Pain After Breast Cancer: Costochondritis

Pain after Breast Cancer: Costochondritis

Is pain after breast cancer normal?  The answer to this question is often vague. For many women, pain is a normal part of recovery after breast cancer treatment.  But for some women, persistent pain after breast cancer may be due to costochondritis.

Costochondritis can be difficult to diagnose, and finding the cause of chest pain is not always a straightforward process. One patient who developed costochondritis described her experience:

“I complained about discomfort and pain in my chest to my oncologist, and he ordered an ultrasound. It showed that the cartilage between my ribs was lumpy and close to the skin. My doctor said it wasn’t anything to worry about because it had been there since my mastectomy. When I asked my surgeon about it, he said it had probably been there forever, but now that my breast was gone, I could feel it. But I did worry because it was below the area where my multifocal tumors had been.”

Because her pain persisted, she continued searching for an explanation. Eventually, she discovered that the source of her discomfort was costochondritis—a condition that can cause significant chest pain but may be overlooked or mistaken for other causes.

What is Costochondritis?

 

Costochondritis is inflammation of the cartilage that joins the ribs to the breastbone (called costal cartilages). Also known as "anterior chest wall pain", it causes discomfort in the chest wall around the breastbone or sternum and pain can range from mild to severe.

What does Costochondritis feel like? 

Costochondritis is not uncommon in women who have been affected by breast cancer.  Costrochondritis pain acts up in a way similar to arthritis and, likewise, can range from mild to severe.   There may be tenderness over the anterior chest and pain may radiate to the back, shoulders, stomach or arms.  Flare ups can be triggered by over-working your arms, lifting, sweeping, or over extending and is aggravated by coughing, lifting, straining, sneezing and deep breathing.  Pain can be constant or intermittent and can last for several days, months or years.

Costochondritis or Tietze Syndrome- How do I know? 

Tietze Syndrome is a less common condition that causes localized pain and inflammation where the ribs connect to the breastbone (sternum). It is similar to costochondritis but is distinguished by visible or palpable swelling around the affected costochondral joints. The area may be tender or painful to the touch, and in some cases, the overlying skin may appear red or feel warm. Tietze Syndrome most commonly affects the upper ribs and may cause discomfort that worsens with movement, deep breathing, coughing, or pressure on the affected area.

Physical and Occupational Therapy for Costochondritis

Treatment for costochondritis is generally focused on reducing pain and inflammation while allowing the irritated tissues around the ribs and chest wall to heal. Because symptoms can resemble other musculoskeletal conditions, such as arthritis, treatment is often individualized based on the severity and underlying factors contributing to the pain.

For many people, symptoms improve with a combination of relative rest, physical therapy, pain-relieving medications, and anti-inflammatory medications. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil or Motrin) or naproxen (Aleve), may help reduce pain and inflammation. However, these medications are not appropriate for everyone, so patients should check with their healthcare provider before using them, particularly if they have a history of stomach ulcers, kidney problems, cardiovascular disease, or take other medications that may interact with NSAIDs.

Physical therapy or occupational therapy can be an important part of treatment, particularly when muscle tension, joint stiffness, posture, restricted chest-wall movement, or breathing mechanics contribute to symptoms. Depending on the individual, treatment may include ice or other pain-relieving modalities, gentle thoracic and rib mobilization, soft-tissue techniques, breathing exercises, posture education, and stretching to improve mobility and reduce tension throughout the chest, upper back, and shoulders. A therapist can also help identify movements or activities that may be aggravating symptoms and develop a gradual plan for returning to normal activities.

For individuals with persistent or severe pain that does not respond to conservative treatment, a healthcare provider may consider additional options, including corticosteroid injections or other targeted injections. Surgery is rarely necessary and is generally reserved for unusual cases that do not respond to other treatments. Because the effectiveness of these more invasive approaches can vary, they should be considered carefully with the appropriate healthcare professional.

The good news is that most cases of costochondritis can be managed conservatively, with treatment aimed at controlling symptoms, restoring comfortable movement, and addressing factors that may be contributing to the irritation.

How to Get Treatment for Costochondritis

At Therapy Achievements, we specialize in treating pain, stiffness, and mobility limitations that can occur during or after cancer treatment. Our physical and occupational therapists have advanced training in manual therapy and other techniques designed to help reduce pain and swelling, improve flexibility, and restore comfortable movement. 

If you are experiencing persistent chest pain or other symptoms that may be related to costochondritis, talk with your healthcare provider about whether therapy may be appropriate for you. To learn more or schedule an appointment with Therapy Achievements, call (256) 509-4398.