The sternum is the bone that connects the two sides of your rib cage together. It protects many of the major organs which are located in your chest and gut. Therefore, it protects your heart, lungs, and stomach. When they feel pain in your sternum, many of us think that they are having a heart attack. However, in most cases, the chest pain doesn’t have anything 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.
In reality, the sternum pain is actually more likely caused by conditions that have to do with the muscles, bones or the digestive tract than with the heart or the sternum itself.
Costochondritis is the most common cause
In most cases, the sternum pain is caused by costochondritis. It appears when the cartilage that connects the ribs to the sternum becomes inflamed.
Costochondritis usually has the following symptoms:
- 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
Even though it doesn’t always have a specific cause, costochondritis is most often a result of a chest pain, strain from physical activity, or joint conditions. Osteoarthritis can be a cause of costochondritis. The good news is that costochondritis isn’t a serious condition and shouldn’t cause you to be concerned.
In case your pain persists or you have other symptoms that might indicate a more serious underlying condition, you should immediately see your doctor.
There are other conditions or injuries to the muscles and bones around your sternum that can cause sternum pain, as follows:
- joint injury
- collarbone (clavicle) injury
- surgery on the sternum (such as open heart surgery)
These are the most common musculoskeletal conditions that may make your sternum hurt.
Sternoclavicular joint injury
The sternoclavicular joint (SC joint) connects the top of your sternum with your clavicle. When this joint gets injured, you will feel pain and discomfort in your sternum. The area in your upper chest where this joint exists will also hurt.
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
The collarbone is directly connected to your sternum. Therefore injuries, dislocation, fractures, or other trauma to the collarbone can affect the sternum.
Check below the most common symptoms of collarbone trauma:
- 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
When you fracture your sternum, the pain is very intense. This happens 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. Think for example at the seat belt tightening in a car accident or your chest getting hit while you’re playing sports or doing other high-impact physical activity.
The most common symptoms of sternum fracture are the following:
- 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
Another cause of pain around your sternum is when pulling or straining a muscle in your chest.
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. 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
- having trouble swallowing
- feeling like you ate too much
- throwing up blood
- having black-colored stool
Gastrointestinal conditions that can cause sternum pain
Because the sternum sits right in front of several major digestive organs, there are many gastrointestinal conditions that can cause its pain.
There are many cases when the acid from your stomach leaks into your esophagus and causes chest pain. The pain usually gets worse when you lie down or bend forward. There is one good news in all this situation. Heartburn usually goes away without treatment after a short time.
It s similar to the heatburn, but the stomach acid starts to bother or wear away the lining of your esophagus. The acid reflux can be part of a chronic condition called gastroesophageal reflux disease.
These are the most common symptoms of acid reflux:
- burning in your chest
- abnormal bitter taste in your mouth
- difficulty swallowing
- throat soreness or hoarseness
- feeling like you have a lump in your throat
Respiratory causes of sternum pain
When your lungs, trachea or other parts of your body that help you breath are affected, your sternum might become painful.
Pleurisy happens when your pleura gets inflamed. In some cases, there can be fluid 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 appears when the bronchial tubes that bring air into your lungs become inflamed. You will feel it when you get the flu or a cold.
Most probably you have already felt that when you have bronchitis, your sternum hurts when you breathe in and out.
Common bronchitis symptoms include:
- persistent wet cough that causes you to spit up mucus
- difficulty breathing
- pain or discomfort in your chest
Flu or cold symptoms that can go along with bronchitis include:
- high fever
- runny nose
Pneumonia happens when your lungs get infected by a virus or bacteria.
It has the following most common symptoms:
- difficulty breathing
- high fever
- persistent cough
Other causes for sternum pain
A stomach 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
- lack of appetite
A panic attack happens when you suddenly feel fear even though you have 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
- feeling alternately hot and cold
- stomach cramps
- chest pain