How to Permanently Fix Costochondritis
Key insights: 60-second read
- Costochondritis is often a symptom of hidden dysfunction around the back - the joint symptoms at the front are frequently a consequence of stiffness and restriction in the corresponding sections of the spine and rib cage at the back.
- A heightened nervous system plays a major role - stress, anxiety, and past trauma can keep your nervous system in a heightened state, amplifying pain and making it harder to recover.
- Deep breathing can down-regulate your nervous system - simple, slow breathing exercises can instantly reduce how heightened your nervous system feels, which can directly impact your pain experience.
- Posture is the missing piece - the positions you put your body in most throughout the day are often the root cause of the dysfunction that leads to costochondritis.
If you have costochondritis - or think you might have costochondritis, you'll know how painful and debilitating it can be. The sharp, stabbing pain at the front of your chest can feel overwhelming, and it often comes with a lot of anxiety - especially when you're unsure as to what is causing it or when it might go away.
In this article, I'd like to show you what you need to consider to give yourself the best chance of permanently fixing costochondritis. Let's talk about the potential hidden cause of your symptoms, share effective exercises to help resolve them, and explain why addressing your nervous system and posture is essential for long-term relief.
"The joint symptoms you feel at the front are very likely a consequence of the corresponding dysfunction through the sections at the back."
On this page
The Hidden Cause: Dysfunction Around the Back
Many people end up with a diagnosis of costochondritis through a process of exclusion. They have had their heart and chest checked out, and nothing has shown up. But what is crucial to understand is that the symptoms you feel at the front are very likely a consequence of dysfunction through the corresponding sections at the back.
How It Works
If the joints around your back become stiff, tight, and immobile, then anything along the course of those ribs can be left vulnerable to dysfunction. This is why treating the front alone may not work - you need to address any hidden restrictions at the back that could be asking your chest to compensate.
Ball Mobility Exercise
This exercise is designed to target the hidden restrictions around the back that may be contributing to your costochondritis symptoms.
How to Do It
- Take a ball - a tennis ball is a good starting point, especially if your pain is intense. A lacrosse ball can be used later when your tissue tolerance improves.
- Identify the level where your chest pain is worst. Come directly around to the back at that same level, then move up a little bit.
- Place the ball right in the middle, on the bumps down your spine, then let it roll off to the side slightly. This is where your spinal joints are.
- Compare left to right: You are looking for the side that feels stiffer, tighter, harder, or more restricted - not necessarily the most tender side.
- Let the ball press into the restricted areas for 30 seconds to a minute.
- Move the ball up or down, systematically working through each joint in the area.
- Once you have addressed the spinal joints, move the ball out to the side, between your shoulder blade and your spine. These areas are the ribs - they may feel more tender, but you are looking for the same stiffness and restriction.
The Role of a Heightened Nervous System
What Pain Really Means
One of the hallmarks of costochondritis is really intense, severe, and persistent pain. But pain does not just represent tissue damage. It represents your brain and nervous system's perception of threat.
This means your pain experience is heavily affected by everything else that goes on in your life - work stress, relationship stress, financial stress, past trauma, or any other factors that leave your nervous system feeling heightened and on edge.
If your nervous system is constantly in a heightened state, your body may not have the environment necessary to give your brain permission to calm down and decrease your pain. Costochondritis is often a mechanical compensation for dysfunction around the back, but it is also heavily influenced by how threatened and stressed your nervous system feels.
Key Insight
"If we are not also giving you something to down-regulate that nervous system at the same time, then we may be missing a crucial piece of the pain puzzle."
Deep Breathing Exercise
This simple deep breathing exercise can instantly down-regulate a heightened nervous system and give you a tool to manage your pain in real time.
How to Do It
- Find a comfortable position where you feel safe and able to relax.
- Take a deep breath in through your nose.
- Pause at the top for a moment.
- Fully exhale all the way out through pursed lips.
- Test yourself: Before you start, close your eyes and give yourself a number out of 10 for how heightened you feel (10 being the most stressed and on edge, 0 being the most relaxed).
- Cycle through 10 slow, deep breaths.
- Recheck your number. You should feel less heightened and more calm.
Why This Works
This breathing pattern prompts your nervous system to relax. It shifts your body out of the "fight or flight" response and into a more restful state. If you find that this exercise helps reduce your pain, it is a sign that your nervous system is a significant contributor to your symptoms.
Tip: Do this consistently throughout the day, not just when you feel symptomatic. By getting ahead of your symptoms, you can prevent your nervous system from reaching a heightened state in the first place.
The Role of Posture
Why Your Posture Matters
- Your symptoms did not appear out of nowhere. They are the result of a "death by a thousand cuts" - small, repeated loads that built up over time until you reached a threshold your body could no longer tolerate.
- The culprit is often your day-to-day shapes. Sitting at a computer, using a phone, relaxing in a recliner, or standing and bending over all create sustained load through specific parts of your spine and rib cage.
- If you do not address these postural habits, the work you put into your tissue may not be permanent. The stiffness will keep coming back because you keep putting your body into the same shapes that created it.
- Solution: Be up taller with your shoulders comfortably back. Then, arrange your environment to support this shape - bring your keyboard closer, adjust your screen height, and set up your workspace so you are not constantly being dragged out of a good position.
"If you aren't taking the time to improve your postures and shapes to better load up those areas, then it may be unrealistic to expect that the work you are putting into that tissue will be permanent."
The Bottom Line
Costochondritis is a complex condition that requires a multi-faceted approach. The pain at the front of your chest is often a symptom of hidden dysfunction around the back, and it is heavily influenced by how threatened and stressed your nervous system feels.
By addressing the mechanical restrictions in your back with targeted mobility work, down-regulating your nervous system with deep breathing, and correcting the postural habits that created the dysfunction in the first place, you can give yourself the best chance of permanently resolving your costochondritis symptoms.
Remember: the work you put in today is not just about relieving pain in the moment - it is about creating an environment where your body can heal and stay healthy long-term.
I hope this article helps you understand and manage your costochondritis. If you have a different issue, or simply want to learn more about how your body moves, head over to the Your Wellness Nerd YouTube channel. Subscribe if you feel inclined, and let me know in the comments what you would like me to cover next.
- Grant
Frequently Asked Questions
What is costochondritis and what causes it?
Costochondritis is inflammation of the cartilage where your ribs attach to your breastbone. It often causes sharp, stabbing chest pain that can be mistaken for heart problems. The condition is frequently caused by hidden stiffness and restriction in the corresponding joints around your back, combined with a heightened nervous system and poor posture.
Why does costochondritis hurt so much?
Costochondritis can be intensely painful because the pain is amplified by a heightened nervous system. Your brain and nervous system perceive the mechanical irritation as a significant threat, which increases your pain experience. This is why addressing stress and down-regulating your nervous system is an essential part of recovery.
How long does costochondritis take to heal?
Recovery time varies depending on the individual, the severity of the condition, and how consistently you address the contributing factors. With a comprehensive approach that includes mobility work, nervous system regulation, and posture correction, many people see significant improvement within weeks to months.
Can stress make costochondritis worse?
Yes. Stress keeps your nervous system in a heightened state, which amplifies your perception of pain. If you are stressed, your body is less able to calm down and repair. Managing stress through breathing exercises, mindfulness, and lifestyle changes is crucial for recovery.
What should I do if the ball exercise makes my pain worse?
If the ball exercise increases your pain, ease off immediately. You may need to use a softer ball or less pressure. The goal is to gently encourage the tissue to release, not to push through sharp pain. The trick is locate areas of tightness - not just spots that hurt. Ideally, you want the ball to free up any restricted spots, not just irritate the already irritated ones. If the pain persists, consult a physiotherapist for a personalised assessment.
One key insight
"Costochondritis is often a mechanical compensation for dysfunction around the back, heavily influenced by how threatened and stressed your nervous system feels. Addressing the mechanical restrictions, down-regulating your nervous system, and correcting your posture is the key to permanent relief."
Living With Persistent Chest Pain?
If your pain has lasted longer than expected, feels disproportionate, or hasn't responded to standard treatment, you may benefit from a broader approach. Learn more about our costochondritis physiotherapy services in Port Macquarie.
Want personalised guidance?
If you would like help making sense of your aches, pains, or ongoing symptoms, you can book with Grant either in Port Macquarie or via an online telehealth consultation.
