Sharp chest may not be heart issue

DEAR DOCTOR K: I’m a 38-year-old woman. I recently saw my doctor about a sharp pain that comes and goes in the middle of my chest. She assures me my heart is healthy. What could be causing my discomfort?

DEAR READER: The first thing your doctor worries about if you have chest pain is heart disease, which can be life-threatening. Fortunately, other, less serious conditions cause chest pain more often. But the first thing to be ruled out is heart disease, and it’s good news that it was.

So what caused your chest pain? There are many possibilities, but from your brief description I suspect a different culprit: costochondritis, an inflammation of the costochondral joints. These are the joints that join your ribs to your breastbone.

The main symptom of costochondritis is sharp, stabbing or aching pain along the front edges of the breastbone. The pain may may radiate to the back or abdomen or spread down the arm, one reason why it’s often mistaken for a heart attack.

Costochondritis often results from unusually stressful physical activity or traumatic injury. It can also be caused by respiratory infections, which can inflame the costochondral joints. Strain from coughing can produce the condition. In most cases, however, there is no obvious cause.

To diagnose the condition, your doctor will apply pressure to the joints where the ribs meet the breastbone, in the part of the chest where you feel pain. If that pressure causes pain, and pressure in other areas of the chest away from the joints does not, you probably have costochondritis.

Nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen and naproxen are usually effective. You can also try pain-relieving creams, which you apply directly on your skin. Cool compresses or heating pads and stretching exercises may help.With treatment, symptoms should begin to ease within a week. If your pain doesn’t respond to medications and conservative treatment, your doctor may suggest a steroid injection.