Tietze's syndrome is inflammation of the cartilage (tough, flexible tissue) that joins your ribs to your breastbone (sternum). This area of cartilage is known as the costochondral joint.

When the costochondral joint becomes inflamed, it results in pain, tenderness and (in the case of Tietze’s syndrome) swelling over the ribs and cartilage around the breastbone.

Inflammation is the body’s natural response to infection, irritation or injury. It is not known what causes the costochondral joint to become inflamed, but in some cases it has been linked to respiratory infections and excessive coughing.

It is also not known how many people are affected by Tietze’s syndrome in the UK, but the condition is not believed to be common. Tietze’s syndrome is more common in young adults.

Tietze’s syndrome vs costochondritis

Tietze’s syndrome is sometimes confused with another similar condition called costochondritis. Costochondritis is also inflammation of the costchondrial joint, causing pain and tenderness, but there is no swelling.

These rest of these pages refer to Tietze’s syndrome, but the advice is also applicable to costochondritis.

Outlook

Tietze's syndrome tends to improve on its own after a few weeks. However, you may still have some swelling after the pain and tenderness have gone.

Many people can relieve the symptoms of Tietze’s syndrome themselves with rest and by using non-steroidal anti-inflammatory drugs (NSAIDs) to control the pain and swelling.

The symptoms of Tietze's syndrome can either disappear very quickly or come and go for several years.

The pain and tenderness associated with Tietze’s syndrome may come on gradually or suddenly.
Symptoms include:

• a sharp pain in your upper ribs
• tenderness around the area of your upper ribs
• swelling around the area of your upper ribs

Sudden movements of your ribs, during physical activity or when you cough or sneeze, may make the pain worse.

The pain of Tietze's syndrome may be confused with a heart attack. However, the pain of a heart attack is usually more widespread, while the pain of Tietze’s syndrome usually just affects a small area.

The cause of Tietze's syndrome is not fully understood, although it may be linked to:

• upper respiratory tract infections, such as sinusitis and laryngitis
• severe coughing, which strains your chest area
• injury to your chest
• physical strain from strenuous exercise

Tietze's syndrome tends to improve on its own after a few weeks, although you may still be left with some swelling after the pain and tenderness have gone.

Many people can relieve the symptoms of Tietze’s syndrome themselves with rest and by using non-steroidal anti-inflammatory drugs (NSAIDs) to control the pain and swelling. If pain is severe, a stronger painkiller such as a corticosteroid injection may be prescribed by your GP.

Rest

Tietze’s syndrome can be aggravated by any activity that places stress on your chest area, such as racket sports, athletics or simply reaching up to a high cupboard.

Any activity that seems to make the pain in your chest area worse should be avoided until the inflammation in your ribs and cartilage has gone down.

Non-steroidal anti-inflammatory drugs (NSAIDs)

The symptoms of Tietze's syndrome can be treated with non-steroidal anti-inflammatory painkillers (NSAIDs), which can help to relieve inflammation and pain.

NSAIDs include ibuprofen, naproxen and aspirin.
You should not use NSAIDs if you have asthma, high blood pressure, or kidney or heart problems. You should not take aspirin if you are under the age of 16.

Corticosteroids

In severe cases of Tietze's syndrome, corticosteroid injections may also be used to treat the condition.

Corticosteroids are medicines that help to reduce swelling and pain, and can be injected into and around your costochondral joint. Before having a corticosteroid injection, you will be given a local anaesthetic to numb the area around the injection.

Having too many corticosteroid injections can damage your costochondral joint, so you may only be able to have this type of treatment once or twice.