Quick answer. Costochondritis is inflammation of the cartilage that joins your ribs to your breastbone, causing chest wall pain that is benign and harmless in itself. The key is to be sure it is not a heart problem: chest pain with breathlessness, sweating or pain spreading to the arm or jaw needs 995 straight away.
Costochondritis is one of the most common causes of chest wall pain seen in Singapore GP clinics, and although the pain can feel alarming, the condition itself is benign. It happens when the cartilage connecting your ribs to your breastbone (sternum) becomes inflamed, producing a sharp or aching pain at the front of the chest that typically worsens when you press on the area, take a deep breath, cough or twist your upper body.
Because any chest pain naturally raises the worry of a heart attack, costochondritis is often a diagnosis of reassurance once more serious causes have been excluded. This guide explains what costochondritis feels like, why it happens and how it is treated, while making clear the warning signs that mean you should not assume it is only your rib cartilage and should seek emergency help instead.
At a glance
| Feature | Likely costochondritis | Needs urgent review (call 995) |
|---|---|---|
| Where the pain is | Front of chest over the rib joints, can be pinpointed | Central or left-sided, hard to point to, deep |
| What makes it worse | Pressing the area, deep breaths, twisting, coughing | Exertion, walking, emotional stress |
| Tenderness on pressing | Yes, pressing reproduces the pain | No, pressing does not change the pain |
| Other symptoms | Usually none | Breathlessness, sweating, nausea, dizziness |
| Pain spreading | Stays at the chest wall | Spreads to arm, jaw, neck or back |
What is costochondritis?
Costochondritis is inflammation of the costal cartilage, the firm but flexible tissue that connects each rib to the sternum (breastbone) at the front of the chest. When these rib-to-cartilage joints become inflamed, they produce a localised pain and tenderness that can be surprisingly sharp.
It is a common and benign condition that anyone can develop, though it is seen most often in adults and tends to affect women slightly more than men. In Singapore it is a frequent reason people attend a GP or even a hospital A&E worried about their heart, only to be reassured that the pain is coming from the chest wall and not the heart itself. A closely related condition, Tietze syndrome, causes similar pain but with visible swelling over the joint; costochondritis has no swelling.
Symptoms and signs
The hallmark of costochondritis is chest wall pain that you can usually reproduce by pressing on the affected area. Common features include:
- Sharp, aching or pressure-like pain at the front of the chest, often beside the breastbone
- Pain that worsens with deep breaths, coughing, sneezing or twisting the trunk
- Tenderness when you press on the rib joints, which often reproduces the exact pain
- Pain affecting more than one rib, frequently the fourth to sixth ribs
- Discomfort that may ease with rest and gentle movement and flare with activity
Importantly, costochondritis does not cause breathlessness, sweating, palpitations, dizziness or pain spreading to the arm or jaw. If you have those symptoms, the pain should not be assumed to be costochondritis.
Causes and risk factors
Often no single cause is found, but costochondritis is frequently linked to strain or minor injury of the chest wall. Recognised triggers and risk factors include:
- Repeated coughing, for example during a chest infection or after a viral illness
- Heavy lifting, vigorous exercise or unaccustomed upper-body activity
- Minor trauma or impact to the chest
- Poor posture, especially with prolonged desk or screen work
- Certain viral infections affecting the upper respiratory tract
Because the cartilage has limited blood supply, inflammation can settle slowly, which is why symptoms sometimes linger for several weeks before fully resolving.
How it is diagnosed
Costochondritis is largely a clinical diagnosis, made from your description of the pain and a physical examination. The doctor will press along the rib joints to see whether this reproduces your pain, which is a strong pointer towards the chest wall as the source.
There is no specific test that confirms costochondritis. Instead, tests are often done to rule out more serious causes of chest pain, particularly the heart and lungs. Depending on your age, risk factors and symptoms, a doctor may arrange an electrocardiogram (ECG), a chest X-ray or blood tests. If these are normal and the pain is clearly reproducible on pressing, costochondritis becomes the likely explanation.
Treatment options
Costochondritis usually settles on its own over a few weeks. Treatment focuses on easing the pain and reducing aggravating activity:
- Simple pain relief such as paracetamol, or anti-inflammatory medication (for example ibuprofen) if suitable for you
- Resting from activities that flare the pain, such as heavy lifting or strenuous exercise
- Applying a warm compress to the area for comfort
- Gentle stretching and posture correction once the acute pain eases
For pain that is persistent or severe, a doctor may consider a local steroid or anaesthetic injection into the affected joint. No surgery is needed, and there are no meaningful long-term risks from costochondritis itself. Most cases require nothing more than over-the-counter measures, so no procedure-based cost range applies.
When to see a doctor and which specialist
Because costochondritis is benign, mild chest wall pain that you can clearly reproduce by pressing, and that has no other symptoms, can often be managed at home or with a routine visit to your GP, who can examine you, exclude other causes and confirm the diagnosis.
However, never assume chest pain is costochondritis if you have any warning signs of a heart problem. Call 995 or go to A&E immediately if you have chest pain with any of the following:
- Breathlessness, sweating, nausea or feeling faint
- Pain that spreads to the arm, jaw, neck or back
- A crushing, tight or heavy central chest pain, especially on exertion
- Palpitations or a feeling of impending collapse
Also see a doctor promptly if the pain is worsening, you have a high fever, or it does not improve after a few weeks. Your GP can refer you on if a heart or lung cause needs specialist assessment.
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- Best GP & Family Clinics in Singapore — our editorial shortlist
- GP & family clinics directory
- OGTT Test
- Tension Headache
- Cluster Headache
- Retinal Detachment
- Uveitis
Sources
- NHS – Costochondritis
- Mayo Clinic – Costochondritis
- HealthHub Singapore – Heart Attack
- Singapore Heart Foundation – Warning Signs
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