Costochondritis: symptoms, causes, treatments, and stretches to ease chest tightness
Chest pain can be scary, but costochondritis is manageable. Learn the signs, causes, and how to find relief with simple exercises and at-home treatments.
Table of Contents
Costochondritis is often harmless, but it’s a common reason people go to the emergency room. The primary symptom of costochondritis — which refers to inflammation of the cartilage around the breastbone — is chest pain.
“Costochondritis can mimic a heart attack,” says Mark Schroeckenstein, PT, DPT, a physical therapist at Hinge Health. One study found that up to 45% of emergency room and urgent care visits for chest pain are due to musculoskeletal issues like costochondritis. “It’s tricky to differentiate between the two, so when in doubt, always get it checked out,” Dr. Schroeckenstein says.
Read on to learn more about costochondritis, including causes, treatments, and how to manage and prevent it. This includes exercises recommended by Hinge Health physical therapists to ease stiffness and tightness in your chest.
Reviewed by our clinical and medical experts
Mark Schroeckenstein, PT, DPT
Dr. Schroeckenstein is a Hinge Health physical therapist who works with athletes of all types and has advanced training in treating runners, golfers, cyclists, and soccer players.
Christynne Helfrich, PT, DPT
Dr. Helfrich is a Hinge Health physical therapist with nearly 15 years of experience. She is an orthopedic certified specialist and is certified in myofascial trigger point therapy. Read More
Richard Keyme, MD
Dr. Keyme is board-certified in Physical Medicine & Rehabilitation, Brain Injury Medicine, and fellowship-trained in Interventional Pain & Spine. He is a Senior Expert Physician at Hinge Health. Read More
What is costochondritis?
Costochondritis means there is inflammation in the costochondral joints, where the cartilage attaches the ribs to the breastbone (sternum). Costochondritis is not a heart-related condition but it is a common cause of pain in the middle of the chest. It occurs most often in adults, particularly women between ages 40 and 50 — but it can happen to anyone.
Costochondritis symptoms
Symptoms of costochondritis can mimic a heart attack, but there are usually distinct differences. However, because chest pain is serious, it is always best to be evaluated by a healthcare provider if you are unsure. Typical symptoms may include:
Chest pain, described as sharp, aching, tightness, or pressure
Pain along the breastbone
Pain with deep breathing, coughing, or sneezing
Pain during movement, particularly reaching overhead or twisting
Pain when putting pressure over the area, such as lying on the affected side
Heart attack symptoms
In contrast, chest pain from a heart attack is usually described as a deep, heavy pressure that does not change when you press on your chest bone or move your arms overhead.
Heart attack pain also tends to worsen with general cardiovascular effort (like walking or jogging) rather than specific twisting or reaching movements. It often occurs alongside other symptoms, such as:
Shortness of breath
Nausea
Chills
Dizziness
A helpful check: If your chest pain can be recreated by physically pressing on a tender spot or moving your arm in a specific way, it is likely due to a musculoskeletal issue rather than your heart.
Causes of costochondritis
Costochondritis is often idiopathic, which means it develops without a clear cause. However, several known triggers — such as viral infections, injuries, or a sudden increase in physical activity — can contribute to inflammation in the chest wall. Some of the main causes include:
Illness. Respiratory infections — like the flu, bronchitis, or a heavy cold — can inflame cartilage in the chest, often due to the strain of frequent coughing.
Trauma. A hit to the chest, whether from sports, a fall, or car accident, can trigger pain and inflammation.
Doing more activity than usual. Strenuous lifting, pushing, pulling, or rotating can sometimes irritate the chest muscles and joints, particularly if you do more than your body is currently ready for.
Repetitive movements. Activities that involve frequent twisting or throwing can be a trigger for costochondritis, especially if these are new movements or you increase your intensity too quickly. If you’re sick with a virus, excessive coughing or vomiting could also be a trigger.
How long does it take for costochondritis to heal?
“It depends on the cause,” says Dr. Schroeckenstein. “If costochondritis is associated with a respiratory infection, it typically fades as you get better. The same goes for trauma or heavy physical exertion.” Most cases resolve within a few days to a few weeks, but sometimes it can last longer or recur.
Treatments for costochondritis
Costochondritis often resolves on its own, but you can support your recovery with simple at-home strategies, like using cold and heat therapy or taking over-the-counter medication. Gentle movement and stretching can also make it easier to return to your usual activities once you feel better. These approaches include:
Do gentle mobility and stretching exercises. Movement increases blood flow, bringing oxygen and nutrients to the area for healing. It also helps ease stiffness and tension, while also preparing your muscles and other soft tissues for more activity after recovery. Doing gentle, dynamic exercises (like the ones below) can also alleviate pain from costochondritis.
Modify painful activities. You don’t want to be completely sedentary, but temporarily dialing back on sports or movements that increase pain gives the sensitive area time to calm down. You can gradually reintroduce these activities as you begin to feel better.
Try deep breathing exercises. “Deep breathing exercises, like diaphragmatic breathing, gently expand the chest and rib cage from the inside out,” says Dr. Schroeckenstein. “This helps maintain mobility in your chest, while also soothing a sensitive nervous system.” Continuing to take full, deep breaths also keeps your lungs clear, helping to prevent pneumonia that can occur if discomfort leads to shallow breathing.
Apply ice or heat. Ice and heat can help alleviate pain and promote recovery. Ice can reduce inflammation and numb pain, whereas heat can relax tight chest muscles and improve blood flow. Try both, or choose the method that works best for you.
Try over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can do your targeted exercises and stay active when you have pain from costochondritis. Other options are topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are safe to take.
Follow your doctor’s orders. If costochondritis is related to an infection, follow prescribed treatments, such as rest and antibiotics. Your pain should ease up as the infection resolves.
Consider complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for costochondritis pain relief, such as massage, acupuncture, or chiropractic care.
Gentle chest and upper body stretches
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- Shoulder gators
- Standing child's pose
- Standing chest stretch
- Resisted T
Performing these gentle movements as you recover helps ease pain and promote healing. They can also help you maintain mobility, flexibility, and strength, making it easier to get back to the sports and activities you enjoy.
The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.
How to prevent costochondritis
While you can’t always prevent costochondritis, you can make your body more resilient. Keeping your upper body strong and flexible helps your chest wall handle the demands of daily life and exercise with less irritation. Try these Hinge Health physical therapist-backed tips:
Do warm-up exercises before working out. Whether you’re playing sports, working out, or doing heavy physical work around the house or at work, take five to 10 minutes to prepare your body for the activity. A dynamic warm-up gradually increases your heart rate and warms up your muscles, making them more elastic and less prone to irritation.
Train regularly. Consistency builds resilience. “Sudden bursts of activity can sometimes catch your body off guard,” says Dr. Schroeckenstein. By engaging in regular physical activity, you ensure your body has the capacity to handle the demands of vigorous movement—whether that’s a sport, a hobby, or a busy day of chores—with ease.
Progress gradually. Sudden increases in activity levels — whether it’s lifting heavier weights, playing extra sets of tennis, or rowing longer distances — can sometimes be a shock to the system. When you’re starting a new activity or leveling up, try increasing weight, intensity, or duration slowly (and one at a time). This gives your body the time it needs to adapt to the new challenge.
Stay flexible. Your chest muscles can feel stiff if you spend long periods in the same position — whether that’s at a computer, over your phone, or behind a wheel. Taking movement snack breaks to do the stretches above helps keep your chest, shoulders, and upper back mobile and feeling good.
Build upper body strength. Stronger muscles take pressure off surrounding joints and support healthy posture. Focus on strengthening your chest, shoulders, upper back, and core, including rotational exercises to help prepare your body for twisting movements in daily life and sports.
Physical therapy (PT) is for more than just recovering from surgery or injury. It’s one of the top treatments for joint and muscle pain. It helps build strength, improve mobility, and reduce pain. And it doesn't always need to be in person.
Hinge Health members can conveniently access customized plans or chat with their care team at home or on the go — and experience an average 68% reduction in pain* within the first 12 weeks of their program. Learn more*.
When to see a doctor
Any time you have questions about chest pain, it’s a good idea to seek immediate medical attention. Especially if you also have the following symptoms:
Pain radiating down the arm
Pain in the jaw
Shortness of breath
Cold sweat
Nausea
Heart palpitations
Fever or other unusual symptoms
PT tip: Your chest needs movement too
“People often hesitate to move a painful chest, but the rib cage is actually designed for mobility,” says Dr. Schroeckenstein. While we often focus on the back or shoulders, the chest is frequently overlooked in recovery. Gentle movement here can be surprisingly soothing — helping to improve breathing mechanics and reduce sensitivity in the area.
How Hinge Health can help you
If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.
Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
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References
Wertli, M. M., Dangma, T. D., Müller, S. E., Gort, L. M., Klauser, B. S., Melzer, L., Held, U., Steurer, J., Hasler, S., & Burgstaller, J. M. (2019). Non-cardiac chest pain patients in the emergency department: Do physicians have a plan how to diagnose and treat them? A retrospective study. PloS One, 14(2), e0211615. doi:10.1371/journal.pone.0211615
Chang, L., Avancena, G., & Lebron-Solis, B. (2025). Costochondritis. PM&R Knowledge Now. American Academy of Physical Medicine & Rehabilitation. https://now.aapmr.org/costochondritis/
Schumann, J. A., & Parente, J. J. (2024). Costochondritis. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK532931/
Mott, T., Jones, G., & Roman, K. (2021). Costochondritis: Rapid Evidence Review. American Family Physician, 104(1), 73–78. https://www.aafp.org/pubs/afp/issues/2021/0700/p73.html
Zaruba, R. A., & Wilson, E. (2017). IMPAIRMENT BASED EXAMINATION AND TREATMENT OF COSTOCHONDRITIS: A CASE SERIES. International Journal of Sports Physical Therapy, 12(3), 458. https://pmc.ncbi.nlm.nih.gov/articles/PMC5455195/
American Heart Association. (2019). Heart Attack and Stroke Symptoms. Www.heart.org. https://www.heart.org/en/about-us/heart-attack-and-stroke-symptoms