The collarbone (clavicle) is the horizontal bone connecting the sternum (breastbone) to the shoulder blade (scapula) via two joints: the sternoclavicular (SC) joint and the acromioclavicular (AC) joint. Pain in this area is a frequent complaint stemming from various sources, including muscle strains, traumatic injuries, or underlying medical conditions. Understanding the nature and location of the discomfort helps identify the cause.
Sudden Pain from Acute Injuries
Immediate, sharp collarbone pain often follows a sudden, traumatic event. A clavicle fracture is common, typically occurring after a direct blow or a fall onto the shoulder or an outstretched arm. Symptoms include swelling, bruising, and sharp pain when moving the arm, sometimes accompanied by a grinding sensation; a visible deformity or bump indicates displaced fracture fragments.
An acromioclavicular (AC) joint separation (shoulder separation) involves ligament damage, usually from a forceful fall directly onto the shoulder. Symptoms include pain and tenderness at the top of the shoulder. Severe cases may show a noticeable bulge where the collarbone is misaligned relative to the shoulder blade.
A sternoclavicular (SC) joint dislocation also causes immediate pain. A posterior SC joint dislocation, where the clavicle is pushed behind the sternum, is serious due to the bone’s proximity to the trachea, esophagus, and major blood vessels. This injury requires immediate medical attention because the displaced bone can compress these structures, potentially causing difficulty breathing or swallowing.
Pain Caused by Joint Wear and Posture
Chronic, gradual collarbone pain often relates to mechanical stress, repetitive motion, or degenerative changes. Osteoarthritis, caused by the gradual wearing down of cartilage, can affect both the AC and SC joints. This pain develops slowly, is aggravated by movement, and may be accompanied by a clicking sound (crepitus). The joint may become visibly enlarged due to the formation of bone spurs.
Repetitive strain from activities like weightlifting or throwing can lead to distal clavicular osteolysis, sometimes called “weightlifter’s shoulder.” This involves bone resorption or stress-related fractures at the end of the clavicle nearest the shoulder. The resulting deep ache worsens when lifting objects overhead or moving the arm across the chest.
Poor long-term posture, such as slouching forward while sitting at a desk, also contributes to chronic collarbone discomfort. This slumped position puts undue stress on the muscles and ligaments surrounding the shoulder girdle and neck, referring a dull, persistent pain to the clavicle area. The continuous mechanical strain increases muscle tension and leads to chronic discomfort.
Identifying Less Obvious Causes of Collarbone Pain
Collarbone pain can occasionally be a symptom of a deeper medical issue not directly related to a bone or joint injury. Thoracic Outlet Syndrome (TOS) occurs when nerves or blood vessels are compressed in the narrow passageway between the collarbone and the first rib. This compression causes pain, numbness, and tingling that radiates into the arm and hand, sometimes accompanied by swelling or discoloration.
Bone infection, known as osteomyelitis, is a rare but serious cause requiring prompt identification. When the clavicle is affected, the localized pain is severe and accompanied by systemic symptoms. These signs include fever, warmth, significant swelling over the bone, and a general feeling of being unwell.
In rare instances, pain near the collarbone is referred pain, meaning the source is located elsewhere in the body. Certain heart conditions, such as pericarditis (inflammation of the sac around the heart), can cause chest pain that radiates to the neck, shoulder, and underneath the collarbone. This referred pain is often worsened by taking a deep breath or lying down.
Urgent Symptoms Requiring Medical Review
Seek immediate medical attention if the pain results from severe trauma, such as a car accident or significant fall. This is important if you notice a visible deformity, cannot move your arm, or feel any loss of sensation, numbness, or tingling in the arm or hand. Severe pain accompanied by signs of respiratory distress, such as shortness of breath or difficulty swallowing, suggests a potentially life-threatening complication.
Consult a healthcare professional for persistent, unexplained pain that does not improve after several days of rest and over-the-counter relief. A chronic ache that is worsening, or any pain associated with systemic symptoms like persistent fever, chills, or swelling, warrants a formal medical evaluation. Early diagnosis of conditions like TOS or bone infection can prevent long-term complications, making professional review a necessary step.