Costochondritis is a condition that results in pain and inflammation in the chest area. It affects the breastbone in the ribs, which is the long bone in the middle that keeps the ribs together, often referred to as the sternum. Usually, the pain will disappear on its own, however, it can last for a long time depending on the individual. For people with chronic costochondritis, the symptoms can return recurringly, even after treatment. For people living with costochondritis, it’s important to know this easy and inexpensive way to manage the chronic chest pain when it re-appears.
Do Hot and Cold Therapy work for Costochondritis?
The Mayo Clinic recommends using heat therapy for costochondritis, by applying heat to the affected area several times. It is recommended to apply heat to the area for 20 to 30 minutes once every two hours, for as long as needed. Heating blankets on a low setting can work well for this. Cold works as well, and it is recommended to place a cold pack on the affected area for 10 to 20 minutes at a time, ensuring there is a cloth or towel between the pack and your skin.
How Can Heat and Cold Affect Pain?
According to studies, heat and cold therapies are very commonly used in the U.S. to treat all kinds of pain, especially back pain. Hot and cold therapies have different properties and effects.
Cold therapy works as an anesthetic. It helps reduce blood flow, inflammation, tissue damage, and swelling. This type of treatment numbs the tissue, slowing down the pain receptors. As a result, the pain receptors won’t be able to transmit the pain messages to the brain.
Heat therapy is completely different in that it boosts the blood flow and improves circulation, which in turn relaxes the muscles. While comparatively, cold therapy reduces inflammation and numbs the pain.
When to Use Hot Therapy vs. Cold Therapy?
Heat therapy and cold therapy are used in different cases. It is best to use the correct therapy depending on what condition and symptoms you are dealing with. If you have any concerns, you should always consult your doctor before using any new type of treatment or therapy. Below is a table that demonstrates which therapy will suit which health problem.
Cold Therapy | What Is it For | Hot Therapy | What Is it For |
Gout flare-ups | To numb the pain and calm down the flare-ups | Arthritis | To relax the muscles and joints |
Headaches | To numb the pain | Headaches | To relax the muscle spasms |
Strains (after a muscle has been injured) | To reduce the inflammation and numb the pain | Strains (after a muscle has been injured) | To reduce the stiffness and slow down the bleeding. |
Sprains (after a ligament injury) | To reduce the inflammation and numb the pain | Sprains (after a ligament injury) | To reduce the stiffness and slow down the bleeding. |
Acute inflammation | To numb the pain and ease inflammation. | Chronic injury | To deal with the stiffness after the inflammation has subsided. |
Safety Tips for Hot and Cold Therapy
If you use hot or cold therapy incorrectly, you can hurt your skin and make your condition even worse. It’s crucial to know when to use them, and which one to use. Here are some general safety tips to avoid harm when using either of these therapies:
- Don’t apply the treatment for more than 20 minutes
- Don’t apply hot or cold treatments directly on your skin. Use a towel to avoid freezing or burning your skin.
- Use a comfortable temperature, don’t apply anything too hot or too cold to your skin. Stop if you’re in pain.
- Wait for your skin to regain its normal temperature before applying more treatment.
- Don’t apply heat or cold therapy on an open wound.
Safety Tips for Hot Therapy
These safety tips apply only for hot therapy:
- Don’t apply heat to bruises or swelling.
- Don’t apply heat on an inflamed spot, the inflammation will get worse.
Safety Tips for Cold Therapy
These safety tips apply only for cold therapy:
- Don’t use ice on stiff and tight muscles or the pain will be aggravated.
- Make sure to check the skin while applying ice treatment, preferably every 5 minutes. Check for any blisters, redness, or any indication of skin damage.
Common Cold Therapy Devices
There are many different cold therapy devices available on the market. The least expensive options are more popular than others. The pricier options are worth investing in if you’re experiencing chronic pain.
Here are some of the most common hot/cold therapy tools:
Cold Pack
When most people think about cold therapy, the first thing that comes to mind is a cold pack. They’re flexible, easy to use, durable, and ideal for everyday use. It soothes chronic and acute pain, swelling, injuries, inflammation, and more. A typical example would be the FlexiKold Gel Ice Pack available on Amazon.
Reuseable cold packs are great, but if you can’t afford one then a plastic bag full of ice cubes, wrapped in a towel, works quite well.
Cryotherapy Machine
Cryotherapy refers to a type of ice treatment. The goal of these devices is to reduce the temperature, cause the blood vessels to constrict, and reduce discomfort and inflammation. Cryotherapy is usually used to reduce swelling and muscle pain, for example after a sprain or damage. For effective results, continuous treatment is important. These devices are better if you need to apply cold therapy for more than a few hours. One such example of a cryotherapy machine is the Arctic Ice Machine by Pain Management Technologies. This device can supply cold to the pain for up to five hours, which is a little easier than switching out 5 cold packs if it’s hard for you to move around.
Common Hot Therapy Devices
Plenty of different devices for hot therapy treatment are available for purchase. Here are some of the most common ones you can find.
Hot Pack
A hot pack is can be heated to achieve a temperature suitable for hot therapy. It can be used on different parts of the body to distribute heat evenly. It helps relax the muscles and soothe the tension and stress. Some hot packs can be used for multiple purposes, like My Heating Pad for Pain Relief for example. This pack can be used for both hot and cold therapy.
Reusable hot packs are nice and easy to use. If you’re in a pinch though, you can simply microwave a wet rag for 30 seconds or so to create a simple hot pad. Be careful it’s not too hot before placing it on your skin.
Heated Blanket or a Heating Pad
This is a material that can be wrapped around the body to warm up specific areas. It helps with muscle pain, discomfort, and cramps. Most of the pads or blanks on the market offer different temperature settings to get just the right amount of heat. One such item is the Mighty Bliss Electric Heating Pad.
Be sure to speak with your pharmacist, nurse, or physician if you have any questions before trying any new type of therapy.
What Other Conditions Can Hot and Cold Therapy Help?
Anything related to pain, muscle stiffness, sprains, inflammation or injury can be treated with hot and cold therapy. Hot and cold therapies are truly multi-purpose and can be used for a wide variety of medical conditions. Because of their soothing capabilities, these treatments can be effective for pain relief caused by different conditions such as fibromyalgia, rheumatoid arthritis, osteoarthritis, and costochondritis.
If you’ve recently been exercising or perhaps training for a certain sport, and you’ve injured yourself, you can use heat and cold treatment to jump start the recovery process and numb the pain. However, hot and cold treatment has to be used properly. If you use them incorrectly they can do more harm than good, so it’s important to read and adhere to any safety instructions that come with any device that you may purchase.
At the end of the day, heat and cold therapy are inexpensive options to try if you have costochondritis, and they are typically one of the first options that would be suggested by a physician to relieve the pain aside from basic over the counter pain medications. Heat and cold therapy treatments are an easy starting point for pain relief without using medication, and you should give them a try if you’re experiencing pain. By using heat/cold therapy in conjunction with other treatments, such as stretching, yoga, physical therapy, and medication you can attack your costochondritis pain and root causes from multiple angles and reduce your discomfort even further.
References
https://www.mayoclinic.org/diseases-conditions/costochondritis/symptoms-causes/syc-20371175
https://en.wikipedia.org/wiki/Costochondritis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225921/
https://www.webmd.com/pain-management/try-heat-or-ice
https://www.painscience.com/articles/ice-heat-confusion.php
https://capitolrehabofarlington.com/2010/10/athletes-tip-alternate-heat-and-ice-for-speedier-recovery/
https://3riversortho.com/2017/05/16/heat-vs-cold-therapy-work-use/
http://trihealth.adam.com/content.aspx?productId=28&pid=28&gid=000095
https://www.medicalnewstoday.com/articles/29108.php#heat_therapy
https://www.healthline.com/health/heating-pad-for-back-pain
https://www.healthline.com/health/chronic-pain/treating-pain-with-heat-and-cold
https://www.painscience.com/articles/heating.php
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4494172/
Have you found hot or cold therapy effective for reducing your pain from costochondritis? Feel free to comment below.

Dr. Ahmed Zayed is a surgery resident practicing plastic surgery and working on his masters degree. Dr. Zayed has a passion for helping people live healthy lives, and has authored several books. He has contributed to publications such as the Washington Post, HuffPo, Chicago Tribune, and more. Dr. Zayed has an MD from the University of Alexandria, one of the largest medical schools in Egypt.
Last year I discovered that, if I immerse my body in a 300l barrel of water outside for 5-10 minutes, I am pain free for an hour or two.
For 7 years, following an accident in which I was uninjured, but was life threatening, I have had chronic pain in my neck, shoulders, back, flanks and ribs … more recently along the lower edges of my floating ribs.
I believe it to be fibromyalgia…though I have never been diagnosed.
in the last 3 months i have been in 3 different hospitals and have seen about 6 different doctors spending about a month in the hospital in total. one diagnosed me with myocarditis after doing an angiogram(keep in mind i am only 20 years old). the other doctors in the one hospital didn’t even diagnose me with anything after staying a week in the hospital and just send me home with bed rest. At one stage i was on 20 different types of medications, everything from natural minerals to drugs prescribed by the hospitals. i have seen 3 general surgeons, 2 cardiologists, one homeopathic doctor . the last doctor diagnosed me with costochondritis and placed me on bed rest for 3 weeks. i am currently using a hotwater bottle at night before i go to bed to relieve my pain. i have found that taking a warm shower or bath with your whole body in the water also relieves pain. i am also following an anti-inflammatory diet