The purpose of this case report is to describe the clinical presentation and chiropractic management of Tietze syndrome.


A 34-year-old woman presented with unexplained left-sided chest pain. Electrocardiogram and radiographs were taken at a medical emergency department to rule out cardiovascular and pulmonary causes, and pain medication did not relieve her pain. Physical examination showed tenderness on palpation and swelling of the second and third chondrosternal joints, as well as thoracic joint dysfunction. Heart and lung pathology was ruled out, and chondrosternal joint swelling was present, Tietze syndrome was diagnosed.


A treatment plan aimed at restoring normal thoracic and rib joint movement and decreasing inflammation of the chondrosternal joints resulted in lower pain levels. Treatment consisted of diversified high-velocity, low-amplitude chiropractic manipulation; Activator technique; and cryotherapy.

J Chiropr Med. 2011 Mar;10(1):60-3. [PMID:22027210]

Author information: Gijsbers E, Knaap SF. Chiropractor, Private Practice, Hoofddorp, The Netherlands.

Free PMC Article