Sternum pain is a common symptom that can arise from a wide array of conditions. While often minor, sternum pain can also signal a severe underlying problem. Due to its central location near several vital organs, understanding its origins is important. A medical professional should evaluate any unexplained or persistent sternum pain to ensure an accurate diagnosis and appropriate treatment.
Musculoskeletal Reasons for Pain
Pain in the sternum often originates from the bones, cartilage, and muscles. A common cause is costochondritis, an inflammation of the cartilage that connects the ribs to the breastbone. It presents as sharp, aching, or pressure-like pain, often worsening with deep breaths, coughing, or direct pressure. Pain may radiate to the arms and shoulders, often affecting the upper left ribs.
Pectoral or intercostal muscle strains (between the ribs) can also cause sternum pain. These strains result from physical activities, strenuous coughing, or direct injury to the chest. This pain is localized and may feel sore or tender. Direct trauma to the chest, such as from an accident, can lead to a sternum fracture or bruising, which causes significant pain.
Heart-Related Causes of Chest Discomfort
Serious causes of sternum pain relate to the heart and major blood vessels. Angina or a heart attack, resulting from reduced heart blood flow, causes sensations like pressure, tightness, squeezing, or aching in the chest. Pain can spread to the left arm, shoulder, neck, jaw, or back, accompanied by shortness of breath, sweating, or nausea. These symptoms warrant immediate medical attention.
Pericarditis, inflammation of the heart’s surrounding sac, causes sharp, stabbing chest pain. Pain may be felt behind the breastbone or on the left chest, worsening when lying down, coughing, or deep breathing. Leaning forward provides some relief from pericarditis pain. Aortic dissection, a rare, life-threatening condition, involves a tear in the aorta’s inner layer. This condition causes sudden, severe, tearing or ripping pain in the chest or upper back that can spread to other areas.
Digestive and Lung-Related Factors
Digestive and respiratory conditions can also cause sternum pain. Gastroesophageal Reflux Disease (GERD) is a common digestive cause, where stomach acid flows back into the esophagus, leading to a burning sensation behind the sternum (heartburn). Discomfort worsens after eating or lying down, and may include a sour taste or difficulty swallowing. Esophageal spasms, involuntary muscle contractions, can cause sudden, intense chest pain mimicking a heart attack.
Lung-related issues can also contribute to sternum pain. Pleurisy, inflammation of the lung lining, causes sharp chest pain intensifying with deep breathing, coughing, or sneezing. Pleurisy pain is localized to one side but can spread to the shoulder or back. Severe coughing from respiratory infections like bronchitis or pneumonia can strain muscles around the sternum, producing a dull ache or tenderness.
Other Potential Triggers and Medical Guidance
Other causes of sternum pain include anxiety and panic attacks. These psychological events can trigger symptoms like chest tightness, sharp pain, shortness of breath, and heart palpitations, which may be mistaken for a cardiac event. Anxiety-related chest pain can feel like a sudden, sharp stabbing sensation or a persistent ache, accompanied by dizziness or sweating. Shingles, caused by varicella-zoster virus reactivation, can also cause nerve pain in the chest before a visible rash. Pain is described as burning, tingling, or itching and affects only one side.
Seek professional medical attention for unexplained chest pain. Immediate evaluation is needed if pain is sudden, severe, radiates to the arms, back, neck, or jaw, or is accompanied by shortness of breath, dizziness, or sweating. For persistent mild pain or discomfort with specific movements, a non-emergency medical appointment is advisable. A healthcare provider can conduct examinations and tests to determine the underlying cause and recommend appropriate management.