Sternal Pain


Sternal pain is an acute or chronic pain or discomfort felt in the region of sternum and the associated structures.

The first seven ribs attached to the sternum or the breastbone in the front are known as sternal or true ribs. The sternum or breastbone is a long, flat bone located in the center of the thorax (chest). It connects to the rib bones via cartilage, forming the rib cage with them. It helps to protect the lungs, heart and major blood vessels from physical trauma.

The sternum is composed of vascular cancellous tissue, covered by a thin layer of compact bone, which is thickest in the manubrium between the articular facets for the clavicles.

At times, sternal pain is also accompanied by sensations like a cracking sound.

Conditions and Causes

There are a number of conditions that might lead to sternal pain. Here we briefly list a few amongst them.

A) Sternal Fractures

Fractures of the sternum are relatively uncommon. These normally occur from a trauma, such as when a driver’s chest is forced into the steering column of a car in a car accident.

A sternal fracture is usually a comminuted fracture, implying that it is broken into pieces.

B) Sternoclavicular (SC) Joint Injury

The sternoclavicular joint or the SC joint is the connection of the sternum (breastbone) to the clavicle .i.e. collarbone.

Sternoclavicular joint can also dislocate from its normal position. The clavicle will dislocate either in front (an anterior SC dislocation) or behind (a posterior SC dislocation).

C) Broken collarbone

The collarbone, also known as the clavicle, is the bone at the top of the chest, between the breastbone (sternum) and the shoulder blade (scapula). Clavicle fractures are extremely common and can occur in adolescents, athletes and babies, during accidents, falls or at birth.

D) Costochondritis

This is an inflammation of the junctions where the upper ribs join with the cartilage that holds them to the breastbone or sternum. The condition causes localized chest pain that can be reproduced by pushing on the cartilage in the front of your ribcage.

Tietze Syndrome, an inflammatory condition of the breast area is also another form of costochondritis.

E) Trauma

Sternal pain might also occur because of a fall while running or a similar injury.

Diagnosis and Treatment

A physician will begin the examination of possible causes of sternal pain with an interview about your medical history. The symptoms and events preceding your pain will also be questioned in detail.

This is mostly followed by an x-ray of the affected area (around the sternum) to identify any prominent fractures or similar conditions.

General forms of treatment available for sternal pain include:

· Nonsteroidal anti-inflammatory drugs (NSAIDs)

· Local injections (corticosteroids)

· Rest