Costochondritis or Cancer? Chest Wall Pain Explained

This page is for anyone with a sore spot on the chest wall who is worried it could be cancer. It explains costochondritis, other causes of chest pain, and when to get help.

Costochondritis is inflammation of the cartilage that connects a rib to the breastbone, and MedlinePlus calls it a common cause of chest pain. MedlinePlus says that if the area where the ribs meet the breastbone is tender and sore, costochondritis is the most likely cause. Still, chest pain is never a symptom to shrug off. MedlinePlus says the pain of costochondritis can be similar to the pain of a heart attack. A provider needs to examine chest pain.

The ribs attach to the breastbone through pieces of cartilage, which is firm, flexible tissue. When that cartilage becomes inflamed, the result is costochondritis.

Often there is no known cause. MedlinePlus lists several possible triggers: an injury to the chest, hard or strenuous exercise, a viral infection, and strain from bouts of coughing. MedlinePlus also names infections after surgery as a possible cause.

The pain has a recognizable pattern.

• It is sharp and felt at the front of the chest wall. It may spread toward the back or belly.
• It gets worse with a deep breath or a cough.
• There is tenderness when you press the spot where the rib joins the breastbone.
• It eases with rest and quiet breathing.

That last exam finding matters. Pressing on the joint and reproducing the pain is how a provider recognizes costochondritis.

Cancer pain does not have one single pattern, so the honest answer starts with context. NCI is direct about it: symptoms like these are most often caused by illness, injury, benign tumors, or other problems. A benign tumor is a growth that is not cancer.

NCI adds a point that cuts the other way. Often, cancer does not cause pain, so do not wait to feel pain before seeing a doctor. In other words, pain is neither proof of cancer nor is its absence proof of health. For general symptoms, NCI asks you to watch persistence: if a symptom does not get better after a few weeks, see your doctor so problems can be found and treated early. Do not wait that long with chest pain. See the section below.

Costochondritis usually follows the opposite course. MedlinePlus says the pain often goes away in a few days or weeks, though it can take up to a few months. MedlinePlus lists avoiding activities that make it worse, hot or cold compresses, and over-the-counter pain relievers. Ask your provider before taking any pain reliever, because some people should not take ibuprofen or naproxen.

So the practical difference is behavior over time. A tender spot that eases with rest and fades over weeks fits costochondritis. A change that persists, returns, or comes with other unexplained changes deserves a visit. Our page on cancer symptoms covers the changes doctors want to hear about.

MedlinePlus groups the causes by body system, and most have nothing to do with cancer.

• Heart and blood vessels. Angina or a heart attack, which can feel like tightness, heavy pressure, squeezing, or crushing pain. Also pericarditis, which is inflammation of the sac around the heart.
• Lungs. Pneumonia can cause sharp pain that worsens with deep breathing or coughing, and pleurisy usually feels sharp too. A blood clot in the lung or a collapsed lung can also cause chest pain. Sudden sharp pain with shortness of breath needs 911.
• Digestive system. Heartburn, spasms of the esophagus, gallstones, and stomach ulcers.
• Muscles, bones, and nerves. Costochondritis, strained muscles or tendons, and shingles.

This is why a provider may order a chest x-ray or other tests even when costochondritis seems likely. Tests help rule out serious causes such as heart and lung problems.

The visit usually starts with an exam. Tenderness when the provider presses where the rib joins the breastbone supports costochondritis. The story matters too: recent coughing fits, new exercise, an injury, or a viral illness all point toward an inflamed joint.

If the pattern does not fit, or if anything suggests the heart or lungs, tests come next. Getting checked is not overreacting. It is how a cause gets found and confirmed. If a symptom still worries you after a normal visit, say so. Our guide a symptom is not a diagnosis explains how to ask for a clear follow-up plan.

Chest pain should not wait for a scheduled visit. MedlinePlus gives clear lines.

• Call 911 or go to the emergency room right away if you have new chest pain. MedlinePlus says the pain of costochondritis can be similar to the pain of a heart attack, so do not decide the cause on your own. Do not drive yourself.
• Call 911 if you have sudden crushing, squeezing, tightening, or pressure in your chest; pain spreading to the jaw, left arm, or between the shoulder blades; or pain with nausea, dizziness, sweating, a racing heart, or shortness of breath.
• Call 911 if sudden sharp chest pain with shortness of breath starts, especially after a long trip, bed rest, or other time without moving, or if one leg is swollen. This can signal a blood clot that has moved to the lung.
• Call 911 if you know you have angina and the chest discomfort is suddenly stronger, comes on with lighter activity, lasts longer than usual, or happens at rest.
• Call 911 if you have trouble breathing, gasping, or a feeling that you cannot get enough air (MedlinePlus).
• Contact your provider right away if you have a fever or are coughing up yellow-green phlegm, if severe chest pain does not go away, if you have trouble swallowing, or if any chest pain lasts longer than 3 to 5 days.
• If costochondritis has been diagnosed, call back right away if the pain gets worse or keeps going after pain medicine, you feel sharp pain with every breath, or you see pus, redness, or swelling around your ribs.
• If you are getting chemotherapy, a temperature of 100.4°F (38°C) or higher means you should call your care team right away, day or night. Do not wait to see if it passes. Chills or other signs of infection need the same right-away call, even without a fever (CDC).

NCI says any symptom that has not improved after a few weeks needs a visit. That is the outer limit for general symptoms. For chest pain, use the shorter steps above.

• Costochondritis — MedlinePlus Medical Encyclopedia
• Chest pain — MedlinePlus Medical Encyclopedia
• Breathing difficulties - first aid — MedlinePlus Medical Encyclopedia
• CDC — Watch Out for Fever (Preventing Infections in Cancer Patients)
• CDC — Signs and Symptoms of Infection (Preventing Infections in Cancer Patients)
• NCI — Non-Small Cell Lung Cancer Treatment (PDQ), signs and symptoms
• Symptoms of Cancer — National Cancer Institute