Top 7 Causes of Sternum Pain | How to Get Relief

6 most common causes

Osteoarthritis

Acute Costochondritis

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Heart Attack

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Pleurisy

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Sternum fracture

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Most common questions

Sternum pain can be caused by a variety of conditions, some of which are serious. Some common causes of sternum pain include inflammation, arthritis, muscle strain, heartburn and acid reflux, heart attack, and sternum injury.

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If your sternum pain is severe, radiating to other parts of the body, or accompanied by symptoms such as shortness of breath, nausea, sweating, or dizziness, it could be a sign of a heart attack or other serious condition and requires immediate medical attention.

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If the pain is from a minor known injury and can be managed with rest, ice, and over-the-counter medications, seeing a doctor may not be necessary. If the cause of your sternum pain is unknown, or if it persists despite at-home care, it is a good idea to see a doctor for further evaluation and treatment. If the sternum pain is severe, worsening, or accompanied by other symptoms such as shortness of breath, nausea, or sweating, you should seek medical attention immediately.

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The treatment for sternum pain might include rest, gentle stretching, anti-inflammatory medications, steroid medications, lifestyle and diet changes, pain medication, or in some cases surgery. Treatment depends on the underlying cause, so it is important to consult a healthcare professional for an accurate diagnosis and appropriate treatment plan. If your sternum pain is severe, worsening, or accompanied by other symptoms such as shortness of breath, nausea, or sweating, you should seek medical attention immediately.

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The sternum, also known as the breastbone, is the long, flat bone in the middle of your chest. You can have pain in this area because of infection, inflammation, injury, or the breakdown of cartilage affecting the sternum itself.

Problems with nearby organs like the heart, lungs, and esophagus can also cause pain in this area. This includes a heart attack, pleurisy (a lung inflammation), and acid reflux.

Usually, if the pain is in the actual sternum, you’ll have sharp pain when you push in the middle of your chest. But because the symptoms of chest bone pain are so similar to other causes of chest pain, you might need to have tests to check for heart attack and other serious conditions.

If your problem is just with your actual sternum, you may feel better with rest, gentle stretching, and anti-inflammatory medications. But if there are other issues, you might need prescription medications, joint injections, or surgery.

Causes of sternum pain

1. Costochondritis

Symptoms

• Pain in the sternum, usually sharp
• Worsening pain with deep breathing or movement
• Pushing or pressure on the sternum is painful.

Costochondritis is inflammation of the cartilage that links your ribs to your sternum. It’s the most common cause of chest bone pain. Usually you feel pain when you push on the sides of your sternum. In many cases, the cause is unknown, but it is sometimes related to exercise or a recent illness.

Because costochondritis feels so much like more serious causes of sternum pain, you should see a doctor. They will probably do a chest X-ray and an electrocardiogram (EKG), which will be normal if it’s costochondritis.

Usually, costochondritis gets better with rest and gentle stretching. But if you are very uncomfortable, ice and anti-inflammatory medication can help. If the pain is severe, you may need a steroid injection.

Dr. Rx

If you have costochondritis or a muscle strain, ask your doctor how long your symptoms might last, and how you can manage your symptoms. It’s a relief to be diagnosed with a non-life-threatening condition, but it doesn’t mean that your pain goes away immediately! There are things you can do to control the pain. —Dr. Anne Jacobsen

2. Sternoclavicular arthritis

Symptoms

• Pain at the top of the sternum
• Worsening pain with activity
• Swelling and tenderness
• Pain radiating into the arms

Osteoarthritis is a breakdown of joint cartilage over time. The sternoclavicular joint is where the top of the sternum (breastbone) meets the clavicle (collarbone).

Osteoarthritis in this area can cause pain in the sternum, especially near the top part. It happens as you age, but it might occur earlier if you had a previous injury in that area. Because this is the area where your torso connects to your arms, this joint works hard. A study in the Journal of Clinical Rheumatology found that 90% of people over the age of 60 have osteoarthritis in this joint, but not all have symptoms.

Your doctor may order X-rays, a CT scan, or an MRI to diagnose sternoclavicular arthritis. Rest and anti-inflammatory medication may help you feel better. Some people may need joint injections with steroid medications. When sternum pain is severe, you may need surgery.

3. Muscle strain

Symptoms

• Sharp or achy pain in the sternum
• Worsening pain with movement
• Muscle spasm
• Bruising or tenderness of a chest wall muscle

A strained or pulled muscle in the chest wall can cause chest bone pain. This injury is caused by overuse or repetitive movement, an increase in activity level, or a sudden improper movement. Pulled muscles can also happen during an illness that causes coughing or vomiting.

Rest, ice, and over-the-counter pain medications can relieve muscle strain. But in more severe cases, you may need physical therapy or surgery.

4. Heartburn and acid reflux

Symptoms

• Burning pain in the chest, abdomen, or throat after eating
• Pain in the sternum
• Bad breath or bad taste in your mouth

Heartburn is a brief burning pain in your throat, chest, or abdomen that is caused by stomach acid. When it happens frequently, it can be a sign of acid reflux.

Both heartburn and reflux are caused by a problem with the sphincter (ring of muscles) that separates the esophagus from the stomach. When the sphincter doesn’t close tightly or opens too frequently, stomach acid or food can travel out of the stomach back into the esophagus.

Heartburn can also be caused by a hiatal hernia, which happens when part of the stomach slips through a hole in the diaphragm (the muscle that separates the chest from the abdomen).

Certain foods and drinks, including spicy or fatty foods, alcohol, and coffee, can trigger heartburn. Overweight people and pregnant women have a higher risk for reflux.

Your doctor may prescribe changes to your lifestyle and diet, medications, and sometimes surgery.

5. Pleurisy

Symptoms

• Sharp sternum pain
• Worsening pain with breathing and coughing
• Pain may go away when you hold your breath
• Cough and fever

The lungs and the inside of the chest are covered with a thin protective tissue called the pleura.  Pleurisy is inflammation and swelling of this tissue. A viral or bacterial lung infection, autoimmune disease, or other conditions in the lungs or chest can cause pleurisy.

Rest, over-the-counter anti-inflammatory medications (ibuprofen), and sometimes antibiotics can help you get better.

6. Heart attack

Symptoms

• Pain or pressure under the sternum
• Pain radiating to the arm or jaw
• Shortness of breath
• Nausea
• Sweating

Some people having a heart attack experience chest pain in or under the sternum. A heart attack is a blockage in an artery of the heart, which prevents blood and oxygen from reaching that area. It is caused by a blood clot that travels from a fatty buildup (plaque), inside the artery.

Heart attack can be life-threatening and requires immediate treatment. When you go to the ER for sternum pain, you’ll likely have tests like an EKG, blood tests, and a chest X-ray.

Treatment should begin as soon as possible after symptoms start, so call 9-1-1, if your pain could be heart related. You may get medications or have a procedure like a heart catheterization with balloon or stent treatments to open up your arteries. Severe cases may need surgery to create a bypass around the blocked artery.

7. Sternum fracture

Symptoms

• Pain in the sternum
• Worsening pain when breathing, coughing, or moving
• Swelling and tenderness of the sternum

Sternum fracture is a break in the sternum bone. This usually only happens in a serious trauma, like a car accident or falls from a high height. Seatbelts save lives in car accidents, but they cross over the sternum, which can fracture it in a high-impact crash.

Because breaking the bone requires such force, doctors will order additional CT scans to check for injuries to the vital organs behind the sternum, including the heart, lungs, and major blood vessels.

Ice, over-the-counter pain medications, and, sometimes, prescription pain medications may relieve your sternum pain. You may need surgery to fix the break or to treat other injuries inside the chest.

Pro Tip

A number of the conditions mentioned here (for instance, costochondritis, muscle strain, and pleurisy) are what doctors refer to as a “diagnosis of exclusion.” This means that there’s not one specific test to make the diagnosis and that the symptoms can mimic the symptoms of other serious conditions. Once we rule out anything serious, we treat the non-serious problem that is most likely. —Dr. Jacobsen

Other possible causes

Other conditions that may cause pain near the sternum include:

• Pneumonia or bronchitis
• A blood clot in the lung (pulmonary embolism)
• Anxiety
• Tumors
• Patients who have had open heart surgery may have chronic pain in the sternum because doctors have to split this bone in half to perform the procedure.
• Some people have genetic conditions that cause the sternum to sink into the chest or to jut forward, and this may cause pain.

When to call the doctor

• Pain in the sternum from a minor injury
• Pain is not controlled with rest, ice, and over-the-counter medications.

Should I go to the ER for sternum pain?

Because these conditions may have overlapping symptoms, many people with pain in the sternum will need to be tested for a heart attack. You should go to the ER immediately if you have any of the following:

• Sternum or chest bone pain that isn’t from a minor injury
• Pain radiating to your arms, jaw, or back
• Shortness of breath, nausea, sweating, or dizziness
• Pain related to a car accident or other traumatic injury

Pro Tip

Pain in the sternum is a complaint where we really need to consider every piece of evidence to feel confident making the right diagnosis. Bloodwork shows if there is injury to the heart muscle or an infection. An EKG shows if there are electrical changes from a heart attack. A chest x-ray or CT scan can show some infections. —Dr. Jacobsen

Treatments

At-home care

If you had a minor injury or if your doctor has ruled out serious causes of your pain, try the following:

• Rest
• Ice
• Over-the-counter anti-inflammatory or pain medications

Other treatment options

• Prescription medications like antibiotics or heart medications
• Joint injection
• Physical therapy
• Surgery

Anne Jacobsen, MD.

Community Emergency Medicine Physician, Kansas City

Dr. Jacobsen is a board-certified Emergency Medicine physician and writer for Buoy Health. She received her undergraduate degrees in Chemistry and Biology from Macalester College (2006) and graduated from the University of Kansas School of Medicine (2010). She completed an Emergency Medicine residency program at the University of Missouri-Kansas City (2013). She practices community Emergency Medic…

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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.

Middle chest pain: possible causes, treatment

Doctors call the phenomenon when a person has pain in the chest in the middle, thoracalgia. There can be a lot of reasons for the appearance of pain syndrome, from the most harmless to quite serious pathologies. In order not to miss an important “alarm bell” from your body, it is best to contact a neurologist , who will examine you and determine why your chest began to hurt.

Middle chest pain: causes

There can be many reasons why pain appeared in the middle of the chest, so it is worth considering the intensity of the pain syndrome, its frequency and the specific localization of pain. By doing this, it will be possible to narrow the search for pathology leading to unpleasant sensations.

Heart pathologies

Pain in the chest is often associated with diseases of the cardiovascular system, the heart. If you feel thoracic all the time, this may indicate an aortic aneurysm. In this case, the pain in the left or right side of the chest is felt for a long time, and it will become stronger every time the person moves from rest to physical activity. The condition is treated exclusively surgically, so hospitalization will be required to confirm this diagnosis. Pain in the center of the chest in front can also appear if a pulmonary embolism develops. The pain syndrome becomes stronger on inspiration, and taking analgesics allows you to suppress it. Compressive pain may indicate that a person has angina pectoris, and pain can also be a symptom of myocardial infarction.

Respiratory damage

If there is pain in the front in the center of the chest, and at the same time you feel interruptions in breathing, you cannot breathe deeply, cough and shortness of breath appear, the problem may be the occurrence of pulmonary diseases, which include tracheitis, pneumonia, bronchitis, pleurisy and some others. The same symptoms can occur with diseases of the diaphragm.

Injuries

Pain in front of the chest, in the middle, or between the ribs may occur in a person who has survived an accident, has been involved in a fight, or has damaged chest structures from a fall or blow. Such pains intensify when he tries to turn around, bend down, take a deep breath, and are explained by the fact that blood vessels rupture, the periosteum is damaged, cracks and fractures form. In such a situation, at rest, the pain syndrome can disappear almost completely, which gives a person a false confidence that there is no need to consult a doctor.

Diseases of the spine

The most common reason why the chest hurts in the middle is osteochondrosis, if we talk about the pathologies of the spinal column. Pain in osteochondrosis can be constant or manifest in the form of seizures. The pain will be the same in intensity and manifestation with radiculopathy in the thoracic spine. Also, pain syndrome can indicate an intervertebral hernia and congenital anomalies in the structure of the spinal column.

Neurological diseases

Causes of pain in the chest in the middle can be neuralgic in nature. The most common diagnosis in this case is intercostal neuralgia, in which it is very painful in the sternum, it radiates to the back under the shoulder blade, which makes it easy for a person to confuse pain with heart pain.

Esophageal problems

Pain in the shoulder blades and in the middle of the chest may be associated with pathologies of the esophagus. The reason in this case is, as a rule, a spasm, which manifests itself more often in the morning or after eating. Pain in the chest area is relieved by taking antispasmodic drugs. Often spasms of the esophagus are accompanied by spasm of the muscular walls of the stomach.

How to relieve pain. First Aid

Often a person who has pain in the middle of the chest does not know what to do in such a situation. Some people are in so much pain that they faint. At the same time, a strong fright is observed, the pulse rate increases, the skin turns pale. The first thing to do if suddenly a person has severe pain in the sternum, internal organs and spine:

Also, if a person has pain in the middle of the chest, it is best to ask everyone present to leave the room and ensure complete rest for the patient until the ambulance arrives.

Diagnostics

The first thing the doctor will do is to interview and examine the patient, which will narrow the search for pathology by concomitant signs. After that, various diagnostic procedures can be prescribed to determine the cause of the pain syndrome. 9 may be useful0003 magnetic resonance or computed tomography , x-ray , ultrasound , blood tests, etc. This will determine why there are pains in the middle of the chest that radiate to the back, upper limbs or ribs.

Which doctor to contact

If you are able to visit the clinic on your own, you can make an appointment with the general practitioner . He will determine the approximate cause of the pain syndrome and the direction of further search, as well as give you directions for diagnostic procedures and, if necessary, to specialized specialists. In the event that there is a sharp pain in the chest in the middle, it is difficult and difficult to move, it is impossible to get out of bed without pain, call an ambulance. After the examination at home, the specialist will provide first aid and determine whether you need to be taken to the hospital.

You can make an appointment with specialists online , as well as by phone 8 (812) 901-03-03.

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 artery 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.

Pain sensations resemble seizures. Pain during such attacks is simply unbearable – it seems to burn, press and constrict, it arises in the area behind the sternum and radiates to the left shoulder or to the whole arm. Very often, 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 is delayed (lasts 15-20 minutes) and repeated doses of nitroglycerin were 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 conditions of “oxygen starvation” in case of 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 the development of 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.