What is the first-line treatment for Tietze syndrome and Costochondritis?

• A. Antibiotics
• B. Corticosteroid injections
• C. NSAIDs
• D. Opioid analgesics

Answer: (C)

NSAIDs are the first-line approach because Tietze syndrome and costochondritis involve inflammatory pain of the chest wall joints, and NSAIDs directly reduce inflammation and provide analgesia by blocking prostaglandin synthesis. This helps relieve tenderness and swelling with relatively safe, short-term use. Rest and gentle activity modification, plus local heat or ice, can support this treatment. Antibiotics aren’t useful since these conditions aren’t caused by infection. Corticosteroid injections may help if pain is localized and persistent despite NSAIDs, but they’re not the initial choice due to risks and the general effectiveness of NSAIDs. Opioid analgesics are reserved for severe, refractory pain after NSAIDs have been tried, because of their higher risk of adverse effects and dependence.