Does costochondritis cause shoulder pain?

Are you experiencing rib cage pain that spreads to your shoulder? Don’t worry, you’re not alone. Many people experience these symptoms and the cause is often attributed to costochondritis.

Costochondritis is an inflammation of the cartilage that connects a rib to the breastbone in close proximity to your shoulder. In this article, we will discuss the relationship between costochondritis and shoulder pain.

Understanding Costochondritis

Costochondritis occurs when there is inflammation of the cartilage connecting ribs to their sternum or breastbone. It can happen without any apparent reason or as a result of injury or infection.

While most cases are mild, some people experience severe pain which leads them to believe they may be suffering from a heart attack because of its location. However, it’s important always to consult a physician if chest pains occur.

Causes of Costochronditis

The exact cause of costochronditis isn’t clear. However, several factors can increase one’s risk including:

  • Repetitive strain injuries
  • Chest trauma
  • Any recent physical trauma where your chest was injured
  • Extreme coughing resulting in incessant pressure on costo-sternum joint leading ultimately leading up joint stiffness.
  • Heavy lifting as this strains both intercostal muscles and joints

Apart from Trauma caused by aforementioned activities certain medical disorders have been linked with its onset :

Condition Medical history Mannerism
Arthritis (inflammatory) History indicating similar arthritis-like condition Inflammation all over body along with extra-articular manifestations affecting lungs etc.
Viral infections/electrolyte imbalance Dehydration/muscle ache/diarrhea post-viral fever or medication
Tumour/s Patient with history of cancerous growth i.e breast ca/lymphoma(costochondritis is a rare presenting complaint in breast carcinoma)12.

Symptomatology

Typical symptoms include

  • Chest pain, Long lasting pain or short attacks – this occurs on the left side of your chest and especially along your sternum (breastbone).
    In some cases, patients experience intense moments like squeezing which eventually elapses by itself.
  • Pain when moving |bending down or breathing deepy
  • Mild to chronic tenderness at the junction between ribs and sternum/breastbone.

Some costochondritis sufferers report experiencing shoulder pain, while others may have pain that radiates around to their back. This prompts many people to ask “does costochondritis cause shoulder pain”?

Costochronditis and Shoulder Pain

Costochronditis can cause inflammation, which often leads to radiating pains from the chest area all throughout one’s body – including shoulders 3.

While both conditions can be similar, there are distinct differences: whereas rotator cuff injury shows up with active movements (i.ecarrying groceries above head), costo-radiatropathies present on passive movements such as taking a deep breath or making sudden jerky torso motion.

The link between costochronditis and shoulder pains remains obscure since few medical researchers have exhaustively studied it. Yet apart from general inflammation due to an overlap syndrome these possible causes hypothesize its connection :

Musculoskeletal Overlap Syndromes

This group comprises various interrelated musculoskeletal disorders co-existing together responsible for persistent somatic complaints like shooting/textured sensations commonly affecting upper body part owing their anatomical vicinity linked by nerves :[Table demonstrated below]4

Medical Condition Associated Symptoms
Fibromyalgia Unexplained fatigue, sleep disturbance
Myofascial Pain Syndrome Tenderness in the knots due to trigger points
Chest Wall Syndromes (Costochondritis) Pain / tenderness on pressing breastbone/affected rib.
Rotator Cuff syndrome Sharp or dull aching pain with pointing movements of shoulder and scapula.

Characterized by sharp/stabbing chest pain mimicking acute heart attack.

One study by [Kobza et al., 2011]5 revealed that patients suffering from costochornditis were also prone to suffer from rotator cuff disorders which triggered chronic shoulder pains.

Nerve Irritation

Croft et al. mentioned three possible nerve roots supplying the upper ribs . Chronic irritation or pressure on these nerves leads to referred pain in multiple areas such as neck and shoulders [^6].

One reason for nerve root compression leading up-to costo-shoulder impingement includes using improper techniques while lifting weights, long surgical incisions over affected region causing damage to thoracic branches[^7].

Postural Discomforts

Posture plays crucial role resulting in developing thorax ailments. A slouched posture accentuates spinal curves leading ultimately erosion of lumbar muscle tone, thus precipitating an exarcerbation existing conditions like CostoChondritis leading upto radiating discomfort around both localised numbness or tingling at extremities.

Diagnosis & Treatment Options

Diagnosis is often based on \
a thorough medical history |
physical examinations |> If suspected MRI/CT scan can done but this isn’t typical unless it presents with trauma/specific diagnosis
X-ray studies |

When diagnosed early enough most cases resolve under conservative management within days-weeks of decreasing physical activity, pain management, or rest. If symptoms continue to worsen despite therapy, Medications like anti-inflammatories can be recommended.

More severe cases require Physiotherapy: chiropractic techniques such as massage may help relieve muscle tension while increasing joint mobility 6.

In rare cases, surgery might be needed if the condition has progressed significantly enough (left undiagnosed/treated) to limit daily activities.

Conclusion

Although costochondritis isn’t generally considered a serious ailment it can certainly cause uncomfortable shoulder and chest pain. The extent of this discomfort varies from mild discomforts that are temporary in nature to more chronic and persistent conditions that might require physical/surgical intervention.

Therefore one should refer their doctor immediately once they start experiencing unexpected pains indicative of an underlying disease process for early diagnosis and avoidance of complicating factors !


  1. Pumper GD, Pike S & Masheter CW; Costochondral tumors presenting as rib lesions | Journal Of Pediatric Surgery 

  2. Feigenberg SJ et al.; Costochondritis-like review is a manifestation / MMWR Morb.Mortal weekly Rept 

  3. Universityofmichiganhealth.org/conditions-treatments/musculoskeletal-and-orthopedic/pain?&_ga=2.36443743.56934519.1603393355-1870210487.1598541155#muscleandjoint 

  4. Macfarlane GJ et al.; EULAR revised recommendation papers over somatic symptom disorders using meta-analysis.(BMJ journal) 

  5. Kobza RM et al., Co-existence between rotator cuff syndrome and costochonrditis syndromes :a case report(Orthopaedics&Sports medicine ncbi.nlm.nih.gov)
    [^6] Croft AC Costa-Paz M Myocafscial Trigger Points in Patients with thoracic Outlet Syndrome & non Specific Arm Pain | Journal Chiropractic Medicine
    [^7] Van Laarhoven C et al.; Long term function of Intercostal Nerve Re-route predicting for Neuromas due to Chest wall resection as adjuvant treatment (Annals of Surgical Oncology) 

  6. National Health Service uk / health conditions/ costochondritis 

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