Mississauga Chiropractor Presents: Costosternal Syndrome

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Here’s another blog from a Mississauga Chiropractor…

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Costosternal syndrome is the inflammatory process of one or more costochondral cartilages that causes localized tenderness & pain in the anterior chest wall.

 

Main Sub-Types:

a)      Costochondritis:  Bilateral, middle ribs

b)      Tietze’s Syndrome:  Unilateral, upper ribs (swelling)

 

Etiology:

a)      Costochondritis:

  • Incidence: 4%
  • Gender: females > males (2:1)
  • Age:  pediatric or young adult

 

b)      Tietze’s Syndrome:

  • Gender: females > males
  • Age: > 50 years old
  • Ribs 2-5 most common levels

 

Possible Causes:

a)      Cartilage in the ribs is irritated or torn leading to inflammation & pain

b)      Direct trauma, aggressive exercise (straining the joint in the ribs)

c)      Upper respiratory tract infection with cough (causes repeated straining at the costochondral junction)

 

History:

a)      Moderate to severe sharp/shooting anterior chest wall pain

b)      Sudden onset occurring over several days to weeks

c)      Pain is usually unilateral (may e bilateral)

d)      Pain is usually well localized but may radiate to the chest, upper abdomen or back

e)      Pain may be made worse with:

  • Coughing, sneezing, deep inspirations
  • Movement of the upper torso & shoulder

 

Management:

a)      Condition is self-limiting – it will resolve  on its own in weeks to months (6 months maximum)

b)      Pain control with heat, rest, cough suppression

c)      Massage Therapy – to release the muscles around the joints (pecs, intercostals)

d)      Muscle Stretching (pectoralis major)

e)      Activity modification

  • Avoid aggravating activities
  • Limit physical activity during the acute phase
  • Apply ice after activity

 

Prognosis:

a)      Prognosis is excellent and a full recovery is expected

b)      Resolution usually occurs in several weeks to months

c)      Relapse can occur if the patient returns to activity too soon

 

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