What’s Causing My Sternum Pain?

Is this cause for concern?

Your sternum, or breastbone, connects the two sides of your rib cage together. It sits in front of many major organs located in your chest and gut, including your heart, lungs, and stomach. As a result, many conditions that don’t necessarily have anything to do with your sternum may cause pain in your sternum and the surrounding area.

Your first reaction to chest pain, especially severe or consistent chest pain, may be to think it’s a heart attack. But in many cases, chest pain has nothing to do with your heart. This is especially true if you’re under age 40 and don’t have any serious health issues or existing conditions.

Sternum pain is actually more likely caused by conditions that have to do with your muscles, your bones, or your digestive tract than with your heart or the sternum itself.

Keep reading to learn the most common reasons for sternum pain and when you should see your doctor.

Costochondritis is the most common cause

The most common cause of sternum pain is a condition called costochondritis. This occurs when the cartilage that connects your ribs to your sternum becomes inflamed.

Symptoms of costochondritis include:

  • sharp pains or aches on the side of your sternum area
  • pain or discomfort in one or more ribs
  • pain or discomfort that gets worse when you cough or breathe in deeply

Costochondritis doesn’t always have a specific cause, but it’s most often a result of a chest injury, strain from physical activity, or joint conditions like osteoarthritis. Costochondritis isn’t a serious condition and shouldn’t cause you to be concerned.

See your doctor if the pain persists or if you have other symptoms that might indicate a more serious underlying condition.

Other musculoskeletal conditions

What other musculoskeletal conditions cause sternum pain?

Conditions or injuries to the muscles and bones around your sternum can also cause sternum pain.

This includes:

  • joint injury
  • collarbone (clavicle) injury
  • fractures
  • hernias
  • surgery on the sternum (such as open heart surgery)

These aren’t the only musculoskeletal conditions that may make your sternum hurt, but they’re among the most common.

Sternoclavicular joint injury

The sternoclavicular joint (SC joint) connects the top of your sternum with your collarbone (clavicle). Injury to this joint can cause pain and discomfort in your sternum and in the area in your upper chest where this joint exists.

Common symptoms of injury to this joint include:

  • feeling mild pain or having aching and swelling around your upper chest and collarbone area
  • hearing pops or clicks in the joint area
  • feeling stiff around the joint or not being able to fully move your shoulder

Collarbone trauma

The collarbone is directly connected to your sternum, so injuries, dislocation, fractures, or other trauma to the collarbone can affect the sternum.

Common symptoms of collarbone trauma include:

  • bruises or bumps around area of collarbone injury
  • intense pain when you try to move your arm upwards
  • swelling or tenderness around collarbone area
  • pops, clicks, or grinding noises when you lift your arm
  • abnormal frontward sagging of your shoulder

Sternum fracture

Fracturing your sternum can cause a lot of pain, because your sternum is involved in many of your upper body movements. This type of injury is often caused by blunt force injuries to your chest. Examples of this include your seat belt tightening in a car accident or your chest getting hit while you’re playing sports or doing other high-impact physical activity.

Common symptoms include:

  • pain when you breathe in or cough
  • difficulty breathing
  • pops, clicks, or grinding noises when you move your arms
  • swelling and tenderness over the sternum

Muscle strain or hernia

Pulling or straining a muscle in your chest can cause pain around your sternum.

Common symptoms of a pulled muscle include:

  • pain around the pulled muscle
  • discomfort when using the affected muscle
  • bruising or tenderness around the affected muscle

A hernia can also cause sternum pain. A hernia happens when an organ is pushed or pulled from the area where it normally sits into a nearby part of the body.

The most common kind is a hiatal hernia. This happens when your stomach moves up past your diaphragm into your chest cavity.

Common symptoms of a hiatal hernia include:

  • frequent burping
  • heartburn
  • having trouble swallowing
  • feeling like you ate too much
  • throwing up blood
  • having black-colored stool

Which gastrointestinal conditions cause sternum pain?

Your sternum sits right in front of several major digestive organs. Conditions that affect your esophagus, stomach, and intestines can all cause sternum pain. Having heartburn or acid reflux after a meal are the most common gastrointestinal causes for sternum pain.

Heartburn

Heartburn happens when acid from your stomach leaks into your esophagus and causes chest pain. It’s common to get right after you eat. Pain usually gets worse when you lie down or bend forward.

Heartburn usually goes away without treatment after a short time.

 

Acid reflux

Acid reflux is similar to heartburn, but happens when stomach acid or even what’s in your stomach starts to bother or wear away the lining of your esophagus. It can be part of a chronic condition called gastroesophageal  reflux disease.

Symptoms of acid reflux include:

  • burning in your chest
  • abnormal bitter taste in your mouth
  • difficulty swallowing
  • coughing
  • throat soreness or hoarseness
  • feeling like you have a lump in your throat

Which respiratory conditions cause sternum pain?

Conditions that affect your lungs, windpipe (trachea), and other parts of your body that help you breathe can cause sternum pain.

Pleurisy

Pleurisy happens when your pleura gets inflamed. The pleura is made up of tissue within your chest cavity and around your lungs. In some cases, fluid can build up around this tissue. This is called pleural effusion.

Common symptoms include:

  • sharp pain when you breathe in, sneeze, or cough
  • feeling like you can’t get enough air
  • an abnormal cough
  • fever (in rare cases)

Bronchitis

Bronchitis happens when the bronchial tubes that bring air into your lungs become inflamed. It often happens when you get the flu or a cold.

Bronchitis pain can also make your sternum hurt as you breathe in and out. It can last only briefly (acute bronchitis) or become a long-term condition (chronic bronchitis) due to smoking or infections.

Common bronchitis symptoms include:

  • persistent wet cough that causes you to spit up mucus
  • wheezing
  • difficulty breathing
  • pain or discomfort in your chest

Flu or cold symptoms that can go along with bronchitis include:

  • high fever
  • exhaustion
  • runny nose
  • diarrhea
  • vomiting

 

Pneumonia

Pneumonia happens when your lungs get infected by a virus or bacteria.

Common symptoms of pneumonia include:

  • difficulty breathing
  • high fever
  • persistent cough

Can other conditions cause sternum pain?

Other conditions that affect your gastrointestinal tract or your chest muscles can cause sternum pain.

Stomach ulcer

A stomach ulcer (peptic ulcer) happens when you get a sore on the lining of your stomach or at the bottom of your esophagus.

Symptoms of a stomach ulcer include:

  • stomach pain, especially on an empty stomach, that responds to antacids
  • feeling bloated
  • nausea
  • lack of appetite

Panic attack

A panic attack happens when you suddenly feel fear, as if something dangerous or threatening is happening, with no actual reason to be afraid. It’s often a result of stress or a symptom of mental health conditions, such as generalized anxiety disorder or  depression.

Symptoms of a panic attack include:

  • feeling like something bad is about to happen
  • feeling dizzy or lightheaded
  • having trouble breathing or swallowing
  • sweating
  • feeling alternately hot and cold
  • stomach cramps
  • chest pain

 

Is it a heart attack?

Sternum pain can sometimes be the result of a heart attack.This is much less likely if you’re under age 40 or are in overall good health. They’re more likely to happen if you’re over 40 and have an existing condition, such as heart disease.

A heart attack is life-threatening. You should go to the emergency room right away if you have any symptoms besides sternum pain that may indicate a heart attack, especially if they appear without any obvious cause or if you’ve had a heart attack before.

Symptoms of heart attack include:

  • chest pain in the middle or left side of your chest
  • pain or discomfort in your upper body, including your arms, shoulder, and jaw
  • feeling dizzy or lightheaded
  • having trouble breathing
  • sweating
  • nausea

The more of these symptoms you have, the more likely that you’re having a heart attack.

When to see your doctor

See your doctor right away if you have heart attack symptoms or symptoms that cause you sharp, consistent pain that gets in the way of your daily life.

You should also see your doctor if you have any of the following symptoms:

  • sternum and general chest pain that has no obvious cause
  • sweating, dizziness, or nausea with no specific cause
  • trouble breathing
  • pain that spreads from your chest throughout your upper body
  • chest tightness

If you’re experiencing other symptoms and they last for more than a few days, talk to your doctor.

The bottom line

Your next steps depend on what condition might be causing your sternum pain and how severe the condition is.

You may just need to take over-the-counter pain medication or change your diet. But you may need long-term treatment if the underlying condition is more serious. In some cases, you may need surgery to treat a heart or gastrointestinal condition.

Once your doctor diagnoses the cause, they can develop a treatment plan that can help relieve the symptoms and causes of your sternum pain.

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