Bone Chest Pain

The bones of the thoracic cavity are part of the outer chest wall with the sternum, clavicle and ribs in the front (anterior), ribs on the sides (lateral) and ribs and vertebrae at the back (posterior). The scapula may also be considered as part of the chest wall as any pathology within this bone may also cause bone chest pain.

Causes of Bone Chest Pain

Pain arising from the bones or joints may cause chest pain that will often elicit tenderness to touch or firm pressure. The pain usually aggravates with breathing or movement and may ease when at rest.

The most common causes of bone or joint chest pain include :

Fractures

Fractures of the bones of the thoracic cavity (sternum, ribs, clavicle or vertebrae) will cause chest pain that can be felt in the bone or referred to surrounding areas. A fracture is most often caused by severe force (trauma) although even slight force can result in a fracture in patients with osteoporosis. A fracture (broken bone) may be complete, where the bone has separated or incomplete where the bone is still connected¬† (‘bone crack’). The latter is more likely in a fracture of a vertera (spine bone) or sternum (breastbone).

There is usually swelling, redness and pain visible at the point of the fracture as well as of the surrounding soft tissue. The pain usually aggravates with movement or breathing.

Costochondritis

Costochondritis which is the inflammation of the cartilage and joints between the ribs and sternum (breast bone). It can vary in intensity from a dull ache to a sharp pain and is one of the main causes of breastbone pain. There are a number of causes of costochondritis with trauma, excessive pressure on the ribcage (internal like when sneezing or coughing forcefully and external like when sleeping on the chest on a hard surface), abnormal body movements and weight bearing exercises being among the main causes. Fibromyalgia, infection and respiratory illnesses may also be responsible for costochondritis.

Apart from pain and/or tenderness at the costosternal joint, there may also be visible or palpable swelling, pain when taking deep breaths or coughing. In severe cases, it can cause a difficulty breathing due to pain upon inspiration (inhaling). Costochondritis may lead to a sublaxation (dislocation) of the joint and some patients may stretch their arms and report a ‘clicking’ or ‘popping’ sound which relieves the pain at times.

Osteoporosis

Osteoporosis is degenerative bone condition where the density of the bone gradually decreases thereby causing weak and fragile bones. There may be many major and minor fractures that will occur over years, some of which may not even be noticed.

Bone pain is not a common symptom of osteoporosis unless there is a fracture.

Arthritis

Osteoarthritis occurs when the cartilagenous ends of a bone wears down and bones surfaces make contact with each other. While it is not common in the ribs, breastbone or thoracic and cervical (chest) vertebrae, it is nevertheless a possibility. Rheumatoid arthritis is a type of autoimmune disease where there is painful joint swelling. Similar to osteoarthritis, the joints of the bones that make up the thoracic cavity are not a common site for rheumatoid arthritis but it is possible.

Joint swelling and pain are the most marked signs of arthritis of the bones and joints of the chest cavity.

Infections

Bone or joint infections do not usually occur as primary infections. Usually an infection from elsewhere in the body spreads to the bone (osteomyelitis) causing bone pain, tenderness, fever and weight loss. These infections are usually due to bacteria although some fungi may also cause bone infections.

Tuberculosis (TB) of the bone and joint(s) usually occurs secondary to TB of the lung (pulmonary TB) and is caused by the bacteria, Mycobacterium tuberculosis. When this bacterial infection affects the bones of the thoracic cavity, it is more likely to affect the vertebrae (Pott’s disease).

The respiratory symptoms of TB are most noticeable and these include persistent coughing which may at times be a bloody cough, fever and night sweats, difficulty breathing and weight loss. It is more likely to cause lung chest pain although pain may be felt within the bones or joints once the infection spreads to these sites (miliary TB).

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  • HITESH BHATI

    some times when i do work seeing down side and again when i lift my body up i feel pain in chest at sternum. then i just pull my chest back side of my left then a sound cut come out from it and some thing releaises and i again got relaxes. i cant find what is stucking again and again in my sternum bone is there and nerve or a bone problem. let me know how it can be dignoses. plz help me.

    thanks

    hitesh bhati (india)

  • Dr. Chris

    Hi Hitesh Bhati

    I am not unsure that I understand you correctly due to the English but it seems that you may muscle strain or more likely inflammation of the cartilage/joints that connects the rib to the cartilages. This can cause a popping sound or even grating sound when you almost exceed the range of motion or carry heavy weights. You should see your doctor about this.

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  • Jaytown

    there is a bump or bone that sticks out kinda round and its located in the middle of my chest or below my sternum its kinda hard to explain but it is tender and some times it feels like something is poking me. i dont remember seeing this before and im kinda worried about it, any ideas

  • Dr. Chris

    Hi Jaytown

    Middle of your chest means that it is over (on top of) your breastbone. Below the sternum indicates that it is within the abdominal cavity. The chances are that if you are experiencing both these problems that they may be due to different causes.

    A “bump” on the middle of your chest would stem from the sternum (breastbone) itself. It could be due to a number of factors affecting the skin, tendons or bone itself. If it is the bone, it should not just come and go. It is a little confusing to fully understand what you mean through an online platform like this and you should see a doctor about it. “Bumps” on the side of the bone could be related to certain nutritional deficiencies and “bumps” on the bone itself could be bony metastases (cancer spread from another site). Non-cancerous protruberances are also a possibility.

    The “bump” below the breastbone could very likely be related to gas trapped in the colon. You should have experienced some other gastrointestinal symptoms and this would be transient. If it is constant, then it may be related to more serious conditions.

    Either way, only a doctor would be able to tell you what exactly is causing this after examining you further.

  • francojane

    hello. i woke up one morning with chest pains. (female 28yrs) it feels like when you sit back on a corner for a long time, but when you stand up, your chest felt like it was folded. thats how it feels. but from what i know, that pain lasts for a few minutes and goes away. my chest pAin now is for the whole day. pls help? thanks.

  • Dr. Chris

    Hi Francojane

    It could be one of two things – referred pain from the back (spinal column) possibly due to compression on the root of the intercostal nerves or it could be due to acid reflux (GERD) which is usually worse at night and when lying. However the latter would also present with a mild morning sore throat and you would have most likely noticed heartburn at some other time in the day as well. There are other causes which is less common in a person of you age. You should see your doctor and he will consider further investigation.

  • marie

    i had a chest infection and a nasty cough have had this for about 5 weeks now ,, been taking nyproxen which has helped but i have develoed this bruised feeling on my chest just by my left breast and a sore left shoulder and arm ,, have had an ecg which was fine and doc said my chest is clear so what is this feeling in my chest and arm

  • Dr. Chris

    Hi Marie

    It could just be muscle strain from the constant coughing. Remember that the pectoral muscles which are largely responsible for arm movements are located on the chest but are also strained on labored breathing and coughing. This is why you may feel chest pain when moving your hand. The other muscles that are also strained include the respiratory and accessory muscles of respiration. Nevertheless it is always good to be cautious and you should speak to your doctor again, possibly see a cardiologist if you are concerned and seek immediate medical attention if you see any other signs and symptoms start up that may be indicative of a more serious condition.

  • marie

    thanks chris feeling a bit better now my chest is starting to clear and not hurting as much , my arma and shoulder feeling better and the pain now moe off than on ,, im starting to feel a bit dizzy at times though and wondered if this was normal due to the fact i have been ill

  • Dr. Chris

    Hi Marie

    It is possible that the dizziness is related to your recent illness but of course it depends on what type of illness. Common causes following prolonged illness includes dehydration, changes in blood pressure as the body tries to regulate it to a normal level, nutrient deficiencies and so on. You should speak to your doctor about it, especially if it is persisting, getting worse or leading to fainting spells.

  • marie

    hi chris i was diagnosed with brochitis which doc think came on from a chest infection , since then i have had a chest pain near left breast although this is now clearing i also had a sore left shoulder and arm which is also getting better.
    however the dizzines only been here for last couple of days and now have slight pain in my right shoulder but not bad , i am thinking i have pulled muscles or trapped nerves as doc did my kidney and liver function etc which where all fine , also had ecg that was also fine and listened to my chest also fine .
    blood pressure and temp all normal

  • Dr. Chris

    Hi Marie

    A stress ECG (exercise) should be done if it has not already been done.

  • kevin wonnacott

    is it dangerous not to have a shoulder injury/collerbone may be broken ,looked at?

  • Dr. Chris

    Hi Kevin

    Yes, it has to be examined if there is a suspicion of a fracture. And x-ray should be conducted immediately. Leaving it unattended can lead to a host of complications, impair your mobility and compromise any treatment in the long run. Speak to your doctor immediately.

  • Chris

    I have been experiencing a pain in my chest on and off for roughly the past 10 years. I am 27 and used to play sports like football and basketball and did some weight lifting but didnt experience this pain at that time. The pain is present nearly every morning and I can USUALLY get it to go away by streching my arms back and pushing my chest out. It feels like a bone or two are pinching the muscles in my chest. My Dr. said that he didnt see any problems and suggested that it is caused by sleeping on my side, but I am about 60lb overweight and have mild sleep apnea and sleeping on my side lessens my snoring. Any thoughts on what this might be and how I can resolve this problem. Note: it is not debilitating just anoying but occasionally I have to have my wife help me strech to get the pain to release.