What is sternum pain?
Chest pain can be alarming if you're not familiar with the conditions that can cause it. Heart attacks and heart disease are commonly associated with chest pain, but other issues can cause it as well.
Often, the joints in your sternum and ribcage become irritated or inflamed and cause the pain you feel in the front of your chest.
Many conditions cause pain in the sternoclavicular joints and cartilage that make up the sternum. Inflammation can cause mild to severe pain. Tumors can form, injuries can happen, and infections can occur. It's important to understand the symptoms and causes of sternum pain so that you can help your doctor understand what you're feeling.
Sternum pain symptoms
Sternum pain is caused by many different conditions that can all present with similar symptoms. These conditions’ symptoms are more specific than just general pain in the area. They are usually described as:
- Pain or discomfort in the front of the ribcage
- Sharp pain on the side of the sternum
- Pain that gets worse with deep breaths
- Mild, aching pain in the chest
- Joints near or on the sternum pop
Causes of sternum pain
There are several musculoskeletal conditions that can cause sternum pain. Costochondritis is the most common condition that can make your sternum hurt.
Costochondritis is the inflammation of the cartilage in between the rib cage and the sternum. This condition doesn't have a specific cause but can be affiliated with injuries to the rib cage or sternum or caused by intense exercise that flexes the ribcage and irritates the joints.
An injury to the joint where the clavicle (the collarbone) meets the sternum is called a sternoclavicular joint injury. Traumatic injuries to this joint can be caused by contact sports, motor vehicle accidents, or other higher energy impacts.
An atraumatic sternoclavicular joint injury is one where there is no outside force that causes it, but the sternum is injured, irritated, or inflamed.
Collarbone injuries can also cause the sternum to hurt if they occur near it. If your collarbone is injured and doesn't heal correctly, it can cause pain at the joint.
Intercostal nerve inflammation
If you strain a muscle in between your ribs, it is called an intercostal strain. A strain of an intercostal muscle can cause pain in your sternum if it is close to it. The nerves that control the intercostal muscles can also become inflamed if they are injured or strained. This is called intercostal neuralgia.
Rib joint infection
Sternocostal joints, or rib joints at the sternum, can become infected by the staphylococcus aureus (staph) bacteria. This is a very rare condition, only identified in a few intravenous drug abusers, some people with diabetes mellitus, some with rheumatoid arthritis, and disorders of the immune system. The bacterial infection inflames the joints, causes pain, and usually requires surgery.
On rare occasions, tumors can form on the bones in your sternum. If you have developed a sternum tumor, it can grow and form a mass in the center of your chest. There will be pain radiating from the mass, and the tissue can swell. Your intercostal muscles (muscles between the ribs) may begin to atrophy and become weak, which can cause pain as well.
When to see the doctor for sternum pain
If you're experiencing any pain in your chest, you should go to the emergency room immediately. While sternum pain is not a serious condition, if it is not too intense, it is best to get evaluated and get treatment for any pain in your chest because it might be a severe condition. If your sternum pain is accompanied by nausea or vomiting, call 911 or go directly to the emergency room.
If you've been to the emergency room and the doctors didn't find any heart, lung, or other conditions that might constitute a medical emergency, you should schedule an appointment with your doctor. You should also see your doctor if your ribs have been impacted when playing sports or other activities or if you've been in some other type of accident and are in pain.
Diagnosing sternum pain
When you see your doctor, they'll evaluate you for any other conditions that might cause pain in your sternum to rule them out. The doctor will also conduct a physical examination of your chest and move your arms into positions that might trigger the sternum pain. They are looking for tender spots or movements that aggravate your pain to help them determine what is going on.
Since costochondritis pain is similar to other conditions, it's important to look for signs of heart disease, osteoarthritis, lung disease, and intestinal issues. It's likely that your doctor will send you to get X-rays, a CT scan, an MRI, or an electrocardiogram to find out if you have something else causing your chest pain.
Sternum pain treatment
If your sternum pain is caused by costochondritis, the doctor can prescribe nonsteroidal anti-inflammatory (NSAID) drugs to reduce inflammation of the joints and tissue. In some cases, the doctor might prescribe pain medicine if the pain is severe enough. If you have chronic sternum pain and it's keeping you from sleeping, your doctor might give you a tricyclic antidepressant to help you sleep.
It is possible to strain a sternoclavicular joint. If this is the case, the doctor tries to immobilize the side the strain is on and can prescribe a sling or figure-eight brace. Anti-inflammatory medications such as ibuprofen are also prescribed to help reduce any swelling. Sternum tumors require surgery if they are malignant or causing other problems within your chest. An infection in your sternoclavicular joint requires antibiotics and surgery to drain the infection.
American Academy of Orthopaedic Surgeons: "Sternoclavicular (SC) Joint Disorders."
American Family Physician: "Costochondritis: Diagnosis and Treatment."
Centers for Disease Control and Prevention: "Heart Attack Symptoms, Risk, and Recovery."
John Hopkins Medicine: "Clavicle Fractures."
Journal of Thoracic Disease: "Treatment for sternoclavicular joint infections: a multi-institutional study."
National Center for Biotechnical Information: "Intercostal Neuralgia."
National Center for Biotechnology Information: "Sternoclavicular Joint Injury."
National Health Services: "Costochondritis."
Polish Journal of Thoracic and Cardiovascular Surgery: "Surgical treatment of tumours of the sternum – 10 years' experience."
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