The suprasternal notch, a prominent dip at the base of the neck, can sometimes cause discomfort when pressed. Located just above the breastbone, this anatomical landmark can be involved in various conditions. While pain in this region is often benign, understanding its potential origins can help alleviate concern. This article provides general information on the suprasternal notch and reasons for pain when pressure is applied, but it is not a substitute for professional medical advice.
Understanding the Suprasternal Notch
The suprasternal notch, also known as the jugular notch, is a visible depression between the collarbones (clavicles) and directly above the manubrium, the upper part of the breastbone. This easily palpable landmark serves as a reference point for identifying underlying structures in the neck and upper chest.
The notch lies in close proximity to several important anatomical components. Directly behind it is the trachea, or windpipe, which extends upwards about 5 cm above the notch in adults. The esophagus, the tube that carries food to the stomach, is also located nearby. Major blood vessels, such as parts of the aortic arch and brachiocephalic veins, are in the vicinity. The thyroid gland is positioned in the neck, anterior to the trachea, between the suprasternal notch and the cricoid cartilage.
Potential Causes of Pain
Pain when pressing on the suprasternal notch can arise from various causes, from common musculoskeletal issues to less frequent, more serious conditions. Strain or inflammation of neck or chest wall muscles and ligaments, such as the sternocleidomastoid, can lead to localized tenderness. Conditions like costochondritis, an inflammation of the cartilage connecting ribs to the breastbone, might also cause pain radiating to this region.
Issues with the thyroid gland, located just below the notch, can also manifest as pain. Thyroiditis, an inflammation of the thyroid, might result in tenderness, though pain from typical thyroid nodules is less common. Tracheal irritation can also contribute to pain. Upper respiratory infections, which often involve coughing, can lead to tenderness behind the notch. Conditions like bronchitis or the sensation of a foreign body can also cause discomfort.
Esophageal issues, such as gastroesophageal reflux disease (GERD), can sometimes cause referred pain or tenderness in the upper chest and neck, including around the suprasternal notch. Swollen lymph nodes in the neck, typically due to infection, can also be a source of pain when pressed. Direct impact or minor trauma to the area can result in localized pain and tenderness. While less common, more serious conditions like aneurysms (a bulging in a blood vessel) or tumors in the chest or neck can be associated with pain in this area, requiring medical investigation.
When to Seek Medical Attention
While pain in the suprasternal notch area can often be benign, certain symptoms warrant prompt medical evaluation. Consult a healthcare professional if the pain is persistent, does not improve, or worsens. Pain accompanied by difficulty swallowing (dysphagia) or breathing (dyspnea) should also be assessed by a doctor.
Other concerning signs include fever, unexplained weight loss, or changes in voice, such as hoarseness. A visible lump or swelling in the neck or around the suprasternal notch also requires medical attention. If the pain radiates to other areas, such as the arm, jaw, or chest, it could indicate a more serious underlying issue. Pain developing after significant trauma to the neck or chest should also be evaluated by a healthcare provider for proper diagnosis and care.
Diagnosis and General Treatment Approaches
Diagnosing suprasternal notch pain typically begins with a thorough review of the individual’s medical history. A healthcare provider will inquire about the pain’s onset, duration, characteristics, and any factors that make it better or worse. This is followed by a physical examination, including careful palpation of the suprasternal notch area, neck, and chest to identify tenderness, swelling, or other abnormalities.
To pinpoint the underlying cause, various diagnostic tests may be employed. Blood tests can provide insights into conditions such as thyroid dysfunction or inflammation. Imaging studies may be ordered, including an X-ray for bone structures, a CT scan for detailed views of soft tissues and organs, or an ultrasound of the neck and thyroid gland. If an esophageal issue is suspected, an endoscopy, using a thin, flexible tube with a camera, might be performed.
Treatment approaches are tailored to the specific diagnosis. For musculoskeletal pain, anti-inflammatory medications or physical therapy may be recommended to reduce inflammation and improve mobility. If an infection is identified, antibiotics would be prescribed. Acid-reducing medications are typically used for pain related to gastroesophageal reflux disease. In rare cases, such as certain tumors or severe structural issues, surgical intervention might be necessary.