The Nagging Pain of Costochondritis

Last updated: February 2022

"I felt like I was having a heart attack," a friend in an ankylosing spondylitis support group wrote, flabbergasted. "I felt like my chest was on fire, and like my ribs were broken!"

The majority of the commenters told them to quickly see a doctor ASAP to rule out anything serious, like a cardiac emergency (definitely a wise suggestion!). But it also seemed that some people, especially many newly diagnosed folks, weren’t aware of what this particular experience actually was within the AS experience. In this case, it was costochondritis — just one of the many free add-ons AS offers us lucky people (pssst: that was sarcasm).

What is costochondritis?

Here’s a good way of describing it:

Costochondritis is the inflammation of the cartilage around the ribs and breastbone. The pain felt in the chest wall from AS can be due to costochondritis. AS may also cause pain in the chest due to damage to the joints between the ribs and the spine or the ribs and the breastbone.

Costochondritis has sent me to the emergency room twice, many years ago, because I was convinced I was having a heart attack, or, at the very least, a panic attack. Yeah, fun. These days, after many years of costochondritis flare-ups, I’ve learned to recognize it from a mile away. (Yet I do not recommend assuming any chest pain is this just because you have AS; please do speak with your doctor!).

The old rib and chest pain has been happening a lot more lately for me, ever since the world's longest flare-up started for me. It creates a specific sort of tightness in my ribs, and it feels tender and warm and prickly, as though the inside of my chest were lit with a tiny flame. And my chest bones pops and crackles a lot. 

Here’s how I manage it when it pops up

  1. I usually take ibuprofen, which helps with acute pain.
  2. Then I go in for a hot shower, which gets me a bit more mobile so I can stretch. I don't like the sensation of wearing a heat patch on my chest.
  3. I stretch it out! Often, with AS, it hurts too much to move deeply or quickly, so I go nice and slow and I stop if anything hurts. There’s a great video I watch by Dr. Jo, which includes movements for costochondritis pain relief. This has been a lifesaver to me. In no way does it take away the pain or make it go away, but it does alleviate what feels like daggers in my ribs, and it gives me some semblance of control.
  4. I’ve also noticed that when I have costochondritis, I tend to get anxious about it. Having that sort of pressure and pain in the middle of your chest is unnerving, so I try to relax as much as possible. I’ll take some CBD, put a distracting movie on the television, watch some ASMR, get into nature, or listen to some nice music.
  5. Sometimes I'll apply some Vicks to my chest, which feels super cool and tingly.

How do you manage your costochondritis?

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