Pain below Sternum - Causes

Pain below Sternum

The sternum is a flat bone, shaped like the letter ‘T,’ and located bang in the middle of the chest cavity. It is connected via cartilage to the 2 rib bones located on either side. It is commonly known as the chest bone or the breastbone.

Pain below sternum may occur with varying degrees of severity and can be temporary or persist for long periods of time. Sometimes, pain below sternum may be accompanied by cracking or clicking sensations.

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Causes of Pain below Sternum

Doctors categorize ‘pain below sternum’ as chest pain. Such pain is however somewhat different from angina or other forms of chest pain associated with the heart.

The most prevalent causes of pain below sternum, along with the related symptoms, are discussed below:

1. Sternum or Rib Cage Fractures

  • Patients may suffer from pain below sternum if the bone has experienced fractures, which in turn often occurs in severe instances of vehicle accidents or physical injuries. Sternum fractures can only occur due to a direct and forceful blow from a hard object. In such fractures, the bone is crunched or broken into several pieces. It can thus be termed as a rare occurrence.
  • Patients may also experience severe and intense pain below sternum when the rib cage or other bones present in the chest cavity get fractured. Sternum fractures as well as other thoracic cavity bone fractures is a medical emergency and patients need to be immediately hospitalized.
  • Recovery time involves complete bed rest along with restricted mobility. Individuals who have previously had operations of the chest cavity, such as an open heart surgery, repair of the sternum or other chest cavity bones, etc., may suffer from aching sternum pain for a brief period when recovering from sternum fracture. Prescription pain killers can help ease such severe pain.

2. Infections of the Respiratory System

  • Due to the close proximity of the breastbone to the lungs, any kind of infection that affects the organ, its inner lining, or the delicate membrane that covers it, can lead to pain below sternum. Lung infection is considered as one of the major causes of stinging chest bone pain.
  • TB, pneumonia, and asthma, etc. are a few common diseases that can cause infections of the respiratory system. Subsequent cold and accumulation of mucus can increase the severity of pain below sternum. Other chest cavity abnormalities like lung abscess, lung cancer, whooping cough, bronchitis, and tracheitis, may also result in pain below sternum. But such pain is generally experienced by patients when inhaling and exhaling.
  • Individuals with respiratory system infections can be seen to cough forcefully; this can exhaust the muscles and bones present in the chest cavity, thereby causing breastbone pain. Only complete treatment and cure of the underlying respiratory condition will help eliminate sternum pain.

3. Costochondritis 

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  • Inflammation, swelling, or trauma of the cartilage which connects the sternum to the ribs is referred to as costochondritis. It is one of the most common causes of sharp pain below sternum, and thousands of people are affected by it every year.
  • Breastbone pain associated with costochondritis can worsen with coughing and/or deep inhalation. The sternum pain is more pronounced on the left side of the chest cavity, and thus is often similar to the pain elicited during a heart attack or other cardiac conditions.
  • Costochondritis is also referred to as chest wall pain, costosternal syndrome, and costosternal chondrodynia. It is known as Tietze syndrome, if accompanied by swelling.

4. GERD/Gastro-esophageal Reflux Disease

  • GERD is a gastrointestinal condition, commonly known as acid reflux. If pain below sternum is accompanied by burping, then GERD is the primary underlying cause.
  • The stinging pain experienced by GERD patients typically arises due to anomalous relaxation of the sphincter muscle, which is present in the lower section of the esophagus. Such pain then migrates from the esophagus to the chest cavity and results in severe, irritating, and burning sensations, mostly below sternum. Such a sensation is what is called a heartburn. The pain may, on occasions, also travel all the way up to the neck and throat and cause local pain. Other associated symptoms include regurgitation and oral elimination of stomach acid.
  • Doctors may prescribe anti-acid or anti-reflux drugs to ease the pain. It is important to note that non-treatment of GERD can inflame the stomach wall and trigger the onset of peptic ulcers, another potent cause of pain below sternum.

5. Sternoclavicular joint trauma or injury

  • The sternoclavicular joint connects the sternum to the collarbone. Injury or trauma to this joint can result in to pain below sternum; such pain may vary in intensity as per the severity of the injury to the sternoclavicular joint.

6. Clavicle/Collarbone injury or trauma

  • The clavicle is present between the sternum and the shoulder blade, at the top part of the chest. Collarbone injuries are common and can occur due to a fall, accidents, a directly blow, or at the time of childbirth. Treatment of collarbone injury will help subside pain below sternum.

7. Fatigue of the Chest Muscles

  • The chest consists of the pectoral muscles and the intercostal muscles. The latter is located between the ribs; they contract during deep breathing and inhalation which may sometimes cause them to work a lot harder. This can then cause pain and fatigue of both the chest muscles, finally resulting in pain below sternum.

8. Chondrosarcoma/Lymphoma

  • Pain below sternum may also be caused due to dangerous diseases like lymphoma or chondrosarcoma, etc. These diseases may be characterized by the growth of an abnormal mass in the chest cavity, which is what eventually causes breastbone pain.

9. Other Causes of Pain below Sternum

  • Pain below sternum may also be caused due to vigorous exercising, breast cancer, varied heart and chest diseases, bone or bone marrow infection that causes sternum osteomyelitis, bone cancer, high blood pressure, and anxiety, panic attacks, and other psychological disorders.

Treatment of Pain below Sternum

  • Pain below sternum, whether mild or severe, can arise due to minor or life-threatening causes. It is therefore advisable for patients to visit a doctor for correct diagnosis and treatment.
  • Doctors will diagnose the underlying cause of pain below sternum and then treat it as per set, normal medical procedures.
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