How To Treat Costochondritis With Physiotherapy?

costochondritis physiotherapy

How To Treat Costochondritis With Physiotherapy?


More and more people visit our clinic with shooting pains in the chest. Causes are numerous: physical work, anxiety, or even COVID. But, even though these causes might seem diverse, costochondritis is often a symptom of all of them.


In this article, we’ll show you what costochondritis is, how to detect it, and how it can be treated with physiotherapy. As a physiotherapist with more than a decade of experience, I really believe physical therapy is one of the best treatments to help overcome it. 


If you think this could be your case, I invite you to contact us and discover what we can do for you at The Manual Therapy Clinic.


What Is Costochondritis?


It is an inflammation of the cartilage that connects the ribs to the sternum. Well, you could find this definition anywhere online. But let’s take a minute to explain it better.


I assume you know where your ribs are and the vast majority of the world’s population have twelve pairs of ribs (there are always exceptions). The seven upper pairs are called the ‘true ribs’. They are connected to the sternum. Also called the breastbone, the sternum is the vertical bone that forms your chest wall and supports your entire body. 


The true ribs and the breastbone are linked by cartilage – a firm but flexible tissue – (see the red part in the attached picture). When the cartilage becomes inflamed, that’s costochondritis. In other words, the reason why you are reading this blog. 


costal cartilages


If you need more info about this inflammation, visit the costochondritis section on the NHS website, where you will find more info on it. 


What Are Its Causes? 


As we said, costochondritis is nothing more than the inflammation of a specific area of your chest (to be precise, it’s the cartilage that’s inflamed). An inflammation is nothing but your body reacting in order to protect you from an infection or injury.


As stated before, the causes of this inflammation can be diverse. However, there are common patterns that I have found among my patients that allow me to better identify costochondritis. 


Physical Work


Costochondritis is very common among workers who repeat mechanical movements during their daily routines: shop workers, factory workers, nurses, etc.


Stress or anxiety


Although it may seem paradoxical, not doing enough physical activity at work can also cause costochondritis. Office employees with stressful routines can generate physical and mental problems, and these can lead to inflammation of the cartilage too.


Cold Or Flu


Costochondritis has a high seasonal incidence. Winter is the time of year when cases rise. Why? Well, you don’t need to be a genius to guess the answer: more colds and more flu, bring more coughs and more sneezing. As a result, we get more costochondritis.




Covid Related Costochondritis


The most feared disease of recent times is also behind the origin of some cases of costochondritis. Like in the previous chapter, costochondritis appears as a result of coughing, sneezing and shaking…all common symptoms of Covid.

This case is especially sensitive because the world still doesn’t know much about Covid and there’s a lot of fear in the population when they get this illness. Usually, patients associate the pain with lungs or airways or when the cause is related to mechanical repeated movements.


How Do I Know If I Have Costochondritis? 


The most recognisable symptom is that shooting chest pain we talked about before. Sometimes, it’s so painful when breathing that many patients think they are having a heart attack.


In fact, many patients have come to our clinic after having visited emergency rooms or their GP, who have ruled out other diseases. Even worse, costochondritis cannot be detected by x-rays so it makes it more difficult to detect. To diagnose costochondritis is key to understanding that it’s a muscular pain.


That’s when physiotherapists come into play. Physiotherapy is probably the best treatment for costochondritis. Most patients we assist in our clinic – more than you might think – come with a muscle contracture, subluxations or rib blockages which hide the real problem…costochondritis.


Physiotherapy: The Best Treatment For Costochondritis


In my personal experience, physiotherapy is one of the best treatments for costochondritis. How do we do it at The Manual Therapy Clinic? 


  • First of all, we solve the contracture in the area.
  • Next, we align the ribs. In the case of subluxation, through osteopathic manipulative therapy, and, in patients with bone weakness, with muscle-energy technique.
  • Radiofrequency is the last step. The goal here is to reduce inflammation. This can take around two weeks. In our clinic, we work with one of the world’s leading companies in radiofrequency technology, Indiba, which can only be found in two other clinics in Scotland. 


How Long Does Costochondritis Last? 


Well, that’s not an easy question to answer to be honest. Every person has their own condition, and the disease will depend on many factors. But, as a general rule for informational purposes, let’s say that, from the moment the physiotherapy treatment begins, costochondritis should last no longer than 2-4 weeks. 


What If It Isn’t Costochondritis? 


After having read this article, if you think your muscular pain is not related to costochondritis, well…we can still help you at our clinic. Physiotherapy can get a handle on many common conditions. Just take a look at our blog, and you will find other topics that might be associated with your current pain. For instance, it could be lumbago


Any Other Pain? We Can Help!


Costochondritis or not, it’s probable that we can help you at The Manual Therapy Clinic. Feel free to contact us and tell us your case through our website contact form or through social media (Facebook and Instagram).

  • Colin Smith
    Posted at 23:27h, 01 June Reply

    I still have costochondritis after five months. I have been doing physiotherapy exercise the last three weeks,the exercises are helping but l fear will not fix the rib tightness completely. I stiill get some flinching pain in the ribs. I think the problem is more than just cartilage. Tight hinges in the back and ribs seem to play tug of war with one another. Then there is possiblynthe scar tissue to,free up in some of the ribs. Maybe it is a combination of first riest,then freeing up the tight vertabrae. Rigourous sport massage betwween the ribs every couple of weeks rto loosen up,adhesions. Physio exercise to stretch tight spasmodic muscle. Then maybe rib manipulation to free up some of the tightness ofvthe sternum. I think it needs a multiple applied approach. My costocondritis was severe,whole right rib cage went into a very painful spasm after a two week viral coughing fit. Then severe nerve irritation in the arms and shoulders. I used a back pod for four weeks which helped greatly but l reached my stretching limit on it. I ma 85% better so far, but is a difficult illness to treat. But maybe some of your treatments are more effective. Doctors are generally clueless to what costochondritis is. I hope some of my own going experiences help. Some people heal well after a month or two,some may have it for years. I do believe it can be cured but how is a really tough question. No,doubt modern physiotherapy is crucial in easing costochondritis sypmtoms. But massage,treating the ribs at the back,the intercostal muscles,tailor made exercise and mobilising scar tissue are helpful. Kind regards colin.

    • Aránzazu López
      Posted at 09:25h, 13 June Reply

      Good morning Colin. As you explained very well, costochondritis could be very easy to resolve in early stage or very difficult when it becomes severe. A multidisciplinary approach in this cases in necessary to get rid of the problem. This is the reason because we recommend the combination of intercostal deep tissue and fibrotic massage, radiofrequency therapy for the cartilage and periosteum inflammation, osteopath rib and spine manipulations and physical rehabilitation planning to get back the rib cage mobility using the breathing muscles. Everything counts. Thank you for sharing your experience. Aranzazu.

  • R.parvateesam
    Posted at 02:39h, 20 August Reply

    Good morning sir
    My wife suffering from costochondritis since last 2years. . We are used medicine. But not curied, her age 47years.we are requesting Pl helpful suggestion sir

    • Aránzazu López
      Posted at 10:26h, 24 August Reply

      Good morning.
      We would love to help your wife. First of all she will need a proper assessment with our physiotherapists and from there we’ll be able to recommend the specific and personalized treatment for her costochondritis case. So I invite your wife to book a Physiotherapy appointment in our clinic. You can find our therapists availability using the booking system of our website. Looking forward to knowing from you. Regards. Aranzazu.

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