by Andrew Pacholyk, MS, L.Ac.

Costochondritis is an inflammation in the cartilages where the ribs join the breastbone. Since we have to take breaths in and out of our lungs, there cannot be a direct rigid attachment of the ribs to the breastbone.

Instead, the ribs join the breastbone (known medically as the sternum) through flexible cartilages known as costal cartilages. But just like any cartilage, these costal cartilages in the chest wall can get inflamed. This is costochondritis, which literally means inflammation of the cartilage.

The key symptom is pain-not in the center portion of the chest under the breastbone, which is more typical of heart related pain-but rather pain along the edges of the breastbone. Many patients, and even doctors, can occasionally be thrown off as the pain can radiate into the arms, shoulders, or across the entire chest.

Another tip-off that this is cartilage inflammation rather than a more serious heart ailment is the fact that the pain increases with twisting movements of the upper body-reaching for something (especially overhead), taking in a very deep breath, coughing, or sneezing.

The physical examination performed by a doctor shows tenderness over the anterior chest wall area along the breastbone where the rib joins the sternum. There may be some degree of redness over the skin and the pain is more often than not on the left side of the chest area.

The ailment usually disappears as mysteriously as it came on, but often a low dose of Naprosyn or another over-the-counter, anti-inflammatory will stop the pain, along with warm, moist heat. Rare cases, such as an infection into the cartilage, require more aggressive measures, but this is unusual.

Stress contributes to the pain because it makes the muscles tense. Other things which hurt are lifting, pushing, pulling, sneezing, coughing, long hours of driving or using the computer, repetitive motions and caffeine. Cold, rainy and humid weather also make a lot of sufferers feel worse.

Stress causes the nerves to be more stimulated and tightens the muscles, both of which trigger our pain. That pain increases quite a bit in stressful situation versus non stress times. With stress our bodies go into their fight or flight reaction due to the sympathetic nervous system. Ideally these situations should be avoided but where it is not possible it is important that they be carried out with care.

Stress management should be priority. Meditation, light exercise, reading, writing, aromatherapy, music therapy, crystal therapy are all important stress/emotional wranglers that should be considered.

Rest, heat or ice on affected areas should be applied.

Therapies you should consider:

*Glucosamine/Chondroitin Complex (500 mg) 3 x a day (heals cartilage) :avoid if allergic to seafood.
*Ginger Root (inflammation)
*Evening Primrose Oil (inflammation)
*Bromelain (Pineapple enzyme 500 mg) 3 x a day on empty stomach (inflammation)
*Vitamin C with Bioflavanoids (1000 mg) 4 x a day (boosts immune system) :lessen dosage if bowel movements are effected.
*Vitamin E (anti-oxidant, inflammation)
*Eating fatty fish, such as salmon or sardines for their Omega-3 oils (inflammation)
*White Willow Bark (inflammation)
*Goldenseal (inflammation, cleansing, good for viral)
*Valerian Root (calming, helps sleep)
*Grape Seed Extract (antioxidant)
*St. John’s Wort (300 mg) 3 x a day (good for nerve pain and depression)
*A good multivitamin 1 x a day
*B Complex 1 x a day
*Traumeel homeopathic cream applied to area as needed.
*Enteric coated aspirin (325 mg) four a day
*Hot mineral baths once or twice a day
*Take a warm shower twice a day
*Light stretches on the back/neck area after each shower; this keeps body flexible.
*Massage every two weeks, concentrating on neck flanks and shoulder area.
*Work out the neck/shoulder/back area with light weights on a weight machine, to strengthen.
*Acupuncture has shown very promising results for this condition.

I emphasize one point, however, about costochondritis. If you have any doubt whatsoever about your chest pain, and even if you feel it is simply a cartilage inflammation, get a confirmation from a doctor or even a second opinion.

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