Costochondritis II – The wicked itch is almost dead

SternumIt’s time I revisited my previous costochondritis posting as it has been a while since I posted it and its well overdue an update.

It has been over 4.5 years since I was first diagnosed with costochondritis  in my sternum after heavy labour in the garden. It has certainly proven to have been a very long drawn out recovery.  The recovery seems to go on like a logarithmic decay graph with a never-ending tail.

The main symptoms vary between achy pain in the sternum area (a bad flare up) and a very itchy, achy feeling that actually results in a lot of scratching!

For a long time I had been getting on with life, but with a lot of pre-planning of my activities around what I could do (without triggering a flare up) and apportioning accordingly. The activities I knew would strain the chest more I either put off or scheduled for another time when I would be less busy.  Its all been about pain (and itch) flare up management over the last 4+ years.

I started off by using Devil’s Claw (as I couldn’t use ibuprofen due to stomach irritation), taking two capsules once a day. This helped reduce the symptoms to a certain level, but I stopped taking it about a year ago due to other side effects. I had also used (and still do) a pillow to ‘hug’ in bed every night which keeps the sternum area from compressing in on itself, allowing it to rest and heal.

The problem with this condition is the lack of blood supply to the sternum area and hence the long, drawn out healing time.

I am a physically active person. I kayak a lot, I do cardio workouts on a static bike and an elliptical trainer and I also do yoga. I have generally found these activities to be tolerable with costochondritis (except for the arm action on the elliptical which I sometimes have to forego). I have to take it easy with certain yoga poses, again scheduling practice around other activities to avoid  overuse. I always found kayaking to be quite beneficial, but didn’t really know why. I assumed that it just wasn’t straining the chest area.

At the start of 2013 I was still having bouts of itchy costochondritis and was getting quite fed up with it. I visited my GP and mentioned to him that I still had this itch going on and he advised me to continue with physiotherapy exercises (which I admittedly hadn’t been doing for a while). Having had the condition for 4 years, I contemplated that the underlying bad injury was likely healed, but just hoping the rest of the symptoms would go away wasn’t working, so I began to consider what else I could do.

As a result, for the last 2.5 months, I’ve embarked on a fitness programme to try to get myself into better physical condition. It’s been challenging for a long time to do this with costochondritis, as upper body workouts have previously been very limited apart from kayaking. As part of the  fitness program I have introduced swimming as a regular (2-3 times a week) activity. My GP had said a long time ago that swimming was good for costochondritis, but I’d always been too lazy to drag myself along to the pool.

So now I’ve been swimming, and added 3-5 mile runs and cycling, on top of kayaking, and I am also starting to do some light weight training workouts too. The swimming is proving to be very beneficial to the condition, and I have good, healthy “used muscle” feelings around the back between the shoulder blades and across the shoulders and chest too. It hasn’t aggravated the costochondritis, and has taken the itch away most of the time (which is a fantastic feeling after all this time!).

I am attributing a lot of the improvement to the shoulder muscles being fitter and stronger (especially the group of muscles between the shoulders). I suspect that this is what naturally pulls the sternum to be more open, taking a lot of the  pressure off of the area that an unfit shoulder’s forward, slouched position produces. I also suspect that this is the reason that kayaking has been good for it too.

As a bonus, I’ve found that I can enjoy swimming as an activity, and am currently swimming to 2.5km in the pool 2-3 times a week.

The wicked itch is not quite dead, but I have a full grip around it’s throat and am not letting go until it is!

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  1. Barold says:

    Reading this article and the previous one has been very informative, but definitely disheartening. I started getting symptoms a couple weeks ago after working on my car. Went the clinic to get xrays to make sure I didn’t fracture anything and was not having a heart attack. Heading to a more specialized doctor soon. I have a very obvious bump between my second ribs on my sternum, one rib is getting pushed outward while the other is being pushed inward. Hearing about the itch is interesting and I hadn’t read that elsewhere. I definitely had that for a while before I got any of the real pain I am in now. Last summer was kidney stones, this summer its this. Ugh.

  2. Rick says:

    I know this is an old article, but it is the best I have found on this subject. I hope someone is still manning the post.

    I have one very important question, do you get any relief when you raise your arms/elbows above your shoulders? Thank you for your time.

  3. alanf says:

    Hi Rick,

    yes I’m still manning the comments. I can’t say I’ve every tried relief by raising my arms above the shoulders so the true answer is “I don’t know”.
    However relief can be found from opening the chest so maybe this applies here. I mean by sort of pulling the arms back (tightening the muscles between your shoulder blades).
    I had a lot of residual for a very long time and I thought I would never go away, but swimming was great for it as was upper body (core conditioning)
    you can look up some core exercises online. However be careful as too much too soon after the injury can definitely set you back.
    I still hug a pillow every night to keep the chest open and it helps a lot.


  4. Rick says:

    Thank you very much for the quick reply, Alan. I do spread the chest by pulling my arms wide apart and that does bring some relief, but lifting my arms and elbows above my shoulders is my best remedy. If I take my right or left hand and rest it on the other shoulder, I also get relief. I’ve been going to physical therapy for about a month and sometimes it helps a lot, but the pain comes back usually the next day. I have some stretches that I do daily for the upper chest and exercises for my core that I hope are the final remedy. This all started about a year ago, but didn’t get to this level till the last 4 months.

    Thanks again, Alan for posting this info and for maintaining it as well.

  5. alanf says:

    My advice – 1. don’t over do the exercise. You may be pushing things too much. 2. Hug a pillow in bed, it the biggest single thing that helped me. 3. Try swimming it made a big difference to me to clear up the residual stuff.


  6. Rick says:

    Thank you, Alan. I meant to tell you about the pillow hug, as I’m a side sleeper and sometimes wake up very sore. I’ll be hugging a pillow tonight friend. I’m sure my wife will understand. I have been going very light on the exercises and my PT seems to have a good handle on the problem areas. Shoulders, especially between the shoulder blades and the use of a stability ball for core strengthening. I’ll have to look into swimming. Haven’t done that in quite some time. Thanks again for your time, Alan, it’s very much appreciated.

  7. sharlene says:

    How are you going? Thank you for this informative post. Such a wicked condition this is. My 13 year old son was diagnosed 3 days ago after suffering for 8 weeks, 5 hospital visits, xrays, ultrasound, blood tests, massage, and at least 25+ drs with drs surgeries and hospital visits, finally we had a diagnosis. Living with constant heart attack pains he can’t sleep, go to school, play computer games, he can’t do anything except exist. Such a depressing and unfair condition. So cruel.

    I am going to demand oral steroids tomorrow at the GP surgery. He as prescribed low dose aspirin (in a high dose) 3 times per day, but it doesn’t seem to be doing anything. Panadeine just causes stomach upset. Oral steroids will cause reflux, and gastric problems, but I feel there is no other choice. Did you try oral steroids? If so, what was your experience with them?

  8. alanf says:

    Hi Sharlene, I didn’t try any steroidal meds for the condition all. Hopefully at 13 your son is young enough to have a complete recovery. Just rest it for a while and avoid anything that upsets it fro about 2-3 months then rehab. Swimming is good for rehab.

  9. Chris says:

    I’ve been suffering from costochondritis (or something similar) for about 2.5 years and I recently discovered that caffeine makes it much worse. By simply cutting caffeine out of my daily routine I was able to go from regular pain to infrequent bouts of pain at the end of a day. I think the pain at the end of the day is purely due to tiredness, having been working all day.

    The reason caffeine is so bad for costo is because it causes the chest muscles to strain. Ginger tea or simply eating raw ginger is also a good remedy as it is an anti-inflammatory.

    Today I’ve been swimming and the sharp pains have come right back. Later on I’ll probably get the tense feeling that means I need to pop my chest by stretching my arms out behind me. This relieves the pain.

    It seems like it’s a long road to recovery and any physical exercise involving the chest can be a set back. Climbing is the worst! However, I believe it will go away eventually.

    Hopefully these tips are of some use.


  10. alanf says:

    Some interesting tips there, thanks for sharing. It is a long road to recovery. I still have minor symptoms on an off now several years later. The condition requires physio exercise to rehab, and keep it at bay. You are right though too much and it just gets aggravated again in my experience.
    There are things I just avoid/minimise doing. Carrying extremely heavy loads even for short distances is one of those things.


  11. Elaine says:

    Hi Alan,

    Thank you for all of the information. I have had chest pain and the deep itch for a couple of years now. Just over the past 6 months or so it has gotten much worse. I also experience the terrible itch and your posts are the first that I’ve read about someone else having that symptom. My GP diagnosed me with costo in May of this year and started me on Celebrex. It does help dull the pain but that nasty itch is still present (especially at night). I like your idea of sleeping with the pillow and I am going to try that. I haven’t been to workout in a few weeks and it’s bringing me down but I know that is probably making it worse. By the way, have you felt any kind of numbness on your chest or discomfort just from clothing rubbing? I find that just having the seatbelt pressure against my chest is very irritating. Thanks!!

  12. alanf says:

    Hi Elaine,
    you are welcome. It’s a weird condition. Best thing for it was swimming. other than that just time, pillow hugs at night and symptom relief. Yes I was thinking it was just me with the itch. It is weird isn’t it? I didn’t have any numbness or discomfort from clothing or seatbelts. Just by compression of the sternum area for instance by sleeping on side without hugging pillow or sitting slouched forward with drooping shoulders. That and carrying too heavy objects. That needs to be avoided at all costs during the healing phase.

  13. Elaine says:

    Thank you for your quick reply! I have read a few posts from people stating that caffeine (coffee) made their costo worse. Have you had any experience with that? That is, of course, if you are a caffeine drinker. I do limit my coffee to a couple of cups in the morning and just cannot see giving that up! I am seeing my GP tomorrow just to rule out anything other than the costo. I recently took a trip and was lifting my suitcase more than I should have and I think that flared it up again more than usual. I have resigned myself to no more heavy lifting until I get this under control. Thanks again for your response and for this very helpful blog!

  14. alanf says:

    Yes avoid heavy lifting until it settles at all costs! Swimming and light weight training can help it heal. Physio band and work too. Boring activities, but they do work.
    Itch can be relieved by Devil’s Claw herbal supplement, but read over any side effects before using. Other than that hugging the pillow at night is the best bet.

  15. Chris says:

    Elaine, I posted about caffeine affecting me. I only drink one cup in the morning and I still noticed the benefits of coming off it. I’ve lapsed back into drinking a cup in the morning and when I combine this with a tea in the afternoon it can be agony.

    It sucks, I know.


  16. Anthony says:

    Great site for information. I got it two weeks ago just sitting on a couch and went to the ER where i was diagnosed with it. Over the next two days it turned into a very dull ache and right now (two weeks later) it has become barely noticeable unless i bend over for something but i do feel a slight itch here and there. Did that ever happen to you when you bent over? I saw a naturopathic doctor who said I should go to a chiro to make sure it’s not a rib displacement.



  17. Lincoln says:

    Hi all

    Finally an interesting and helpful read. I have had costo for about 3months now, did the heart attack check at the hospital along with all the other tests and then then my GP gave me the result. Its horrible, i have gone from being really active to almost non active apart from light duties. So i have waited for xmas to pass whilst i took on extra rest time and have been trawling the net looking for the best rehab exercises, swimming was top of my list to start of with, my question is, which are the best strokes to start with and for how long to start off with?

    any other help on exercises is most welcome.

    Thank you, lincoln

  18. alanf says:

    Breast stroke probably best. It’s a more leisurely pace. How long depends on what stage of the injury you are at. Let your body tell you when you are doing too much. I’d start off with short swims if you are in recent recovery. Therabands are good for Physio too. Again, don’t start using the strongest bands. The physio exercises with bands are similar to those prescribed for rotator cuff injuries. All of these are very mundane, but are very good for this condition.


  19. Lincoln says:

    Hi Alan.

    Thanks for that. As for what stage i am at, hard to tell, that horrible dull background pain is there nearly all the time or I may get a few spikey jabs during my working day, all manageable though. During anything to physical does make the ache far more present and nearly to have a rest point, which is what i do.

    As for the bands i bought a set over christmas with different stages packed in there, so it will be light to start of with.

    I figure the swimming will also help my lower back and shoulders now because they are as stiff as a board. How does the pillow thing work, my costo is on my left hand side which by sods law is the side i sleep on.


  20. alanf says:

    I used the pillow to avoid chest compression whilst lying on my side. (I had the costo on both sides). I couldn’t choose which side was best.
    I’d say try the pillow and try sleeping on either side and you will likely find what works for you. The main thing is to avoid compression in the sternum area overnight, which the pillow does well even when lying on your sides.


  21. Dayle says:

    Just thought id post after reading about everyones experience with this.

    I wont go into detail but mune started just over 2yrs ago, did all tests etc…

    Anyway, it does get you down and i was taking Anti inflammatory tablets and using gel for a long time when the pain was there which was almost daily, id have a week or two where it seemed to get better and then it would flare up.
    I still have it but no where near as bad as it first was, i started taking Red Krill oil tablets, Glaucosomine and Chondrotin (sp?) whether it has helped or just got better by itself im unsure but i still take one or two daily.

    I haven’t really made any lifestyle changes although i havent used my weights since it started and im kind of afraid to get back into golf incase it gets worse again, but im sure at some point i will.

    I still get soreness now but applying gel on the area normally clears it up and being in the wrong position i can feel a little discomfort. One thing i did try and do through all this and i still do is to use a pillow to hug when sleeping, i am certain that sleeping in certain positions makes it sore the following day.

    But anyway whether i will fully get over this i hope so, i decided to be positive one day and not let it get me down, and since then it seems to have gotten better. I do things as i normally would and have just spent 18weeks renovating my house with no big issues, its been sore a few times but nothing major.

    Try and keep positive and not let it affect you too much, theres not much you can do about it so dont let it get you down too much.


  22. Susanna says:

    So glad to find this!! I have had chronic Lyme disease for over 30 years, diagnosed with Costo about 5 years ago, though I think I have had it for 10,( always freaked me out, thought it was breast cancer). For the last 2 years, I have had an itchy sternum, comes and goes, mostly after I have worn a bra. I know my costo gets inflamed from stupid, awful BRAS! Tried every kind of ointment to relieve the itching, but there was never redness, swelling or rash. An inner itch, that’s what it feels like and burning and some pain. Of course it would be Costochondritis! So happy you started this best info I have found, many thanks, Susanna

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