Chest Wall Pain, Costochondritis (Child)

Your child’s ribs are joined to the breastbone (sternum). This is the long flat bone in front of the chest. If these joints or the cartilage around the ribs become inflamed, it is called costochondritis. This is a common condition in preteens. Costochondritis causes tenderness on the sides of the breastbone. Your child may have mild swelling and sharp pain with breathing or coughing. Costochondritis often follows a viral illness that causes the child to cough a lot. It can also be linked to carrying a heavy school bag. It may also follow an injury, such as a fall or car accident.

Costochondritis pain may last for weeks, but eventually goes away on its own. The usual treatment is to take ibuprofen for 1 to 2 weeks as instructed on the label to ease discomfort. Ibuprofen is an anti-inflammatory medicine and is available over the counter. Your child may also need to take medicine to stop a cough. These are also available over the counter. Ask your healthcare provider to recommend specific medicines if you are not sure what to give your child.

Home care

Follow the healthcare provider’s instructions for giving medicines to your child. Don’t give any medicines that the provider has not approved.

  • Allow your child to rest as needed. Give pain medicine before an activity or before sleeping at night.

  • Put a covered heating pad or warm cloth on the area for 20 minutes. Do this 4 times a day. This may ease pain and swelling. You can also alternate the heat with cold. You can make a cold pack by wrapping a bag of chipped ice or frozen vegetables in a thin towel.

  • Have your child hold a pillow against his or her chest to ease pain when coughing.

  • Talk with your child about how he or she is feeling and what things help ease pain. Talk with your child’s provider if prescribed medicines don’t relieve the pain.

  • Ask the provider about exercises to stretch the chest muscles and ease pain. Exercises should not be done if they cause your child any pain.

Follow-up care

Follow up with your child’s healthcare provider, or as advised.

Special note to parents

Your child should not play sports until his or her healthcare provider says it’s OK.

When to seek medical advice

Call your child’s healthcare provider right away if any of these occur:

  • Fever (see Fever and children below)

  • Pain doesn’t get better or gets worse even with medicine

  • Change in the type of pain or pain gets worse

  • Chest pain does not get better in 7 days

 

Call 911

This is the fastest and safest way to get to the emergency department. The paramedics can also start treatment on the way to the hospital.

Call 911, or get medical care right away if any of these occur:

  • Trouble breathing, shortness of breath, or fast breathing

  • Your child acts very ill, or is too weak to stand

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Baby under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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