Symptoms of Tietze Syndrome

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Tietze syndrome is a rare medical condition involving chest pain, shoulder or arm pain, and swelling. The pain typically originates in the area between two ribs and may be red or warm to the touch. Pain severity ranges from mild to severe and may interfere with daily activities.

Learn about Tietze syndrome, its symptoms, when to seek medical care, and more.

Man sitting on sofa holds his chest

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Frequent Symptoms

Tietze syndrome affects males and females equally and is most often seen in people under age 40. Although the cause of Tietze syndrome is unknown, some researchers think it may be related to excessive coughing, vomiting, chest injuries, certain infections, or chest surgery.

The primary symptom of Tietze syndrome is chest pain, which typically occurs at your sternum, the top of your chest, in the area between ribs two and three. The sharp, dull, or achy pain can be felt in the shoulders and arms, even when the source of the pain is in the rib area.

Pain from Tietze syndrome ranges from mild to severe. In 70% of cases, it affects only one area or side of the chest.

Common Symptoms of Tietze Syndrome

Rare Symptoms

While the pain of Tietze syndrome commonly starts in the area between two ribs, it may also occur in a larger area of the chest, neck, shoulders, and arms. Less common symptoms of Tietze syndrome include the following:

  • Pain on both sides of the chest
  • Pain in the ribs other than between ribs two and three
  • Swelling in the chest, shoulders, or arms
  • Redness or warmth in the chest, shoulders, or arms

Tietze syndrome may be difficult to distinguish from other health conditions and is often confused with costochondritis, another non-life-threatening condition involving chest pain.

Knowing the differences in symptoms, especially rare symptoms, can help your provider determine the underlying cause of your chest pain. For example, Tietze syndrome can have similar symptoms to a chest tumor, especially when there is increased swelling. Your provider may want to do a biopsy to rule out a growing tumor.


Tietze syndrome is not known to be associated with other medical conditions, meaning it does not lead to more serious illnesses. Most people with Tietze syndrome recover within weeks or months without complications.

However, this condition can be severe enough to interfere with daily life and prevent you from participating in certain activities due to pain.

Tietze syndrome may make it difficult to:

  • Take a deep breath without feeling pain
  • Exercise, play sports, or be physically active
  • Cough or sneeze without feeling pain
  • Do chores, especially when they require physical exertion
  • Change positions or move throughout the day without pain

When to See a Healthcare Provider

It is important to seek medical care when you experience chest pain because it can be a symptom of a more serious, sometimes life-threatening, medical condition. For example, a heart attack is a life-threatening condition that may include symptoms such as chest pain that spreads to the neck, shoulders, and arms.

When to Call 911

Call 911 immediately if you experience heart attack symptoms such as:

Other serious medical conditions that may be confused with Tietze syndrome include:

Most people with chest pain do not have a life-threatening concern. However, it is possible; medical care can help rule out serious medical conditions.

Once you are diagnosed with Tietze syndrome, your healthcare provider may recommend over-the-counter (OTC) pain medications, like nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen), or for more severe cases, corticosteroid injections, to treat Tietze syndrome. The goal of treatment is to help you be more comfortable, relieve pain, and get back to daily activities.


Tietze syndrome is a rare medical condition that involves chest pain. Less common symptoms include swelling, redness, and warmth in the chest, shoulders, or arms. While this is not a life-threatening health concern, Tietze syndrome can be painful enough to interfere with daily life.

Seek medical care whenever you experience chest pain to rule out more serious health concerns. Medical care and treatment can help with pain relief and comfort until the symptoms disappear.

A Word From Verywell

Tietze syndrome can be challenging to identify since the symptoms may initially appear like more severe health concerns. Call 911 or go to the emergency room if you suspect a heart attack. The symptoms of Tietze syndrome can be uncomfortable and interfere with daily life, but they usually resolve within weeks or months. If you or someone you know suspects or is experiencing Tietze syndrome, reach out to a healthcare provider for support.

7 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.
  1. National Organization for Rare Disorders. Tietze syndrome.

  2. Genetic and Rare Disease Information Center. Tietze syndrome.

  3. Rokicki W, Rokicki M, Rydel M. What do we know about Tietze’s syndromeKardiochir Torakochirurgia Pol. 2018;15(3):180-182. doi:10.5114/kitp.2018.78443

  4. Kaplan T, Gunal N, Gulbahar G, et al. Painful chest wall swellings: Tietze syndrome or chest wall tumorThorac Cardiovasc Surg. 2016;64(3):239-244. doi:10.1055/s-0035-1545261

  5. Tan C, Lim R, Yeow M, Fong J, Balakrishnan T. Tietze’s syndrome post-covid-19 infection in an adult patientCureus. 2022;14(7). doi:10.7759/cureus.27499

  6. Harvard Medical School. When chest pain strikes: What to expect at the emergency room.

  7. Sawada K, Ihoriya H, Yamada T, et al. A patient presenting painful chest wall swelling: Tietze syndromeWorld J Emerg Med. 2019;10(2):122-124. doi:10.5847/wjem.j.1920-8642.2019.02.011

By Ashley Olivine, Ph.D., MPH
Dr. Ashley Olivine is a health psychologist and public health professional with over a decade of experience serving clients in the clinical setting and private practice. She has also researched a wide variety psychology and public health topics such as the management of health risk factors, chronic illness, maternal and child wellbeing, and child development.