Clavicle pain usually comes from one of a handful of causes: a fracture, joint wear and tear, or repetitive stress on the structures around the bone. The collarbone connects your shoulder to your breastbone and sits just beneath the skin with little muscle padding, which makes it vulnerable to injury and easy to feel when something goes wrong. Where the pain falls along the bone, what triggers it, and how it started can narrow down what’s happening.
Fractures: The Most Common Cause
Broken collarbones account for roughly 10% of all bone fractures and affect about 1 in 1,000 people each year. About 70% of these breaks happen in the middle of the bone, the thinnest section with no muscles or ligaments to reinforce it. A fall onto an outstretched hand, a direct blow during sports, or a car accident are the typical triggers. You’ll usually know right away: sharp pain, visible swelling, sometimes a bump or deformity where the bone shifted, and difficulty raising your arm.
Recovery time depends heavily on age. Adults typically need 8 to 12 weeks, adolescents 6 to 8 weeks, and children under 8 can heal in as little as 3 to 6 weeks. Most clavicle fractures heal with a sling and rest. During recovery, you should avoid using that arm to lift, push, or pull until you’re cleared. Surgery is reserved for fractures where the bone is significantly displaced or breaks through the skin.
AC Joint Problems
The acromioclavicular (AC) joint sits at the outer tip of your collarbone where it meets the shoulder blade. Pain here is one of the most common reasons for clavicle pain that isn’t a fracture. Two conditions affect this joint frequently, and they can feel similar.
Osteoarthritis
Wear and tear gradually erodes the cartilage cushioning the AC joint. This is especially common in people who’ve spent years lifting heavy weights or doing overhead work. The pain tends to be on top of the shoulder, worsening when you reach across your body, press overhead (like a bench press or push-up), or lean on that side while sleeping. You might feel stiffness in the morning that loosens up with movement, or notice a bony bump where the joint has developed bone spurs. An X-ray with a specific angled view can confirm the diagnosis by showing narrowed joint space and bone spur formation.
Weightlifter’s Shoulder
Distal clavicular osteolysis, commonly called weightlifter’s shoulder, is an overuse condition where the outer end of the clavicle actually starts to break down and weaken. Repetitive stress and microtrauma at the AC joint trigger this bone resorption. Despite the name, it doesn’t only affect weightlifters. Construction workers, swimmers, tennis players, volleyball players, and anyone who repeatedly loads the shoulder with overhead force can develop it. The pain feels similar to AC joint arthritis: an ache at the top of the shoulder that flares with pressing movements and overhead activity. Imaging typically shows an irregular, moth-eaten appearance at the end of the clavicle. Backing off the aggravating activity is the first step in treatment, and many cases resolve with rest and modified training.
Joint Separation and Ligament Injuries
A fall directly onto the point of your shoulder can sprain or tear the ligaments holding the AC joint together. This is different from a fracture: the bone is intact, but the joint itself has been disrupted. Mild separations cause localized pain and swelling. More severe separations produce a visible step-off deformity where the collarbone rides up higher than normal. The symptoms overlap significantly with fractures (pain, swelling, limited motion), so imaging is usually needed to tell them apart.
On the other end of the collarbone, the sternoclavicular (SC) joint connects to your breastbone. Injuries here are less common but can happen from a hard blow to the chest or shoulder. The most frequently seen SC joint injury is a ligament sprain, though fractures of the inner clavicle also occur. Some people, particularly those who are naturally loose-jointed, experience the bone slipping in and out of place (subluxation) even without significant trauma. This can produce clicking, popping, or a vague ache near the center of the chest. Fractures at the inner end of the clavicle are tricky because regular X-rays can miss them. A CT scan is the more reliable tool for evaluating this area.
Thoracic Outlet Syndrome
If your clavicle pain comes with numbness, tingling, or weakness running down your arm, the issue may not be the bone itself. In thoracic outlet syndrome, the space between the collarbone and the first rib narrows, compressing nerves or blood vessels. This can result from an old fracture that healed with extra bone, an anatomical variation like an extra rib, overdeveloped muscles from bodybuilding, chronic poor posture, or excess body weight. The pain is often diffuse rather than pinpoint, and it may worsen when you raise your arms overhead or carry heavy bags. Physical therapy focused on posture correction and stretching the muscles around the collarbone is the typical first-line treatment.
Less Common Causes
Bone infections (osteomyelitis) can settle in the clavicle, though this is rare in otherwise healthy people. It usually develops when an infection elsewhere in the body spreads through the bloodstream, or when bacteria enter through a surgical site or traumatic wound. Signs include localized pain with redness, warmth, and sometimes fever. Inflammatory conditions like rheumatoid arthritis can also affect the clavicle joints, particularly the SC joint, causing chronic swelling and pain that may come and go in flares.
Primary bone cancer starting in the clavicle is extremely rare, affecting fewer than 4,000 people in the U.S. each year across all bone sites. Cancer that has spread from elsewhere in the body (metastatic disease) is more likely than a tumor originating in the clavicle. Persistent, worsening pain that doesn’t respond to rest or anti-inflammatory medication, especially with unexplained weight loss or night pain that wakes you up, warrants prompt evaluation.
How to Narrow Down the Cause
Location matters. Pain in the middle of the collarbone after a fall or impact is a fracture until proven otherwise. Pain at the outer end near the shoulder, especially if it developed gradually and worsens with pressing or overhead movements, points toward AC joint arthritis or osteolysis. Pain near the breastbone suggests an SC joint issue.
The onset matters too. Sudden pain after trauma is almost always a fracture, separation, or sprain. Pain that crept in over weeks or months, particularly if you lift weights or do repetitive overhead work, suggests an overuse condition. Pain accompanied by arm tingling or numbness raises the possibility of nerve compression.
A standard X-ray is the first imaging test for most clavicle complaints. For AC joint issues, a specific angled view (called a Zanca view) gives the clearest picture. If the inner clavicle is the concern, a CT scan is more reliable because standard X-rays frequently miss fractures in that area. MRI is less useful for evaluating the bone itself but can show soft tissue swelling and joint inflammation. In some cases, a corticosteroid injection into the AC joint serves double duty: if the pain disappears temporarily, it confirms the joint as the source.