and sweating.1,2

Tietze syndrome is less common than costochondritis. It tends to affect young adults under age 40, while costochondritis tends to affect adults ages 40 and older.1,2

What causes these two conditions?

The exact cause of these conditions is not known. But there are several factors that may play a role, such as:1,2

  • Genetics
  • Certain viruses or infections
  • Repeated physical strain
  • Injury

Costochondritis and Tietze syndrome can occur on their own. However, certain rheumatic diseases like psoriatic arthritis (PsA) can increase the risk of developing either condition.1,2

How are they diagnosed?

The path to diagnosis for both costochondritis and Tietze syndrome is similar. Doctors will examine the history and area of chest pain. People with Tietze syndrome will also have swelling.1,2

Some tests may be required to rule out other conditions. These tests could include:1,2

  • An electrocardiogram (ECG) to measure heart activity
  • A blood test to assess inflammation
  • A chest X-ray to look for injury

Blood tests may show signs of inflammation in people with Tietze syndrome. People with costochondritis alone usually have normal tests for inflammation.1,2

Understanding treatment options

The prognosis for both costochondritis and Tietze syndrome is usually good. Sometimes the conditions will improve on their own after a few weeks. Still, pain can last for months or more.1,2

Most people will respond well to treatment. Doctors may suggest rest and avoiding activity. They may also prescribe one or more of the following treatments:1,2

  • Nonsteroidal inflammatory drugs (NSAIDs), such as ibuprofen or naproxen
  • Prescription painkillers
  • Corticosteroid injections
  • Transcutaneous electrical nerve stimulation (TENS), a method of pain relief where a mild electric current is delivered to the affected area

There are no long-term problems linked to costochondritis or Tietze syndrome. However, recurrences are more likely in those who also have an underlying rheumatologic disease, such as PsA.1,2

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