The Connection Between EDS and Costochondritis Chest Pain

The Link Between EDS and Costochondritis

Costochondritis, an inflammation of the cartilage connecting the ribs and breastbone, causes chest pain that can greatly impact quality of life. But what causes costochondritis? For some, the culprit could be a little-known condition called Ehlers-Danlos syndrome (EDS).

What is Costochondritis?

Costochondritis refers to inflammation of the costal cartilage, the rubbery connective tissue between each rib bone and the breastbone (sternum). When these cartilage joints become irritated, it can cause severe chest wall pain.

While costochondritis often has no clear cause, for some patients it may result from:

• Injury to the chest
• Joint inflammation
• Mechanical stresses from repetitive movements
• Infection
• Arthritis

When all other potential causes are ruled out, the source of recurring or unexplained costochondritis may be an underlying condition like Ehlers-Danlos syndrome.

Ehlers-Danlos Syndrome and Flexible Joints

Ehlers-Danlos syndrome (EDS) is an inherited disorder that weakens connective tissues throughout the body. Abnormalities in collagen production can lead to extremely flexible, unstable joints.

There are 13 subtypes of EDS. The most flexible type, known as hypermobile EDS, frequently correlates with costochondritis in patients.

The EDS and Costochondritis Connection

The unstable, hypermobile joints caused by EDS make costal cartilage more prone to injury and inflammation for several reasons:

• Weak connective tissue allows ribs to subluxate (partially dislocate)
• Hypermobile joints lead to unstable motion and tissue strain
• EDS causes poor proprioception so patients are unaware of painful joint positions
• Low muscle tone and scapular instability fail to properly support chest/ribs

Together, these factors significantly raise costochondritis risk for EDS patients compared to the general public.

Characteristics of Costochondritis Pain Related to EDS

While costochondritis symptoms can vary greatly for different patients based on source, those tied to EDS often share some unique characteristics:

Intense Chest Wall Pain

EDS patients frequently report excruciating pain radiating along the chest wall, ribcage and sometimes upper abdomen. Pain typically focuses near the sternum but may be felt anywhere from the costal cartilage.

Sudden onset of stabbing, sharp pains often stem from a partially dislocated rib. Dull, constant ache tends to signal chronic inflammation issues.

Pain Triggers Related to EDS Subtypes

Specific EDS variants produce distinctive patterns of symptoms:

• Hypermobile EDS - Dislocations and pain after activity or at end range of motion
• Classical EDS - Fragile tissue leads to spontaneous ruptures, tears and swelling
• Vascular EDS - Risk of arterial dissection or organ rupture; intense pain

Identifying triggers provides clues into which EDS subtype may be causing recurring costochondritis flares.

Long Duration of Costochondritis Episodes

While costochondritis often resolves within days or weeks in the general population, EDS patients typically battle symptoms for months or even years.

Lax ligaments struggle to properly stabilize the chest cavity after initial injury, perpetuating chronic inflammation.

Getting a Costochondritis Diagnosis

Since many doctors are unfamiliar linking EDS with costochondritis, getting properly diagnosed can prove challenging. But an accurate diagnosis is key to managing this agonizing condition.

Reviewing Symptoms and Health History

When initially discussing symptoms with your physician, be prepared to:

• Pinpoint location, severity, duration and triggers of chest pains
• Note any recent infections, injuries, overexertion or repetitive strain to the ribs/chest
• Discuss factors like job duties, posture, sleeping positions that could impact ribs
• Mention any hyperflexibility, joint instability or family history of similar issues

Physical Examination of Chest and Ribs

During the hands-on exam, your doctor will likely:

• Palpate along the chest to locate tender spots and swelling
• Test range of motion in neck, shoulders and ribs to assess flexibility and mechanics
• Check for hypermobility in other joints like knees, elbows and hands
• Have you mimic movements that reproduce pain to aid diagnosis

Use of Diagnostic Imaging

While often normal with costochondritis, chest x-rays, CT scans or MRIs can sometimes reveal subtle joint abnormalities indicative of EDS. Always mention EDS as a possibility to encourage more careful inspection of imaging.

Relieving Costochondritis Pain Related to EDS

Gaining relief from the intense chest and rib pain caused by EDS and costochondritis involves both treatment of symptoms and preventing recurrent dislocations with lifestyle changes.

Medications to Control Costochondritis Pain

Over-the-counter or prescription medications may provide temporary respite when flare-ups occur:

• NSAIDs like ibuprofen or naproxen reduce inflammation and discomfort
• Muscle relaxants ease spasms; useful with intense pain
• Nerve pain drugs like gabapentin calm neuropathic symptoms
• Corticosteroid joint injections block inflammation

Seeking Physical Therapy and Bracing Assistance

Consulting a physical therapist knowledgeable about EDS can provide immense relief through:

• Joint mobilization techniques to treat stuck costal cartilage
• Soft tissue massage to loosen tight chest and shoulder girdle muscles
• Strengthening exercises to better support chest cavity
• Postural correction and body mechanics training
• Custom bracing to stabilize vulnerable rib joints

Lifestyle Changes to Prevent Recurrent Dislocations

Implementing proactive modifications can also minimize costochondritis flares:

• Pacing daily activities to avoid overexertion
• Using proper body mechanics with bending, lifting, reaching movements
• Improving posture and strengthening core/shoulders
• Sleeping with adequate support for chest and shoulders
• Aiming for healthy body weight to reduce tissue strain

Cultivating joint stability through fitness and mindful movement is key to diminishing pain long-term.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.