Healthy Living

When to Be Concerned About Sternum Pain


The sternum, also called as the breastbone, is a flat bone situated at the center of the chest. It connects to the ribs through cartilages and forms the front of the rib cage, which helps protect the lungs, heart, and major blood vessels from injuries. 

Since the sternum is near to the heart, many individuals who experience sternum pain often confuse it with cardiac chest pain, worrying that they may be having a symptom of a heart attack. Sternum pain is usually not related to heart problems because it is mainly caused by problems with the breastbone itself or the surrounding cartilages. This condition is often true to people who are younger than 40 years old without serious health-related issues or existing health conditions.  

Common Cause of Sternum Pain: Costochondritis

Costochondritis is also referred to as chest wall pain, costosternal chondrodynia, or costosternal syndrome. This condition occurs when there cartilage inflammation in the breastbone region. This condition causes localized chest pain that is somewhat similar to a heart attack and other heart problems. In some cases, the inflammation is accompanied by chest swelling called the Tietze syndrome. 

Pain experienced by individuals with costochondritis:

  • Pressure-like, aching, or sharp pain (usually on the left side of the sternum)
  • Pain in more than one rib
  • Worsening pain when taking a deep breath or coughing

The exact cause of costochondritis is still unknown in most people. Treatment is usually focused on relieving pain while waiting for the condition to improve, which often takes several weeks or even longer. In few cases, costochondritis may be due to the following conditions:

  • Chest injury
  • Arthritis (rheumatoid arthritis, osteoarthritis, or ankylosing spondylitis)
  • Physical strain such as severe coughing, strenuous exercise, or heavy lifting
  • Joint inflammation or infection caused by bacteria, fungi, or viruses
  • Noncancerous and cancerous tumors 

Musculoskeletal Conditions

Any kind of condition or injury to the bones or muscles around the sternum may also result in sternum pain. Such conditions may include fractures, surgery done on the sternum, joint-related injury, hernias, and collarbone injury. Although not all musculoskeletal conditions cause sternum pain, they are the most common ones that can cause pain in the breastbone region. 

1. Sternoclavicular Joint Injury

The SC joint connects the top region of the sternum along with the collarbone or clavicle. Any kind of injury caused to this joint can lead to a sense of discomfort or pain in the sternum including the upper chest region, where this joint is located. 

Some of the common symptoms an individual may experience include:

  • Stiff or painful shoulder
  • Unable to fully move the shoulder
  • Mild pain or swelling in the collarbone and upper chest region
  • Joint noises (popping or clicking sounds coming from the joints)

2. Collarbone Injuries

The collarbone is directly attached to the sternum. For this reason, any kind of dislocation, injury, trauma, or fracture caused to the collarbone can, in turn, affect the sternum. Some of the common symptoms an individual with collarbone injury may experience include:

  • Swelling, tenderness, or bruises around the collarbone area 
  • Extreme pain when lifting an arm
  • Grinding, popping, or clicking noises when lifting an arm
  • Abnormal sagging of the shoulder toward the front

3. Sternal Fracture

A sternal fracture can cause intense pain since the sternum is involved in a number of upper body movements. This kind of injury is often caused by any blunt force to the chest. Few of the examples are tightening of the seat belt in a car accident, the chest region getting hit while doing high-impact physical activities or while playing any kind of sports. 

The common symptoms of a sternal fracture are:

  • Tenderness and swelling over the sternum
  • Breathing difficulty
  • Pain when breathing or coughing 
  • Grinding, popping, or clicking noises when moving the arms

4. Hernia or Muscle Strain

Pain is experienced around the sternum when there is a pulled muscle or muscle strain in the chest. A pulled muscle may cause symptoms, such as:

  • Pain, tenderness, or bruising around the affected muscle
  • Discomfort when moving the part of the affected muscle

Another cause of sternum pain is hernia, which occurs when an organ is pulled or pushed from its normal anatomical location. A hiatal hernia is one of the common causes of sternum pain. This condition happens when the stomach moves up to the diaphragm and into the chest cavity. Its common symptoms include:

Gastrointestinal Causes

The sternum is situated in front of some of the body's major digestive organs. For this reason, sternum pain can also be caused by conditions that affect the intestines, stomach, and esophagus. The most common gastrointestinal causes of sternum pain are acid reflux and heartburn. 

1. Acid Reflux

This condition occurs when the acid present in the stomach or anything present in the stomach starts to bother the lining of the esophagus. Acid reflux can also be a part of gastroesophageal reflux disease, which is a chronic digestive disorder.  

The following are symptoms related to acid reflux:

  • A sore throat
  • Feeling as if you have a lump in the throat
  • Hoarseness
  • Coughing
  • Difficulty swallowing
  • Unusual bitter taste in the mouth
  • Burning sensation in the chest

2. Heartburn

Individuals who experience heartburn often feel a burning feeling in the chest or throat. This condition happens when stomach acid leaks into the esophagus and causes chest discomforts. Individuals who have heartburn twice a week or more may have the digestive disorder called gastroesophageal reflux disease or GERD. However, not all people with GERD experience this symptom. 

Heartburn is commonly experienced right after consuming a meal. The pain often gets worse when individuals bend forward or lie down. However, most cases of heartburn are temporary and tend to resolve on their own without any treatment. 

Respiratory Conditions

Sternum pain can also be due to respiratory conditions that affect the trachea (windpipe), lungs, and other parts of the body that are involved in breathing. 

1. Bronchitis

Bronchitis occurs when there is inflammation of the bronchial tubes, which bring air into lungs. This condition usually happens when people get the common cold or the flu. Bronchitis can also cause sternum pain when people breathe in and out. Bronchitis can also be acute or chronic, which can be due to infections or smoking. 

The common symptoms of bronchitis include:

  • Chest pain or discomfort 
  • Difficulty breathing
  • Wheezing
  • A productive cough (a cough that produces phlegm or mucus)

The following cold and flu symptoms can also go along with bronchitis:

2. Pleurisy

This condition happens when the pleura gets inflamed. The pleura is composed of tissues in the chest cavity and around the lungs. However, there can be a fluid buildup in this tissue in some cases, causing pleural effusion.

The common symptoms are:

  • Abnormal coughing
  • Breathing difficulty
  • A sharp pain when coughing, sneezing, or breathing
  • Fever (rare symptom)

3. Pneumonia

Pneumonia is a lung infection caused by bacteria, viruses, or fungi. However, pneumonia in adults is commonly caused by bacteria. The most common symptoms of pneumonia are:

Other Causes of Sternum Pain

Apart from the ones mentioned above, there are other conditions that can affect the chest muscles or the gastrointestinal tract leading to sternum pain.

1. Stomach Ulcer

Peptic ulcer or stomach ulcer occurs when an individual gets a sore on the lining of the stomach or at the bottom of the esophagus. The common symptoms of a stomach ulcer are:

  • Nausea
  • Abdominal pain
  • Lack of appetite 
  • Bloating

2. Panic Attack

When a panic attack happens, a person may suddenly feel afraid as if something dangerous is going to happen without an actual cause. It is usually a symptom of mental health problems, such as depression or generalized anxiety disorder. It can also be a result of stress.

A panic attack is characterized by the following symptoms:

  • Chest pain
  • Feeling hot or cold
  • Sweating
  • Difficulty breathing
  • Trouble swallowing
  • Lightheadedness
  • Feeling dizzy
  • Stomach cramps
  • Feeling something bad is going to happen

When to See a Doctor

Immediately seek medical help if you experience symptoms that are similar to a heart attack or when having pain that's affecting your daily activities.  

Consult a doctor if you have any of the following symptoms:

  • Chest tightness
  • Chest pain that spreads throughout the upper body region
  • General chest pain without any obvious cause
  • Breathing difficulty
  • Dizziness
  • Nausea
  • Sweating