Sternum Pain: What Is It?

Pain in your sternum, or breastbone, may be caused by a number of things, including inflammation, a joint or collarbone injury, and acid reflux. Pain in your sternum may also happen with a heart attack, but this is more likely if you’re over the age of 40 and have heart disease.

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.

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.

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

Check out: Muscle strain treatment »

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.

Check out: Post-meal tips to ease heartburn »

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

Learn more: How to prevent acid reflux and heartburn »

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

Check out: 7 home remedies for bronchitis »

Pneumonia

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

Common symptoms of pneumonia include:

• difficulty breathing
• high fever
• persistent cough

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

Check out: 11 ways to stop a panic 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 a 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.

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.

You can find a primary care doctor near you through the Healthline FindCare tool.

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.

Causes and when to see a doctor

Many conditions can cause pain in the sternum, including injuries, pneumonia, bronchitis, and costochondritis. Gastrointestinal problems, such as acid reflux, can cause pain behind the sternum.

People may believe that their sternum pain is a heart attack symptom. However, it is possible to differentiate the two.

In this article, learn about the causes of sternum pain and the differences between sternum pain and heart problems.

The sternum is a flat T-shaped bone that sits at the front of the chest and connects to the ribs with cartilage. It forms part of the rib cage, a series of bones that protects the heart and lungs from injuries.

People often refer to the sternum as the breastbone.

Sternum pain can result from problems with muscles and bones near the sternum, as well as the sternum itself.

Substernal pain is discomfort occurring behind or below the sternum. It often results from gastrointestinal conditions.

Some of the most common causes of sternum and substernal pain are:

• costochondritis
• sternum fracture
• sternoclavicular joint injury
• collarbone injuries
• muscular strain or bruise
• hernia
• acid reflux
• pleurisy
• bronchitis
• pneumonia

Costochondritis is inflammation of the cartilage between the sternum and ribs. The medical term for this area is the costochondral joint.

The symptoms of costochondritis include:

• sharp pain on the side of the sternum area
• pain that worsens with a deep breath or a cough
• discomfort in the ribs

Inflammation in the costochondral joint may occur due to injury, infection, or irritation. A person may experience costochondritis due to:

• impact trauma
• respiratory tract infections
• severe coughing
• physical strains

Learn more about costochondritis here.

Like fractures in other parts of the body, sternum fractures can cause a lot of pain. Sternum fractures usually occur as a direct result of trauma, such as a car accident or sports injury.

People who believe they may have a sternum fracture should seek immediate medical attention in case of additional damage to the heart and lungs.

Symptoms of a sternum fracture include:

• pain during inhaling or coughing
• swelling over the sternum
• difficulty breathing

Learn more about fractures here.

The sternoclavicular joint connects the top of the sternum to the collarbone. Injuries to this joint generally cause pain and discomfort at the top of the sternum in the upper chest area.

People experiencing sternum pain due to a sternoclavicular joint injury will often experience the following:

• mild pain or swelling in the upper chest area
• difficulty or pain when moving the shoulder
• popping or clicking around the joint

The collarbone connects to the top corners of the sternum by cartilage. Due to the direct connection between the two structures, injuries to the collarbone may cause pain in the sternum area.

Collarbone trauma

Impact and stress trauma can damage, or even fracture, a person’s collarbone. Collarbone trauma may affect its connection to the sternum and the surrounding musculature. This may mean a person feels pain either in or around their sternum.

Depending on the location of collarbone trauma, other symptoms may include:

• severe pain when raising the arm
• bruising or swelling in the upper chest area
• abnormal positioning or sagging of the shoulder
• clicking and grinding in the shoulder joint

A great many muscles connect to the sternum and ribs. Injuries or trauma can result in bruising these muscles, which may cause them to ache. Strenuous or repetitive movements can also cause strains in these muscles.

Learn more about muscle strains here.

Most hernias occur in the abdomen. However, a hiatal hernia can affect the chest area and cause substernal pain.

A hiatal hernia occurs when the stomach moves past the diaphragm and into the chest. Symptoms of a hiatal hernia include:

• frequent burping
• heartburn
• vomiting blood
• a feeling of fullness
• trouble swallowing

People with substernal pain and symptoms of a hiatal hernia should see a doctor for prompt treatment.

Learn more about hernias here.

Acid reflux happens when stomach acid wears away the lining of the windpipe (esophagus). This happens primarily in people with gastroesophageal reflux disease (GERD).

Acid reflux may cause substernal pain and discomfort in the chest.

Pain in this region can also result from inflammation or a spasm of the windpipe. People with GERD should talk with their doctor about preventing further damage to this area.

Learn the difference between heartburn, acid reflux, and GERD here.

Pleura are sheets of tissue between the lungs and ribcage. Inflammation to these tissues is pleurisy.

Pleurisy can cause a sharp, stabbing pain at the site of irritation, which may worsen if a person breathes deeply, coughs, or wheezes.

If inflammation occurs toward the upper middle chest, pleurisy may cause substernal pain.

Learn more about pleurisy here.

Bronchitis is the inflammation of the primary airways of the lungs. The condition can cause:

• chest pain
• severe coughing spells
• shortness of breath
• wheezing

Inflammation of the primary airways may cause substernal pain.

Learn more about bronchitis here.

Pneumonia is a common lung infection that causes air sacs in the lungs to inflame and fill with fluid. The medical term for these air sacs is alveoli.

Pneumonia can cause sharp chest pains, which a person may feel behind their sternum.

Other symptoms of pneumonia include.

• severe coughing
• shortness of breath
• fever
• sweating
• nausea and vomiting
• loss of appetite
• confusion

Infectious bacteria, viruses and fungi can cause pneumonia.

Learn more about pneumonia here.

Symptoms of sternum pain vary depending on the cause. The most common symptom is discomfort and pain in the center of the chest, which is the location of the sternum.

Other associated symptoms may include:

• pain or discomfort in the ribs
• pain that worsens during deep breathing or coughing
• mild, aching pain in the upper chest
• swelling in the upper chest
• stiffness in the shoulder joints
• severe pain when raising the arms
• signs of collarbone trauma, such as bruising or swelling
• difficulty breathing
• grinding or popping sensation in joints near the sternum
• frequent belching
• heartburn
• feeling too full
• throwing up blood

People experiencing chest pain may worry they are having a heart attack. However, sternum pain differs from heart attack pain.

People who are having a heart attack experience specific signs before the heart attack itself, whereas most sternum pain starts suddenly.

A heart attack often occurs with the following symptoms:

• pressure, squeezing, or fullness in the center of the chest
• sweating
• nausea
• shortness of breath
• lightheadedness

However, anyone who thinks they are having a heart attack should seek immediate medical attention.

While sternum pain is not usually serious, there are some causes of sternum pain that require immediate medical attention.

A person should seek emergency medical attention if the pain:

• started as a result of direct trauma
• is accompanied by heart attack symptoms
• is persistent and does not improve over time
• is accompanied by intense vomiting or vomiting blood

A person should also speak to a doctor if the pain in their sternum gets worse or does not improve over time.

Physical trauma, costochondritis, and muscle strains are common causes of sternum pain.

Conditions such as pneumonia, pleurisy and GERD can also cause pain in nearby tissue that people may mistake for sternum pain.

Read the article in Spanish.

Tactics of behavior in case of chest pain and risk factors for myocardial infarction – Prevention of diseases and healthy lifestyle – Budgetary institution of the Khanty-Mansiysk Autonomous Okrug – Yugra

The most common cause of chest pain is angina pectoris or “angina pectoris”.

Angina pectoris is a form of coronary heart disease (CHD), the obvious signs of which are considered to be pain in the heart and shortness of breath. This pathology occurs against the background of a violation of the supply of the heart with a sufficient amount of blood, which is a consequence of the defeat of the coronary arteries by atherosclerosis.

Since this pathology is one of the forms of coronary artery disease, if it is present, there is an obstruction in one or both coronary arteries, which prevents the blood from circulating normally. This condition is accompanied by attacks of myocardial ischemia, that is, a lack of oxygen in the heart muscle.

The most obvious sign indicating the development of angina pectoris is considered to be the so-called imbalance between the need of the heart muscle for oxygen and the supply of oxygen to the region of the heart. To put it simply, the patient’s heart receives much less amount of blood than he needs.

Lack of oxygen makes itself felt at the moment of physical activity – that is why in patients with this pathology attacks develop during physical work or under the influence of a stressful situation.

Painful sensations resemble seizures. Pain during such attacks is simply unbearable – it seems to burn, press and compress, it arises in the area behind the sternum and radiates to the left shoulder or to the whole arm. Very common pain is also accompanied by strong anxiety, and fear : a person is trying to find a place for himself, he is holding on to his left chest and cannot fully understand what is happening.

In the case of the initial forms of the development of the disease, pain recedes within one to five minutes after taking the drug. If the pain does not disappear after this period of time, then this is a signal that the disease has acquired a more severe course, and, therefore, the chances of developing a myocardial infarction are high.

In most cases, just one tablet of Nitroglycerin helps to forget about the pain. If one tablet is not enough to get rid of pain, it means that the risk of developing myocardial infarction is increased.

At the first manifestations of retrosternal pain, you should immediately consult a doctor. It should not be thought that young age excludes the possibility of angina pectoris, or that burning behind the sternum when running or walking quickly uphill cannot be a sign of “angina pectoris” in a person involved in sports.

During an attack, the following measures are recommended for immediate relief of pain:

• create physical and psycho-emotional rest for the patient: lie down, sit down, or stop if chest pains appear during exercise;
• urgently needs to take 1 tablet of nitroglycerin under the tongue. The analgesic effect of nitroglycerin usually occurs within 1-5 minutes. To stop an attack, 1-2 tablets of nitroglycerin are enough.
• if the attack drags on (lasts 15-20 minutes) and repeated doses of nitroglycerin are ineffective, you should immediately call an ambulance.

Do not self-medicate. If you do not promptly consult a doctor and do not start the prescribed treatment, the disease progresses.

Under the conditions of “oxygen starvation” with pain, myocardial cells can live for 20-30 minutes . Then they die. This is a heart attack, a site of necrosis in the tissue of the heart. A scar remains on the affected area.

There are risk factors for myocardial infarction , the elimination of which significantly reduces the risk of its development: smoking, high levels of low-density lipoprotein cholesterol and hypercholesterolemia, arterial hypertension.

For the first time chest pain or shortness of breath on previously well tolerated exertion, an urgent need to consult a cardiologist. The District Cardiological Dispensary has the whole range of diagnostic procedures necessary in this case: all currently known methods for diagnosing coronary heart disease, both performed on an outpatient basis and in a hospital.

Experienced cardiologists of the District Cardiology Dispensary evaluate the patient’s condition and decide where to conduct examinations. In some cases of severe manifestation of the disease or ineffectiveness of medical treatment, cardiologists organize the hospitalization of patients in a specialized department, also located in the cardio center. Thus, patients receive the whole range of diagnostic and therapeutic measures in one center, which is an exclusive offer in the city of Surgut.

A.A. Seitov, cardiologist, head of the emergency cardiology department of the KhMAO-Yugra OKD “CD and SSH”

Girdle pain in the chest area: causes, treatment

Any person can face a sharp, acute or aching girdle pain under the chest – from a child of preschool age to a pensioner. Often such a condition – especially if it arose suddenly, recurs on a regular basis, causes physical and psychological discomfort, deprives freedom of movement – makes you nervous. If this ailment is not a consequence, for example, of an injury received while playing sports, then you should not hope that the girdle pain in the chest area will go away by itself. Be sure to see a doctor.

Girdle chest pain: causes

A competent specialist will definitely identify what provoked the problem, focusing on the symptoms you indicated, as well as on the results of some studies (examinations, tests, etc.). As a rule, girdle pain, localized under the breast, can indicate a number of diseases. Sometimes it is easy to identify them, while in other cases it takes a lot of time to make a diagnosis. Since the clinical picture and symptoms of each disease are different, it is worth considering in more detail each cause.

Spinal problems

Pathologies associated with the spine are the most common cause of girdle pain in the chest. In addition to scoliosis, a disease that is now observed in more than half of the population of Russia, the causes can also be various kinds of hernias, protrusions, neuralgia, osteochondrosis, which affect the back, but often go to the chest area or under the ribs. Depending on the disease, not only the chest can hurt. The pain syndrome can radiate to the arm and shoulder blade, if there is a hernia, the back hurts, and when coughing, the pain intensifies.

Diseases of the gastrointestinal tract

Girdle pain that appears in the chest area is often included in the symptoms of diseases of the digestive system, which are located in the upper left and right quadrants of the abdominal cavity. This includes the intestines, stomach and pancreas, liver. Depending on the disease – rupture of the esophagus, pancreatitis, renal colic, ulcers and other pathologies – in addition to chest pain, the back or stomach area may hurt, heartburn, nausea and other unpleasant symptoms are noted

Diseases and pathologies of the heart

Acute girdle chest pain, observed at the level of the heart or around it, often signals ailments that develop in one of the main organs of our body. It can be angina pectoris, myocardial infarction, pericarditis and other heart diseases. Almost all of these conditions pose a huge threat to life, especially for older patients. Urgently see a specialist, delay can cost you dearly!

Respiratory diseases

Pleurisy, pulmonary tuberculosis, pneumonia – because of these diseases, it is not only difficult for a person to breathe: in the vast majority of cases, the symptoms expand, and pathological mucous, purulent or bloody discharge from the respiratory tract is noted, and girdle pain occurs under the chest.

Oncological diseases

Malignant tumors located in the lungs, liver, stomach and other organs adjacent to the chest, as well as metastases formed here, provoke burning, piercing pains under the breasts. Symptoms are typical for stage 2-4 cancer, when only chemotherapy or strong painkillers can help.

Injuries

Usually they are “earned” by professional athletes, but ordinary people are not immune from accidents. At risk are pensioners, postmenopausal women (the amount of calcium in the body decreases), patients with osteoporosis, newborns and children of primary preschool age.

Gestational period

The aching nature of girdle pain at the level of the chest is a frequent companion of the third trimester of pregnancy, when the fetus becomes so large that it presses on the organs adjacent to the enlarged uterus, and its movements cause discomfort to the woman.

How to relieve pain. First Aid

Almost all specialists who are directly or indirectly related to medicine will recommend that you first consult a doctor or call an ambulance team. But what to do if there is no such opportunity at the moment? Any anesthetic that suits you will help relieve an attack of girdle pain in the chest area. Among the most common are Ibuprofen (Nurofen) or Paracetamol, Drotaverine (No-Shpa). Remember that a number of diseases do not tolerate delay: for example, if you suspect a myocardial infarction, you should immediately call an ambulance.

Diagnosis

When you first contact your Neurologist , you will be assigned a series of examinations, including a visual examination, palpation, and referrals for blood and urine tests. In addition, any responsible specialist will definitely prescribe an ultrasound, x-ray or MRI to verify their assumptions. In the event that girdle pain under the breast has a physiological cause (during pregnancy) and is not associated with pathologies, medications allowed during the period of bearing a child will be recommended.

Which doctor should I contact?

cardiologists , gastroenterologists , surgeons, oncologists or pulmonologists can deal with this problem. But most likely, the therapist will refer you to narrow specialists : it is best to contact him if you do not understand what provoked the occurrence of girdle pain around the chest. The clinic “Energo” employs experienced doctors with many years of experience.