DEAR DR. GOTT:
I’ve been diagnosed with costochondritis and have been unable to determine what causes the inflammation. I swim daily and work part-time. Is this a contagious illness I have picked up?
My doctor did not give me any medication except Indocin for pain. My chest and back hurt and I am extremely tired. I have not had any trauma or viral respiratory infections recently, have never smoked, nor did I go near people that smoke.
X-rays were taken and my doctor said my lungs are clear. I have had no surgeries and hope never to have any. I take vitamins, exercise and try to maintain a healthy life. The doctor said it could last as long as three weeks.
Please give me your thoughts on this illness. I had never heard of it before but it is painful and could make one think of a heart attack about to happen.
DEAR READER:
Costochondritis is an inflammation of the cartilage that connects the ribs to the breastbone, resulting in sharp pain. When accompanied by swelling, the condition is known as Tietze syndrome. One or more rib cartilages can be involved and can cause severe pain that may radiate to the neck, shoulder or arm, mimicking the pain of a heart attack. Injury, infection and fibromyalgia are common causes; however, in some instances there is no apparent cause.
Your physician obviously scheduled an X-ray to rule out other conditions, since costochondritis cannot be seen through any imaging test. In fact, it is diagnosed through history, examination and hands-on palpation over the area. It differs from a cardiac-related condition in that the pain from an attack is more widespread, while this pain is focused in a much smaller area.
I am sure you were disappointed when your physician only prescribed Indocin. In actuality, his hands were somewhat tied. Pain relief is obtained through non-steroidal anti-inflammatory drugs, muscle relaxants and, in some cases, anti-depressants. Rest, heat and moderate exercise that doesn’t aggravate the condition will also be beneficial. You do not have a contagious condition. It most often subsides in about two weeks. Obviously, you are beyond that time frame and are still experiencing pain. If your swimming involves stretching your arms out in front of you, modify your strokes to allow healing to occur.
To give you related information, I am sending you a copy of my Health Report “Managing Chronic Pain”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
About Dr. Gott