Mississauga Chiropractor Presents: Costosternal Syndrome

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Categories: Lecture Series

Here’s another blog from a Mississauga Chiropractor…


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)



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)



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



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



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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