The Connection Between Fibromyalgia and Costochondritis

The Connection Between Fibromyalgia and Costochondritis

Fibromyalgia is a complex chronic pain condition that affects millions of people worldwide. One of the most common comorbid conditions seen in fibromyalgia patients is costochondritis - inflammation of the cartilage in the chest.

Up to 70% of people with fibromyalgia also suffer from costochondritis. The two conditions appear to be intimately linked, although the reasons why are still being investigated.

In this article, well explore the connection between fibromyalgia and costochondritis in depth. Well look at the overlapping symptoms, possible causes, diagnosis, and treatment options for both conditions.

Understanding Fibromyalgia

First, lets start with a quick overview of fibromyalgia itself. Fibromyalgia is characterized by widespread muscle pain, fatigue, sleep issues, and cognitive difficulties.

While the root cause is still unknown, researchers believe it stems from abnormalities in how the brain and nervous system process pain signals. It leads to increased sensitivity to stimuli that normally arent painful.

Fibromyalgia often develops after physical trauma, infection, or significant psychological stress. Women are disproportionately affected - up to 90% of fibro patients are female.

There is no cure for fibromyalgia, but symptom management is possible through a combination of medications, exercise, stress reduction, and lifestyle changes.

What is Costochondritis?

Costochondritis causes inflammation of the cartilage in the chest wall, particularly at the junctions where the upper ribs join the sternum or breastbone.

This inflammation produces localized chest pain and tenderness that can mimic heart attack symptoms. The pain may feel sharp, achy, or pressure-like and worsen with movement or deep breathing.

Like fibromyalgia, costochondritis seems to involve abnormal processing of pain signals. In most cases, an infection, injury, or strain triggers the initial chest wall inflammation. But it can persist long after the initial cause resolves.

Costochondritis is often considered a self-limiting condition that will get better over time. But for many fibromyalgia patients, it becomes a chronic overlapping pain issue.

The Fibromyalgia and Costochondritis Connection

So what explains the strong linkage between fibromyalgia and costochondritis?

Researchers have identified some key factors that demonstrate how the two conditions overlap and interact:

Similar Neurotransmitter Abnormalities

Both fibromyalgia and costochondritis appear to involve irregularities in neurotransmitters - the brain chemicals that transmit nerve signals.

One main neurotransmitter implicated is substance P, which helps transmit pain signals. Elevated levels of substance P have been found in the spinal fluid of fibromyalgia patients.

Interestingly, the chest wall cartilage inflammation in costochondritis also seems connected to increased substance P. The higher levels make the nerves in that area overly sensitive to pain.

Dysregulation of other neurotransmitters like serotonin, norepinephrine, and glutamate also occur in both conditions.

Overlapping Trigger Points

Those with fibromyalgia are extremely sensitive to pressure in certain tender points throughout the body. Many of these tender points correspond to the cartilage junctions affected in costochondritis.

In fibromyalgia patients with chest wall pain, tender points are frequently found along the upper ribs and sternum. Irritation of these trigger points appears to provoke costochondritis flares.

Treating these localized tender spots with massage, heat, or injections can provide pain relief in both fibromyalgia and costochondritis.

Central Sensitization

Research also indicates that both conditions involve central sensitization - increased sensitivity of the nerves to pain signals.

Due to abnormalities in pain processing pathways, normal sensory input from the chest wall may get amplified. This fuels chronic inflammation and chest wall pain in costochondritis.

The central sensitization seen with fibromyalgia seems to predispose patients to developing costochondritis as well. Chest wall cartilage may become hypersensitive to inflammatory triggers.

Cardiac Origins

There is evidence that mitral valve prolapse - a mild heart condition where the mitral valve bulges or flops backward - may underlie some cases of fibromyalgia and costochondritis.

Mitral valve prolapse can cause chest pain similar to costochondritis, along with fatigue and pain throughout the body resembling fibromyalgia.

About 40% of those with fibromyalgia have mitral valve prolapse compared to around 5% of the general population. The heart abnormalities may spark neurological and inflammatory changes.

Postural Issues

Many fibromyalgia patients have poor posture with rounded shoulders, forward head position, and a sunken chest. This posture can strain the upper chest and ribs contributing to costochondritis.

Proper stretching, strength training, and postural correction helps take pressure off the chest. This may alleviate pain from both conditions.

Anxiety and Stress

Anxiety disorders and psychological stress often co-occur with both fibromyalgia and costochondritis.

Stress hormones and chronic tension can increase inflammation and nerve sensitivity. This may lower the thresholds for developing overlapping chronic pain issues.

Relaxation techniques like meditation, deep breathing, and yoga help ease anxiety and pain sensitivity.

Shared Symptoms of Fibromyalgia and Costochondritis

Given the interconnected nature of fibromyalgia and costochondritis, its not surprising that they share many common symptoms.

However, there are some key differences in where symptoms originate. Costochondritis pain stems specifically from the chest wall cartilage, while fibromyalgia causes more widespread pain.

Here are some of the overlapping symptoms seen in both conditions:

Chest Pain

The hallmark of costochondritis is intense chest pain, often near the sternum, ribs, and rib cartilage junctions. Fibromyalgia can cause similar chest pain due to tender points in those areas.

Costochondritis pain tends to be very localized. Fibromyalgia chest pain is typically less defined and may radiate to the shoulders, arms, upper back, or neck.

Pain With Movement and Breathing

Because the chest wall is involved during movement and breathing, both costochondritis and fibromyalgia can cause chest pain that worsens with physical exertion or taking deep breaths.

Coughing, twisting, bending, reaching, and pushing can also aggravate chest wall pain.

Diffuse Muscle Aches

While costochondritis affects the chest area, fibromyalgia causes more widespread muscle pain. Fibro can cause a deep muscle ache throughout the whole body.

Those with both conditions often have pain in multiple areas like the chest, neck, back, hips, and limbs.

Fatigue

Debilitating fatigue and low energy are hallmark symptoms of fibromyalgia. Chronic widespread inflammation puts great demand on the body, draining energy reserves.

The chest inflammation of costochondritis can also result in fatigue, especially when pain disrupts sleep night after night.

Sleep Disturbances

Non-restorative sleep and insomnia are very common in fibromyalgia. Costochondritis can also interfere with sleep due to chest pain.

Tossing and turning to find a comfortable position often aggravates chest wall pain at night. This perpetuates sleep issues seen with fibromyalgia.

Anxiety and Depression

Many people with both fibromyalgia and costochondritis develop mood issues like anxiety and depression. Chronic pain and fatigue take a toll on mental health over time.

Costochondritis chest pain can also mimic heart attack symptoms, provoking health anxiety. Learning to manage stress and emotions is essential.

Getting Diagnosed: Fibromyalgia, Costochondritis, or Both?

Given the overlap in symptoms, getting an accurate diagnosis can be challenging. It often takes time and multiple doctor visits to sort out whether fibromyalgia, costochondritis, or both conditions are present.

Here are some keys to getting the right diagnosis:

Detailed History

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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.