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.

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.

Chest pain!

content

1. Cardiovascular diseases
2. Pulmonary diseases
3. Gastroenterological diseases
4. Pathology of the musculoskeletal system

1. Cardiovascular diseases

Typing in a search engine the query “chest pain”, the Internet user must understand: the results will be in the hundreds, if not thousands. Reliable and informative, to put it mildly, not all of them, but a significant part will turn out to be a crime against grammar, anatomy, common sense, the instinct of self-preservation. Finally, those few materials that could really somehow orient and suggest the correct algorithm of actions always suggest the same thing: a doctor is needed. As will be shown below, nothing else can be said here in principle, and our conclusion will be the same. The only motive for such searches, which can be considered rational, and even then with a certain stretch, is the desire to decide which doctor should be consulted in a particular case. But again, your nearest GP (general practitioner) will determine this much faster and more accurately – and refer you to the appropriate specialist if necessary.

It should also be understood that there is no disease called “something hurts in the chest”. It is always a sign, an effect, a symptom, and it never occurs without a cause. In the course of evolution, the chest was formed the way it is: strong enough and resiliently shock-absorbing, compact and, at the same time, accommodating almost all vital organs (only the brain is more reliably protected). But that’s what makes chest pain – any pain! – so important, alarming, diagnostically significant, and sometimes the only sign of an underlying developing severe problem. The possible causes are too numerous and varied to be self-diagnosed, and always too serious to be self-medicated.

Let’s try, however, on the basis of the available literature data, to compile a brief overview of the most typical and common types of pain, according to localization and character, by comparing them with the most probable causes.

Feeling of squeezing heaviness, burning; pain radiates to the neck, left arm, lower jaw; provoked by physical activity. – Angina pectoris as part of coronary heart disease.

The same, but the pain is extremely severe, accompanied by weakness, nausea or vomiting, suffocation, hyperhidrosis (sweating), panic fear of death, loss of consciousness; within 15-30 minutes does not subside at rest and is not stopped by taking nitroglycerin. – Acute myocardial infarction.

Very intense “tearing” pain that occurs against the background of arterial hypertension or collagenosis (a group of systemic connective tissue diseases) as a sudden attack, often radiating to the back. – Dissecting aortic aneurysm.

Acute or dull pain in the projection of the heart, with symptoms of fever, often radiating along the neck or shoulder, subsides somewhat at rest and increases with a change in body position (especially when trying to lie on the back), eating or drinking, deep breathing. – Pericarditis (inflammation of the “heart bag”, the serous membrane of the myocardium).

The same, against the background of a feeling of fatigue and shortness of breath, heart attack-like symptoms. – Myocarditis (inflammation of the heart muscle).

Heart pains of various nature, accompanied by dizziness, palpitations, shortness of breath, sleep disturbances. – Mitral valve prolapse, hypertrophic cardiomyopathy, coronary atherosclerosis, etc.

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2. Pulmonary diseases

Sudden sharp pain with shortness of breath, rapid breathing, tachycardia. – Pulmonary embolism.

Chest pain associated with breathing, coughing and attempts to take a deep breath, localized in a certain area, accompanied by fever, chills, expectoration of sputum, pleural rub. – Pneumonia, pleurisy.

Burning and “grabbing” pain, usually in the midline of the chest, mainly in the upper parts, associated with cough. – Tracheobronchitis.

Sudden acute unilateral pain associated with respiratory failure, shortness of breath, hypotension, dizziness. – Pneumothorax (traumatic or spontaneous).

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3. Gastroenterological diseases

Pain and burning in the retrosternal region, above the diaphragm or above; Discomfort and/or pain syndrome develops or worsens after a heavy meal, is provoked and aggravated by lying down, lasts from 20 minutes to an hour, is often accompanied by excruciating heartburn and is facilitated by taking antacids. – Gastroesophageal reflux (reflux of gastric contents into the esophagus).

As above, but the painful burning is much longer, often localized in the lower part of the chest and subsides after eating (except for spicy and other irritating foods), and also after taking antacids. – Peptic ulcer of the stomach and duodenum, exacerbation of gastroduodenitis.

Prolonged pain in the right lower part of the chest, not associated with food intake or arising/increasing after eating (especially fatty). – Cholecystitis, liver disease.

Prolonged intense pain in the lower part of the chest and supra-umbilical area, radiating to the back, under the shoulder blade, various areas of the chest; provoked by the intake of alcohol, drugs, fatty foods; aggravated by lying down, somewhat relieved by leaning forward. – Pancreatitis.

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4. Pathology of the musculoskeletal system

Dull, sharp, aching, shooting pain, aggravated by palpation along the intercostal nerves or spinal column; with a clear dependence of intensity on body position and physical activity, sometimes with paresthesia and numbness in the fingertips. – Intercostal neuralgia, osteochondrosis, etc.

Clearly localized pain, usually aching or quite intense, aggravated by inhalation and/or exhalation, coughing or palpation. – Broken rib.

The above phenomena and trends are far from exhausting the possible variants of thoracic pain. It is almost impossible, for example, to briefly describe the neurogenic pain syndrome in herpes zoster (herpes zoster).

Psychogenic chest pains (panic attacks, neuroses of various types, senestopathies in schizophrenia, and many others) are too diverse, and sometimes bizarre in nature. Gradually increasing and quite tolerable – at first – non-specific pain in the chest may be the first tangible symptom of the oncological process. Myositis sometimes symptomatically resembles radicular syndrome, and that, in turn, often mimics cardiac pain, etc.

Therefore, in any case: please consult a doctor. Do not wait until it “passes by itself”, do not try to diagnose yourself and cure yourself. It’s too risky, and even if it happens by accident one time, it can be too expensive the next time.

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Pinched nerve in the thoracic region: what to do

Articles

Reading time 10 min

istockphoto.com vehicle). As a result, the muscles and ligaments that strengthen the spine weaken, the anatomical structure of the spinal column is disturbed, protrusions and hernias form, and the risk of infringement of the nerve roots increases. We will tell you how to identify a pinched nerve in the thoracic region and what to do to get rid of this problem.

This article is advisory in nature. Treatment is prescribed by a specialist after consultation.

Causes

A pinched nerve in the thoracic region is a pathological condition in which the intervertebral discs or muscles compress the nerve endings. As a result, a person experiences pain of varying intensity and localization. Most often – in the middle part of the chest, but can also spread to neighboring parts of the body, making diagnosis difficult.

This pathology is equally common in both men and women of all ages. In most cases, it occurs acutely, but chronic pain is also often noted. Possible causes of a pinched nerve in the thoracic region are:

• Injuries

  For example, fractures of the ribs and thoracic vertebrae.

• Osteochondrosis

  Not the most common cause, but it does occur. The thoracic spine is inactive, so hernias, protrusions and bone growths do not form here so often. But if they appear, they begin to compress the spinal nerve, causing acute pain and other neurological symptoms.

• Poor posture

  A common cause of the pathology is scoliosis – curvature of the spine with lateral displacement, which causes discomfort and chronic back pain.

• Myofascial pain syndrome

  Muscle spasm leads to nerve compression and causes pain.

• Neuralgia of the intercostal nerves

  Disease of the peripheral nerves, in which the intercostal nerve roots are compressed.

• Herpes zoster

  The virus spreads along the spinal nerve and causes acute burning pain and characteristic blistering rashes.

Factors that provoke the development of the disease:

• prolonged and excessive load on the spinal column – hard physical work, sports;

• overweight and obesity;

• sedentary lifestyle and sedentary work;

• uneven distribution of the load on the spine – carrying a heavy bag on one shoulder.

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5 The main symptom of the disease is pain. It can have different intensity and be located in all parts of the chest: in the middle, on the left or on the right. Some patients note constant aching pain on both sides, and someone complains of sharp paroxysmal pain in the intercostal muscles, usually on one side. Most often, the pain is localized in the middle part of the chest and spreads along the ribs. Sometimes it can pass into the neck, lower back and shoulder blades. The pain worsens when you try to turn and bend over, as well as during coughing, sneezing and deep breathing.

Other symptoms of pinched thoracic nerve are:

• 1

  Loss of sensation . Sometimes, on the contrary, hyperesthesia occurs and the sensitivity of the skin increases. In this case, any touch is accompanied by an unpleasant sensation and increased pain.

• 2

  Shallow breathing

  Since a deep breath increases pain, the body switches to shallow breathing to compensate.

• 3

  Increased blood pressure resulting in intense pain increased body temperature

• 5

  Fatigue, irritability

  persistent pain syndrome.

• 6

  Blisters and itching in the area of ​​the ribs

  With herpes zoster.

The clinical picture of thoracic nerve entrapment can sometimes mimic an attack of angina pectoris, exacerbation of gastritis and gastric ulcer. Therefore, when the symptoms described above appear, it is necessary to consult a qualified doctor as soon as possible for diagnosis and treatment.

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you have a pinched nerve in your chest, you should immediately contact neurologist. The doctor will conduct an examination, make a diagnosis and prescribe an individual treatment plan. If necessary, he will refer you for a consultation to another specialist: a traumatologist-orthopedist, a cardiologist, a gastroenterologist, a physiotherapist, a rehabilitation specialist.

At the initial consultation:

1. Survey. The doctor clarifies the patient’s complaints, the nature and duration of pain, and also asks about physical activity, chronic diseases and injuries.
2. Inspection and palpation. The specialist examines the skin of the back, chest, palpates the spinal column and back muscles.
3. Neurological examination. The doctor evaluates muscle strength in the limbs, tendon reflexes, superficial and deep sensitivity.

To obtain more diagnostic data, the patient may be assigned additional tests:

• general and biochemical blood tests to detect inflammation and infection in the body;
• chest x-ray;
• CT and MRI are the preferred examination methods;
• Ultrasound of the heart, ECG for suspected cardiac pathology;
• consultation of another narrow specialist to exclude pathology of internal organs.

Make an appointment with a neurologist

Appointment lasts 60 minutes, includes diagnostics, analysis of your MRI and preparation of a treatment plan, takes place both in person and online.

Treatment

A holistic approach is used to treat a pinched nerve in the thoracic spine. The main goals of therapy are:

• elimination of the cause that caused the pinching;
• improvement of well-being and relief of pain;
• prevention of relapse and maintenance of the obtained therapeutic effect.

Several methods are used for treatment:

• Drug treatment

  Depending on the clinical picture and comorbidities, the patient is prescribed the following drugs:

  900 07 non-steroidal anti-inflammatory drugs – eliminate inflammation, relieve pain;
  • muscle relaxants – relax muscles and also reduce pain;
  • anticonvulsants – reduce shootings along the chest, often prescribed for chronic pain;
  • antiviral (antiherpetic) drugs – in case of suspected herpes zoster.

• Massage

  Point and classical massage has the highest efficiency. Properly selected technique will eliminate muscle spasm and improve the mobility of the spinal column.

• Physiotherapy

  The following physiotherapy procedures are prescribed to eliminate the symptoms of pinched thoracic nerve:

  • magnetotherapy — has an analgesic effect;
  • laser therapy – reduces inflammation and local swelling in the treated area.

• exercise therapy

  Properly selected exercises will eliminate muscle tension, improve the mobility of the spinal column and strengthen the muscular frame.

If conservative therapy fails for a long time, the doctor will refer you to a neurosurgeon and suggest surgery.

Self-treatment of a pinched thoracic nerve is strongly discouraged. This can worsen the course of the disease and provoke the development of complications. It is better to entrust this business to professionals.

Consequences

If you ignore the symptoms and do not follow the recommendations of doctors, the pinched thoracic nerve will progress. This can cause serious complications:

• chronic neuropathic syndrome – pain becomes permanent, chronic and difficult to treat;
• undiagnosed severe somatic pathology: ischemic heart disease, diseases of the lungs and stomach.

Prevention

To prevent pinching of the thoracic nerve and related complications, follow these recommendations:

• control your weight, especially if you are obese;

• eat right;

• lead an active lifestyle;

• refrain from playing sports or activities associated with the risk of spinal injury;

• See your doctor promptly when symptoms first appear and for preventive check-ups.