COSTOCHONDRITIS: UNDERSTANDING CHEST & UPPER BACK PAIN
Chest pain is one of those symptoms that makes most people immediately think of their heart. But sometimes, the pain comes from the joints and cartilage in your chest wall caused by a condition called Costochondritis.
At Physio Physique we regularly see both anterior costochondritis (pain at the front of your chest near the sternum) and posterior costochondritis (pain at the back where your ribs connect to your spine).
The good news is physiotherapy can help with both.
WHAT IS COSTOCHONDRITIS?
Costochondritis is caused by inflammation of the cartilage that connects your ribs to the chest bone (costosternal joint) or spine (costovertebral joint).
When the cartilage is irritated or inflamed, they can cause sharp, aching or pressure-like pain.
Symptoms can include:
- Localised tenderness when pressing on the rib joints
- Pain that worsens with movement, deep breathing, coughing or sneezing
- Pain that may radiate to the chest, side or back
!! IMPORTANT !!If you’re ever unsure whether chest pain is heart related, always seek medical attention first.
ANTERIOR VS POSTERIOR COSTOCHONDRITIS
Anterior Costochondritis (front chest pain)
- Pain near chest bone / sternum
- Often feels sharp or pressure-like
- Can mimic heart related pain
Posterior Costochondritis (back rib pain)
- Pain on one side of the upper back (costovertebral joints)
- Can feel like a deep ache between the shoulder blades
- Often worse when twisting, lifting or prolonged sitting
Both are caused by irritation and inflammation of the rib joints with posterior costochondritis being less common of the two.
COMMON CAUSES OF COSTOCHONDRITIS
- Poor posture (slouched sitting, rounded shoulders)
- Repetitive stress (gym, sports, lifting and twisting)
- Rib or thoracic spine stiffness (lack of stretching)
- Persistent coughing or respiratory infections
- Sudden movements or trauma
Think of costochondritis like a “sprained joint” in your rib cage.
BEST EXERCISES FOR COSTOCHONDRITIS PAIN RELIF
Even though it may not feel like it, gentle movement is usually the best approach.
Yes, it will cause some discomfort when you move, but remember “not all pain = harm”.
Below are some general exercises to treat costochondritis without medication.
Posture reset
- Sit tall with your shoulders back and down
- Imagine a string lifting you up from your head
- Hold for 30 seconds, repeat 3-4x per day
Chest (pectoralis) stretch
- Stand in a doorway with elbows bent at 90° and at shoulder height
- Gently push through the doorway until you feel a stretch across the chest
- Hold for 30 seconds, repeat 3-4x a day
Upper back (thoracic) rotation stretch
- Sit tall with arms crossed over your chest
- Slowly rotate side to side
- Repeat 20 times each side, 3-4x per day
Chest & shoulder opener (puppy pose) stretch
- Stand with your arms straight and hands on a wall
- Keep your knees bent to 90° and push your hips back
- Push your chest down towards the floor
- Keep your arms and upper back straight
- Hold for 30 seconds while breathing slowly and deeply
- Repeat 3-4x per day
HOW LONG DOES IT TAKE COSTOCHONDRITIS TO HEAL?
Recovery time varies, but with the right management many people improve without a couple of weeks to a couple of months.
Factors like posture, workload, lifestyle, general health and your commitment to self help exercises can influence your healing time frame.
HOW PHYSIOTHERAPY CAN HELP COSTOCHONDRITIS?
Our physiotherapists will:
- Undertake a comprehensive assessment for your posture, shoulder and spine mobility and muscle imbalances
- Use cupping, dry needling and hands-on therapy to relief muscle tension , reduce joint stiffness and inflammation
- Prescribe tailored exercises to correct your imbalances and dysfunctions
- Teach you self help pain relief strategies
- Guide you back to your daily activities such as sport, gym or work
We use a “whole body” approach to check beyond the painful areas and address all the contributing factors.
- Chest or rib pain lasts longer than 2-3 days
- Pain worsens with breathing, twisting or lifting
- You’ve had multiple flare ups
- You want long term strategies and fix the problem once and for all
Costochondritis can feel worrying and often people admit themselves into hospital due to fears of having a heart attack.
The good news is that with the right assessment and treatment, costochondritis is very manageable.
👉 Book now to settle your chest and rib pain down fast
Reference:
Thoomes, E., van Geffen, M., van der Windt, D., & Scholten-Peeters, W. (2017) Impairment-based examination and treatment of costochondritis: a case series. International Journal of Sports Physical Therapy, 12(3), pp. 480–489. Available at: https://mahara.stmarys.ac.uk/artefact/file/download.php?file=580679&view=147186 (Accessed: 25 August 2025).
