The collarbone (clavicle) is the horizontal bone connecting the breastbone to the shoulder blade, supporting the shoulder joint. Pain in this area specifically while lifting the arm strongly indicates a mechanical problem within the complex shoulder structure. This symptom suggests that the movement is pinching, compressing, or stressing one of the joints, tendons, or nerves housed in the shoulder girdle. The source of this pain often involves issues ranging from joint wear-and-tear to soft tissue inflammation.
Pain from the Acromioclavicular Joint
A frequent source of collarbone pain when lifting the arm is the acromioclavicular (AC) joint, where the outer end of the clavicle meets the acromion. This joint is stressed during most arm movements, especially those involving reaching across the body or lifting overhead. Raising the arm requires the AC joint to move and rotate, which can expose underlying damage.
A common issue is AC joint arthritis, often developing as osteoarthritis from gradual wear and tear or repetitive stress. This condition erodes the cartilage, causing the bones to rub against each other during movement. Osteolysis, characterized by bone resorption, is sometimes seen in weightlifters who perform repetitive presses.
Another mechanical cause is an AC joint separation, an injury to the ligaments connecting the clavicle and the acromion, usually from a fall or direct blow. The severity is graded based on which ligaments are torn and how far the collarbone has shifted. Even a mild separation causes pain when the arm is lifted, as the movement stresses the damaged structures. The pain is typically localized right on top of the shoulder.
Impingement and Rotator Cuff Issues
Pain near the collarbone when lifting the arm is frequently caused by problems with surrounding soft tissues, which can refer discomfort to the clavicular area. This often involves shoulder impingement syndrome, where a tendon or fluid-filled sac gets squeezed between the shoulder bones as the arm is elevated.
The rotator cuff tendons, particularly the supraspinatus tendon, are often involved in this compression. As the arm lifts, the subacromial space beneath the acromion naturally narrows, pinching the tendons passing through it. This pinching results in inflammation (tendinopathy), causing pain that worsens as the arm is raised, especially above shoulder height.
Bursitis, the inflammation of a bursa sac, is closely linked to impingement. The subacromial bursa sits over the rotator cuff tendons and acts as a cushion to reduce friction. When this bursa becomes inflamed, the tight space is further reduced, leading to sharp pain when moving the arm. These conditions are often triggered by overuse, such as repetitive overhead activities, leading to swelling and painful rubbing.
Less Common Nerve and Bony Causes
While joint and soft tissue issues are the most common culprits, pain in the collarbone region when lifting the arm can stem from less frequent causes involving nerves or the bone itself. One such cause is Thoracic Outlet Syndrome (TOS), where nerves or blood vessels are compressed in the space between the clavicle and the first rib. Raising the arm compresses these structures further, often causing pain, tingling, numbness, or weakness that radiates down the arm and hand.
The most common form, neurogenic TOS, involves compression of the brachial plexus, a network of nerves passing through the outlet. This compression is exacerbated by sustained arm elevation because the clavicle is pushed down onto the first rib. Another possibility is referred pain originating from the cervical spine (neck). An irritated nerve root in the neck can send pain signals that make the collarbone feel like the source of discomfort.
Less frequently, a stress fracture or bone bruise of the clavicle can cause localized pain during movement. A stress injury results from repetitive mechanical strain that micro-damages the bone over time. Lifting the arm places rotational and bending forces on the clavicle, aggravating the injury and making movement painful.
Determining When to See a Doctor
While many causes of collarbone pain can be managed initially with rest and anti-inflammatory medication, certain signs indicate the need for professional medical evaluation. Immediate medical attention is required if the pain results from severe, acute trauma like a fall, or if there is a visible deformity or bump near the collarbone. These symptoms may suggest a significant AC joint separation or a clavicle fracture.
Medical advice is also warranted if the pain is accompanied by neurological symptoms, such as numbness, tingling, or weakness in the arm or hand. These can be signs of nerve involvement, like Thoracic Outlet Syndrome or cervical spine issues, which require specific diagnosis and management. Furthermore, if the pain persists for more than a few days despite home care, or if it interferes with sleep or basic daily activities, a doctor can perform an examination and order imaging tests to accurately determine the underlying cause.