CFS & Fibromyalgia Related Conditions Costochondritis Chest Pain in Fibromyalgia By Adrienne Dellwo Adrienne Dellwo LinkedIn Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic. Learn about our editorial process Medically reviewed by David Ozeri, MD Medically reviewed by David Ozeri, MD on September 07, 2020 LinkedIn David Ozeri, MD, is a board-certified rheumatologist from Tel Aviv, Israel specializing in arthritis, autoimmune diseases, and biologic therapies. Learn about our Medical Review Board on September 07, 2020 Print Table of Contents View All Table of Contents Overview Research Symptoms Diagnosis Treatment Do you have areas of your chest that are painful to the touch? A condition called costochondritis, which causes pain around the breastbone and rib cage, could be to blame. It's believed to be common in people with fibromyalgia (FMS). Costochondritis is also called noncardiac chest pain or musculoskeletal chest pain. It does not involve the heart. Because anything and everything can hurt when you have FMS, a lot of people don't realize this pain is from a separate condition that requires its own treatment. Because any other sources of pain can make your FMS symptoms worse, it's important for you to treat costochondritis. Costochondritis can make you think you're having heart problems, which is a scary thing. Even though costochondritis is common, you should get medical attention if you have unexplained chest pain. You don't want to assume that it's FMS-related and end up with permanent heart damage or worse. Basics of Costochrondritis Costochondritis is inflammation of the cartilage that connects your ribs to your breastbone. Depending on how much inflammation there is, it can range from mildly annoying to intensely painful. People sometimes describe the pain as stabbing, aching, or burning. The causes of costochondritis aren't clear, but they may include: Chest trauma, such as from a car accident Repetitive trauma or overuse Viral infections, especially upper respiratory infections Some experts believe FMS may cause costochondritis. Regardless, because FMS amplifies pain, it can make costochondritis much more painful. The FMS Connection Many people with FMS have symptoms very similar to costochondritis. In one study, non-specific chest pain is listed as the most common additional symptom in people who were hospitalized with FMS. Another lists FMS as a frequent cause of musculoskeletal chest pain. No one is exactly sure whether it is true costochondritis or why it occurs with FMS. One hypothesis is that FMS involves inflammation of the fascia, which is a thin layer of connective tissue that runs all through your body. If that's true, it may explain why costochondritis is so common in this condition. The fibromyalgia tender points just beneath the collarbone may play a role as well. (Tender points are 18 spots on the body that are used to diagnose fibromyalgia.) Myofascial pain syndrome, which is common in people with FMS, also could be a cause. Costochondritis is typically a minor injury, but it can take several weeks or months to resolve. If symptoms don't clear up, they could be a sign that something else, such as FMS, is going on. Illustration by Cindy Chung, Verywell Costochrondritis Symptoms Pain in the chest wall and rib cage is the chief symptom of costochondritis. Generally, the pain will get worse with activity or exercise. Taking a deep breath can also cause more pain because it stretches the inflamed cartilage. Sneezing and coughing can increase pain as well. The pain can radiate to your shoulder and arms as well (another way the condition mimics a heart attack). Sometimes the pain is accompanied by redness and/or swelling in the most painful areas. When that's the case, it's called Tietze's syndrome. Diagnosis Your healthcare provider can diagnose costochondritis by pressing on the area where the ribs and breastbone come together. If it's tender and sore there, costochondritis is the most likely cause of pain. Healthcare providers generally will perform other tests to rule out heart problems and other causes of pain before making a diagnosis. Fibromyalgia Doctor Discussion Guide Get our printable guide for your next doctor's appointment to help you ask the right questions. Download PDF Email the Guide Send to yourself or a loved one. Sign Up This Doctor Discussion Guide has been sent to {{form.email}}. There was an error. Please try again. Treatment You can treat costochondritis the way you'd treat any inflammation—ice and anti-inflammatory drugs, including Aleve (naproxen) and ibuprofen-based drugs such as Advil and Motrin. This treatment sometimes runs counter to FMS treatments, which can include other types of pain relievers and heat. If you have both, you might find yourself with an ice pack on your chest and a heating pad on your back at the same time. Be sure to check with your healthcare provider or pharmacist about any possible interactions between anti-inflammatories and your other medications. Your healthcare provider may recommend other types of treatment as well, including physical therapy or acupuncture. A Word From Verywell It's bad enough to live with one source of chronic pain. The more you heap on, the more pain you'll have and the more it can impact your life. Fortunately, costochondritis is fairly easy and inexpensive to treat, and managing it will keep it from exacerbating your FMS symptoms. Was this page helpful? Thanks for your feedback! Learn about treatment and lifestyle changes to cope with fibromyalgia and chronic fatigue syndrome. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 10 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Ayloo A, Cvengros T, Marella S. Evaluation and treatment of musculoskeletal chest pain. Prim Care. 2013;40(4):863-87,viii. doi:10.1016/j.pop.2013.08.007 Bellato E, Marini E, Castoldi F, et al. Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment. Pain Res Treat. 2012;2012:426130. doi:10.1155/2012/426130 Campbell KA, Madva EN, Villegas AC, et al. Non-cardiac chest pain: A review for the consultation-liaison psychiatrist. Psychosomatics. 2017;58(3):252-265. doi:10.1016/j.psym.2016.12.003 Cubos J, Cubos A, Di Stefano F. Chronic costochondritis in an adolescent competitive swimmer: A case report. J Can Chiropr Assoc. 2010;54(4):271-275. Haviland MG, Banta JE, Przekop P. Fibromyalgia: Prevalence, course, and co-morbidities in hospitalized patients in the United States, 1999-2007. Clin Exp Rheumatol. 2011;29(6 Suppl 69):S79-87. Sturm C, Witte T. [Musculoskeletal-related chest pain]. Internist (Berl). 2017;58(1):39-46. doi:10.1007/s00108-016-0166-z Liptan GL. Fascia: A missing link in our understanding of the pathology of fibromyalgia. J Bodyw Mov Ther. 2010;14(1):3-12. doi:10.1016/j.jbmt.2009.08.003 Zaruba RA, Wilson E. Impairment based examination and treatment of costochondritis: A case series. Int J Sports Phys Ther. 2017;12(3):458-467. Sawada K, Ihoriya H, Yamada T, et al. A patient presenting painful chest wall swelling: Tietze syndrome. World J Emerg Med. 2019;10(2):122-124. doi:10.5847/wjem.j.1920-8642.2019.02.011 Hudes K. Low-tech rehabilitation and management of a 64 year old male patient with acute idiopathic onset of costochondritis. J Can Chiropr Assoc. 2008;52(4):224-228. Additional Reading Flowers, LK. Costochondritis. eMedicine. Haviland MG, Banta JE, Przekop P. Fibromyalgia: prevalence, course, and co-morbidities in hospitalized patients in the United States, 1999-2007. Clinical and Experimental Rheumatology. 2011;(6 Suppl 69):S79-87.