Could stress be responsible for my costochondritis?

Q. Over the last few days I developed pain where my rib joins the top of my breastbone. It's tender to the touch. I otherwise feel fine, but I am under a lot of stress. Could that be the cause?

A. Your symptoms are typical for a condition called costochondritis. It's a term that literally means inflammation ("-itis") of the cartilage ("chondral") of the ribs ("costal"). It causes pain just as you described, where one of the ribs attaches to the sternum (breastbone).

Typically, there is no swelling or redness in the area. But pressing just to the side of the sternum will increase the intensity of the pain. This helps confirm the diagnosis.

The cause is unknown. Sometimes it seems to be related to an injury or overuse. For example, lifting weights or repetitive arm motion might be the trigger.

Stress and psychological problems are not known causes of costochondritis. But these problems may make matters worse by increasing how you perceive pain.

The symptoms may take many days or even weeks to get better. Fortunately it is not dangerous, and it almost never leads to any joint damage.

Naturally, you want to avoid behaviors that may have triggered it. You may find that applying heat or ice provides comfort. Also, you might try a topical pain reliever such as diclofenac gel or lidocaine. Oral medications to help reduce symptoms include ibuprofen, naproxen, or acetaminophen.

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