The inflammation explained

The Backpod: Lie back and treat yourself

The published medical research conclusively shows that costochondritis is NOT a systemic or auto-immune inflammation - no matter what you’ve been told by your doctors, specialists or the popular medical sites. 

A 1994 research paper in the American Medical Association Archives of Internal Medicine by Disla et al found no higher inflammation levels in the blood samples of a group of costochondritis patients compared to a group without costochondritis.  This is unequivocal.  That’s why just treating it like an inflammation does not work and does not fix it.

Yes, this is nuts.  The ‘-itis’ ending of the word ‘costochondritis’ means 'inflammation’.  That term started to be used for the problem back in the 1960s, for no justified reason - it used to just be called ‘chest wall pain’.  To busy doctors, it seemed like the word explained what the problem actually is, so they treated it like that.  And most still do.

The research confirms this is the wrong approach.  Of course it is - why should a general systemic inflammation (like rheumatoid arthritis or ankylosing spondylitis) cause such specific pain just at some rib joints on your breastbone and nowhere else in your body?  That just doesn’t make sense.

There IS some localised inflammatory response where your rib joints are straining onto your breastbone.  This is just like spraining your ankle and it then swelling up - it’s a normal body response to strain and injury. 

But it’s not a “mysterious inflammation” arriving for no apparent reason from a clear blue sky.  The rib joints round your front are moving excessively and straining simply because the rib joints round your back can’t move.

Anti-inflammatory diets, medications, and even steroid shots can help things a bit.  If you get your body's inflammation levels down generally, then that takes some of the heat out of the specific straining rib joints on your breastbone.  Also, if you have coeliac disease then a gluten-free diet will help, and if you're low in Vitamin D then correcting that with supplements will help that. 

But none of these things on their own will fix the ongoing straining at the specific rib joints on your breastbone - you do that by freeing up the tight rib joints around the back which are causing it. 

Cheeringly, this isn't usually difficult to do - it's a bog standard normal New Zealand manual physiotherapy problem with a clear treatment approach.  It's MUCH easier than trying to find the magic pill or potion that will somehow miraculously disappear this "mysterious inflammation" that nobody understands.