Breastbone Pain (Sternum)

The breastbone (or breast bone) is the long flat bone located at the centre of the chest to which the ribs and clavicle (shoulder bone) attach. Pain of the breastbone (sternal pain) is a symptom that most of us will experience in life and while it may often be due to a minor cause, breastbone pain may also be indicative of serious medical conditions requiring emergency treatment.

Causes of Breast Bone Pain

The most common cause of breastbone pain is trauma (injury). This could be due to assault or accidental and often causes soft tissue injury. There may be swelling and tenderness to touch but usually the cause of the trauma would be an identifiable event preceding the onset of pain. In the case of severe trauma, there may be a fracture of the sternum especially of injuries sustained in a car accident where the chest makes contact with the steering wheel.

Other causes of breast bone pain may include :

• Gastrointestinal disorders like heartburn (acid reflux) which may cause pain and not just a burning sensation. A hiatal hernia can also cause breastbone pain.

• Cardiac conditions like angina or a heart attack may also cause breastbone pain. If accompanied by any other symptoms like dizziness, you should see a doctor immediately.

• Joint disorders like costochondritis, which is the inflammation of the joints where the ribs attach to the sternum, may also result in breastbone pain. Arthritis and strain to these joints are also possible causes.

• Muscular pain, particularly due to inflammation of the pectoral (chest) muscle could also cause breastbone pain. This is more likely if there is strain of the pectoral muscle like in weight lifting and there may be accompanying inflammation of the joint.

• Respiratory conditions like inflammation of the bronchi, lung or lining of the lung may also result in breastbone pain. This could be a result of TB (tuberculosis), bronchitis, pleuritis (pleurisy) and other conditions of the airways. Cancer of the lungs and airways, like in mesothelioma, may also be responsible for breastbone pain. Pain that aggravates with breathing is more likely due to a condition of the airways or lungs.

• Breast pain may be another possible cause and while the pain can be isolated to the breat tissue itself, there may be referred pain to the sternum. The cause in this case can vary from a breast infection (like mastitis) to inflammation due to injury of the breast or even breast cancer. The breastbone pain is usually not isolated and in most cases, it will occur along with breast pain.

• Abdominal pain may at times be referred up to the breastbone, like in duodenal or gastric ulcers, acute pancreatitis or intestinal gas and cramping.

• Open heart surgery or other cardiothoracic surgery may result in breastbone pain, even months or years after the operation.

• Anxiety and panic attacks can also cause perceived breastbone pain. Sometimes this is not entirely psychological if the person has a history of conditions like asthma or angina.