The sternum, commonly known as the breastbone, is a flat bone located in the center of the chest. It connects the ribs via cartilage and forms the front of the rib cage, protecting the heart, lungs, and major blood vessels. Understanding structures beneath or near this area helps comprehend potential sources of discomfort. This article will explore the anatomy of the region and common reasons why individuals might experience pain or unease there.
Anatomical Overview
Directly beneath the lower portion of the sternum lies the xiphoid process, a small, cartilaginous extension. This structure can sometimes be felt as a small, firm knob. Just below and slightly behind the xiphoid process, several significant organs lie.
The esophagus, the muscular tube that carries food from the throat to the stomach, passes directly behind the sternum. The upper part of the stomach is located immediately beneath the lower sternum. The diaphragm, a dome-shaped muscle essential for breathing, separates the chest and abdominal cavities. Parts of the liver extend upwards and can be found partially beneath the lower sternum.
Common Causes of Discomfort
Discomfort below the sternum often stems from issues related to the digestive system. Acid reflux, also known as gastroesophageal reflux disease (GERD), is a frequent cause, occurring when stomach acid flows back into the esophagus. This can lead to a burning sensation in the chest, often described as heartburn, which may radiate upwards or feel centralized behind the sternum. Another common digestive issue is indigestion, characterized by a feeling of fullness, bloating, or mild burning in the upper abdomen and lower chest after eating.
Musculoskeletal factors can also contribute to pain in this region. Costochondritis involves inflammation of the cartilage that connects the ribs to the sternum, causing localized tenderness and sharp pain that worsens with movement or pressure. Muscle strain in the intercostal muscles or the diaphragm, perhaps from coughing or physical exertion, can also cause pain beneath the sternum. These types of pain typically intensify with specific movements or deep breaths.
Sometimes, discomfort in the sternal area can be linked to anxiety or stress. Panic attacks, for instance, can induce symptoms that mimic heart problems, including chest tightness or a feeling of pressure. This non-cardiac chest pain is often associated with hyperventilation and muscle tension. While not physically damaging, it can be quite distressing.
When to Seek Medical Attention
While many causes of sub-sternal discomfort are not life-threatening, certain symptoms warrant immediate medical evaluation. Severe, crushing chest pain that spreads to the arm, jaw, back, or neck, especially if accompanied by shortness of breath, sweating, or dizziness, could indicate a heart attack. These symptoms require emergency medical attention.
Persistent or worsening pain, even if not severe, should also prompt a visit to a healthcare professional. Pain that does not improve with over-the-counter remedies, disrupts sleep, or is accompanied by unexplained weight loss or difficulty swallowing necessitates medical assessment. Consulting a doctor allows for proper diagnosis and management of the underlying condition.