Costochondritis: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats costochondritis?
A primary care doctor (family medicine or internal medicine) usually diagnoses and treats costochondritis, a condition where the cartilage connecting the ribs to the breastbone becomes inflamed and causes chest pain. The doctor examines the chest wall and rules out other causes of chest pain, then suggests pain relief.
What is costochondritis?
Costochondritis is swelling of the cartilage that joins the ribs to the breastbone. It is also called costosternal syndrome or anterior chest wall syndrome.
It causes chest pain in one area that gets worse with movement or when the spot is pressed. It can feel like a heart problem.
Doctors call it benign, which means it is not harmful, and self-limited, which means it goes away on its own.
Symptoms
The main symptom is pain in the upper front of the chest wall. Common features include:
- Pain that gets worse with movement, deep breaths, coughing, or stretching.
- Pain that may feel sharp or dull.
- A tender spot where one or two ribs meet the breastbone.
- Pain that most often involves the 2nd to 5th rib joints.
Costochondritis usually does not cause shortness of breath, dizziness, nausea, or headache. There is usually no swelling or rash on the chest.
Causes and who gets it
In many people, no cause is found. It may also follow an infection, repeated strain or injury to the chest, or a rheumatologic disorder, which is a joint and immune system condition.
Hard use of the arms, coughing, or strenuous activity may set it off.
It most often affects adults aged 40 to 50 years.
How doctors diagnose it
Costochondritis is a diagnosis of exclusion. That means doctors first rule out more serious causes of chest pain.
The doctor examines the chest wall. Pain is usually brought on by pressing the upper rib joints. The doctor may also use special neck and arm movements to bring on the pain.
An electrocardiogram (ECG), a test that records the heart's electrical activity, should be considered for all adults with chest pain at the front of the chest. A chest x-ray may be done to rule out lung problems such as pneumonia.
The chest x-ray and ECG are normal in costochondritis. More imaging is not recommended to diagnose it.
Treatment
Treatment mostly aims to relieve symptoms. Heat and skin treatments such as capsaicin, diclofenac gel, and lidocaine patches may be used.
Oral NSAIDs, which are pain relievers that lower swelling, or acetaminophen may be considered. The standard of care is topical medicines and oral NSAIDs.
A small number of people have pain that lasts or comes back. They may be sent to a rheumatologist, a doctor who treats joint and immune system conditions.
When to see a doctor
See a doctor to find the cause of your chest pain, since costochondritis can only be diagnosed after other causes are ruled out. Go back to your doctor if you get swelling or a rash on the chest.
Call 911 for chest pain that does not go away, crushing pain or pressure in the chest, or chest pain along with nausea, sweating, dizziness or shortness of breath. Pain that moves from the chest to the arms, shoulder, neck, jaw or back can also be a sign of a heart attack.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can examine your chest wall and order first tests such as a chest x-ray and ECG. They can also refer you to a specialist if the pain does not go away.
Common questions
How do I know if chest pain is costochondritis or my heart?
You cannot always tell the difference yourself. Costochondritis pain often gets worse when you press on the chest or move a certain way, but pain from a heart problem can sometimes hurt when pressed too. Because it can be hard to tell the difference, a doctor has to rule out heart problems first.
How quickly can I be seen for costochondritis?
A direct primary care or concierge doctor can examine you and rule out more serious causes of chest pain such as heart problems. If you have the signs in the Call 911 line above, do not wait for an appointment.
How long does costochondritis last?
Costochondritis often improves within a few weeks with simple pain relief, though it can last longer for some people or come back over time. A primary care doctor can suggest ways to ease symptoms.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
