As a GP, I know that chest pain is one symptom that makes people worry. The immediate concern is that it’s a sign there’s something seriously wrong – such as a problem with their heart or lungs.

But these aren’t the only reasons that chest pain can happen. For many otherwise healthy people, especially those who exercise regularly, the sudden onset of chest pain may actually be caused by a painful, yet generally harmless, condition called costochondritis.

Costochondritis occurs when the tissue connecting the ribs to the breastbone becomes irritated. This causes pain at the front of the chest, usually close to the breastbone. Patients describe the pain as sharp, aching or sore, and it’s often aggravated by stretching, twisting, exercise, coughing or taking a deep breath. The area is frequently tender to touch and pressing on it can cause pain.

Costochondritis is thought to be the cause of approximately 13% of GP visits for chest pain. The condition is diagnosed based on a person’s symptoms and examination.

There’s no specific blood test or scan that can confirm costochondritis. Instead, the diagnosis is usually based on a person’s symptoms and a physical examination. However, tests such as an electrocardiogram (ECG), which records the heart’s electrical activity, or a chest x-ray may sometimes be needed to rule out more serious issues. This is particularly important in people aged over 35 years and those with a history of, or risk factors for, coronary heart disease.

What causes costochondritis?

The exact causes of costochondritis aren’t always clear. It’s often linked to strain affecting the area where the ribs join the breastbone.

For many people, the condition is triggered by repetitive physical activity or overuse of the upper body. Weight training, rowing, heavy lifting or exercises involving repeated pushing and pulling movements can place extra stress on the chest wall.

The risk appears to be greatest when exercise intensity increases too quickly. A sudden jump in training volume, frequency or the weight a person is lifting can overload tissues that haven’t had time to adapt.

Costochondritis can also happen after a minor chest injury – such as a fall or a blow sustained during contact sports. Another common trigger is persistent coughing. This places considerable strain on the chest wall’s muscles and tissues, which is why some people develop costochondritis during or after a heavy cold or chest infection.

How can it be treated?

Understanding what triggered costochondritis is an important part of recovery. Most cases improve with simple self-care measures. The first step is usually trying to temporarily avoid or reduce the activities that provoked the pain – particularly heavy lifting and repetitive upper-body exercise. You should avoid these activities until the pain settles.

Anti-inflammatory pain medicines, such as paracetamol and ibuprofen, can also help reduce symptoms where suitable. Many people also find that applying a heat pack or warm compress helps ease discomfort.

As symptoms begin to settle, gentle chest, shoulder and upper back stretches can help improve mobility and prevent stiffness. For instance, the thoracic extension exercise, in which a person stretches their back over a low chair while their hands are placed behind their head, showed benefit for some patients.

Costochondritis often improves on its own. Symptoms may last for a several weeks or several months, but most people make a full recovery within a year.

Can costochondritis be prevented?

It’s not always possible to prevent costochondritis, but a few sensible precautions can reduce the risk. If you’re starting a new exercise programme or increasing your weights, build up gradually and give your body time to adapt. Good lifting technique, whether in the gym or at work, can also reduce unnecessary strain on the chest wall.

It’s also important to avoid overtraining. Exercising too hard, too often or without adequate recovery increases the risk of overuse injuries, including costochondritis. Rest days are not a sign of weakness; they are part of training.

Don’t forget stretching. Regular stretching can also help maintain flexibility and mobility in the chest, shoulders and upper back.

Most importantly, don’t ignore pain. If your chest wall starts hurting during exercise, resist the temptation to push through it. Continuing to strain irritated tissues can prolong symptoms and delay recovery.

Costochondritis can be painful and worrying, but it’s usually not a serious condition. Just make sure you don’t dismiss any chest pain you’re experiencing or assume it’s costochondritis. This is especially key if your chest pain is severe, feels tight or heavy, or the pain spreads to the arm, neck, jaw or back. Similarly seek medical advice if the pain is accompanied by other symptoms – such as shortness of breath, nausea, sweating or dizziness.

Once more serious causes have been excluded, most people recover fully with a combination of rest, a gradual return to activity and sensible exercise habits.