After having had an extreme spike in chest pain this week, I used my costochondritis hacks to get rid of the pain in a couple of hours, and made sure it didn’t come back.

This time, my costo has flared thanks to an increase in activity, especially a physio-gym routine and taking on some more photography jobs.

I’ve had costochondritis on and off since I was 13 or so - 25+ years. I probably won’t ever get rid of it as it’s a common co-morbid illness with fibromyalgia.

In the last decade, I haven’t been able to take the normal strong anti-inflammatory medications that doctors usually prescribe for costo flares - NSAIDs are off limit when you don’t have good kidneys.

Doctors don’t have any suggestions, apart from the NSAID medications. So, I’ve had to develop a lot of small ‘hacks’ to both deal with the pain of a flare, and prevent them from occurring.

I need to take more care when the weather changes drastically, from wintery weather to summer heat, and the reverse.

Important - When the costochondritis attacks, it can feel like a heart attack. If you have not experienced it a number of times, please do go to an emergency department to rule out your heart as the problem.

When the costochondritis pain spikes

  1. Heat packs, front and back. Try to use wheat, rice or some other filled fabric packs - I've found that mud or gel filled plastic packs aren't as good - perhaps because the non-plastic packs hold more damp heat?
  2. Sit up or stand straight. Spikes typically hit when I'm lounging on the sofa, with a closed chest. And our immediate response is to close in around the painful spike, but that actually makes it worse!
  3. Breathe deeply and slowly. When a spike hits, you can't breathe - it's simply too painful. But that's the best way to calm down the nerves and spasming muscles. Start to breathe slowly, even if you can only manage shallow. Deepen your breathe over time (I find it easier to start to belly breathe, and then add full-lung breathing when the pain has subsided).
  4. Sleep with an open chest. Hug a pillow to keep your arms (and chest) open, lie on a pillow on your back. Recently, I've found lying face down on a pillow, which also props up my shoulders so they aren't closed, works strangely well.
  5. Lightly massage the painful spots. Mostly to calm the nerves and muscles back down.
  6. Use an anti-inflammatory. If you can, use a light NSAID, like ibuprofen or Voltaren gel, to reduce the inflammation quickly, before it sets in for the long haul.

Sometimes, walking gently around my living room can help calm a bad flare down to a level where I can sit with the heat packs.

Preventing a costochondritis flare

No uneven carrying. Shopping bags, backpacks must be evenly distributed. Sling and one-shoulder bags must be avoided.

No heavy loads. Make more trips when carrying shopping bags, and don’t overload your backpack.

No twisting under load. This is probably the worst - don’t try to pick up something that’s on one side of your body and bring it to the front or sling a bag onto your back - that’s a guaranteed trigger! Face the things you want to pick up straight on.

This may also apply to opening heavy doors (the common type here in Europe) - pull them a little bit open then use your hips and legs instead.

Even opening jars - get a tool to make it easier.

No strong reaching. I’m short. At least, in this country I’m considered short. If I reach for things on the top shelf in the fridge (uneven reaching), or in the kitchen cupboards, I almost always feel a costo twinge. Instead I have to use a step ladder.

Change activity levels or types gently. If you know you will have a higher work or study load, or if you are starting a new physical therapy or class, do it slowly. Ramp up. Or down, if you are finishing something. Any sudden changes in activities can trigger a costo flare.

Maintain decent posture

The costochondritis always seems to hit me when I’ve been slouching. The worst is the slumped over a mobile phone or tablet posture, with tension in the arms and chest as you tap at the screen.

Do chest opening exercises daily. Stretch your chest and shoulders in doorways as you walk through them. There are many exercises and stretches that help prevent costochondritis.

Loosen your shoulders and neck. Because the top of my spine is screwed up (love that C2!), I see a physiotherapist regularly. Recently, she’s been working on my shoulders and upper back, and my chest has felt a lot looser - the costo has been more manageable. Get a semi-regular massage or treatment for solid shoulders/upper back may help prevent a flare.



When we are stressed, upset or angry, we close our posture in around our core. We slouch, our head falls forward under the weight of our stress. We breathe shallowly, and hold a lot of tension. We sleep poorly. This is the ideal body and mind state to trigger a costochondritis flare.

Plus, it means we deal worse with the flare when it happens.

Over time, work to reduce the stressors in your life - appointments, work or study load, toxic friends, debt, social ‘demands’ (not the things you really enjoy), other tasks or things you hate. Reduce clutter - it reduces stress! Keep your home clean with a basic cleaning routine, spread out over the week.

Establish some new relaxing habits

  • Meditation has been shown to reduce pain.
  • Go for a walk, preferably in a nature-rich area, . This is both relaxing and improves blood flow (and healing).
  • Take up a gentle hobby that relaxes your mind yet doesn't physically over-stress your body.
  • Try a relaxing night-time ritual to get more sleep - a bath, no screens, and a relaxing scent.

Your costochondritis hacks?

What things do you do that can drastically reduce or stop a flare? Or prevent one from happening?