Causes of Breast Bone Pain (Sternum)

The breast bone, also known as the sternum, is a flat bone located in the middle of the thorax (chest) and serves two important functions in the body. Firstly, the breast bone protects the vital organs lying behind it, primarily the heart and airways, and secondly, it serves as a central point where the ribs and shoulder bones (clavicle) connect and articulate. The breast bone can be divided into three distinct parts :

  1. Manubrium
  2. Body
  3. Xiphoid process

Breast bone pain is a common symptom that is experienced at frequent intervals in life and may be harmless in most cases. However, persistent pain or pain that is increasing in intensity or frequency, should be investigated by a medical doctor. Breast bone pain is usually experienced and described as pain in the bone, under the breast bone or to the side of the bone.  Pain may range from sharp and stabbing sensations to mild soreness or a bruised feeling. In some cases there are reports of a popping sternum which is a clicking or cracking noise from the breastbone  joints that may be present along with pain, tenderness and swelling. Although referred to as the breast bone, the sternum does not lie under the breast but rather in between the breast, extending above (manubrium) and through the cleavage in women.

breast_bone_pain

Causes of Breast Bone Pain

  • Heartburn or reflux is the most common cause of a burning pain along and under the breast bone as a result of esophagitis. Gastroesophageal reflux (GERD) may also result in episodes of severe sharp pains in the chest and is often mistaken for a myocardial infarction (heart attack) during these episodes. Other types of esophagitis may also cause breastbone pain.
  • Fractures of the sternum is rare but may occur in car accident injuries due to the impact with the steering wheel.
  • Joint pain at the points where the shoulder bone (1) and ribs (2) articulate with the breast bone can be due to inflammatory joint disorders like arthritis although this is uncommon. More commonly, joint pain may be due to strain during impact or when exercising, specifically weight lifting. Joint pain is usually felt on either side of the breast bone. Costochondritis and Tietze’s syndrome are two common causes of breastbone pain due to the inflammation of the costal cartilage and joint.
  • Muscle pain, specifically of the pectoral muscles, may cause breast bone pain as they attach at this site. Muscle strain is the most common cause and results typically in a bruised or sore pain, often described as an ache. The intercostal muscles, which lie between the ribs, may also cause breast bone pain and these muscles may get strained during constant deep and forced breathing, particularly in respiratory disorders like emphysema and asthma.
  • Cardiac conditions like coronary artery disease, angina, myocardial infarction (heart attack), myocarditis and pericarditis are serious causes of pain under the breast bone.
  • Respiratory causes of breast bone pain include bronchitis, bronchiectasis and tracheitis. Tuberculosis and pneumonia may also cause pain under the breast bone although these conditions usually affect the sides of the chest around the area of the lungs.
  • Psychological conditions like panic and anxiety attacks may cause a perceived pain under the breast bone which may be related to an increased heart rate (palpitations), heartburn or psychogenic pain (perceived pain).
  • Surgery of the organs within the thoracic (chest cavity) may require separation of the bones of the chest. Cardiothoracis or open heart surgery may be the cause of long term pain in or on the sides of the breast bone even after the wounds heal.
  • Other conditions, which are not common causes of breast bone pain, may include acute pancreatitis, hiatal hernia, stomach ulcers and causes of excessive belching or upper middle abdominal pain. Cancer of the lungs, airways, lung abscess and sarcoidosis may also cause breast bone pain.

Related Questions and Answers

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  • nelly

    Hey doc, am a female of 27 yrs old, i recently had an ESR and FBC with results as follows- Hb(10.8g/100ml), PCV(37.4%), Mcv(81.4fi), McHc(28.8g/dl), platelet(304,000ui), WBC(4100ui), Neutrophil(45.6%), Lymphocyte(40.8%), Others(13.6%). i had this test done bcos for the past 7month now, i have been having a left sided chest pain on exhalation(had 2 x-rays, 3 ECGs and an ECHO, all came out Normal) also, i have been having this constant malaised feeling for about 4months and the whole of my left chest is twitching or undergoing some kind of painless spasms as well as my left eye for about 4 months now too and so decided to run these tests. Is the result normal? People say the WBC is low, what could cause this?

  • Dr. Chris

    Hi Jenny

    It depends on what is causing this pain. It could be related to the chest wall and could be muscular strain, a bruise or even costochondritis. Or it may be deeper lying – in your age group you should consider pleuritis (inflammation of the lining around the lungs) or even pericarditis (inflammation of the lining around the heart). This can occur if you had a respiratory tract infection recently. YES, you should see a doctor to have it assessed.

  • Dr. Chris

    Hi Jenny

    In your age group, chest wall problems are a more common cause of this type of pain. Although the pain is characteristic of pleuritis (inflammation of the lining around the lungs) or even pericarditis (lining around the heart), it is uncommon for your age unless you recently had an infection. However, you have not experienced any respiratory or related symptoms. You should still see your doctor to exclude these serious causes and take note of whether the pain occurs with certain movements, especially arm movements, and report this to your doctor. A chest x-ray may be necessary as a starting point.

  • Dr. Chris

    Hi Nelly

    We don’t respond to questions regarding the evaluation of lab tests results as many patients attempt to “self-diagnose” themselves without seeing a doctor. This can have dire consequences and become a medicolegal issue in the long run. You should not be taking advice from”people” and seek professional medical help. Discuss your blood tests with your doctor and given your symptoms, you should be consulting with a specialist physician at this point.

  • janice I Barnes

    I spit up daily a thick dark gray, greemish phlegm ball everyday which is difficult to spit and often gets stuck in my throat, until I can get rid of it. It really comes up fast after I have eaten at the end of the day or if I really talk a lot for a lengthy time. It does interfere with my breathing, until I have released it. What is this? (I am 58 yrs. old, a jogger since 18 and very slim. Have IBS and colitis badly.)

  • Karla

    Hi my name is karla n I’m 21 have 2 kids.
    I have been gettin chest pains the last past 4 days on the left side right next to my breast it will come really sharp n than it will go away. Help pls!!!

  • Kylie

    Dear Doctor,
    I am a 15 year old girl with pain in my sternum. It started earlier in the day and gradually grew to a moderate dull pain. It affects my sternum and upper spine. Light pressure on my sternum brings me to tears, breathing is really difficult and it hurts so does eating and drinking. Pain medication isn’t working and I don’t really know what I should do.

  • Hi Kylie. It is very concerning that then pain is so intense that it can be triggered with even light pressure. Furthermore the difficulty breathing, eating and drinking is also a worry. Kylie, this could be Tietze’s syndrome which is more often seen in young people, particularly female.

    But it could also be due to an injury which may have led to fractured rib and son. You need to speak to your parents ASAP and see a doctor. The intensity of the pain you describe and breathing/eating issues means that this cannot be left unattended. We cannot comment on other treatment measures as the cause needs to diagnosed by a medical professional who can deal with you face-to-face.

  • Kylie

    Dear Doctor,
    After I got your message I convinced my mother to take me to the doctor immediately. My doctor said that I was must likely having reflux and should take ranitidine and pain pills then come back in two weeks. I would like to know if reflux can cause such issues, because the pain keeps getting worse.

  • Hi Kylie. We would not like to second guess your doctor or any other health care professional as he/she has seen you in person and knows your case. Yes, reflux is a possible cause as the article mentions above. As we said previously, pain that brings you to tears and there is difficulty breathing is a concern. Rather follow your doctor’s advice and if you are feeling uncertain then seek a second opinion from another doctor.

  • Kylie

    Dear Doctor,
    I listen to my doctors advice like you told me too. I didn’t work. Around 1:30 pm I could barely breath and what breaths a did get were short and painful. the pain in my chest instead of being the dull pain from yesterday turned into a sharp stabbing-like pain. The area is much more tender now and hurts very bad. Pain killers aren’t doing anything to help to.

  • Hi Kylie. We are very limited in how much further we can advise you. This is an online platform that guides readers on possible solutions. We cannot make a diagnosis, prescribe a treatment or override the advice or judgement of the medical professional you are seeing. Commenting any further could open us up to liability. Therefore we strongly advise that if you are not experiencing any relief of symptoms and feel your doctor’s approach was inadequate then seek a second opinion. Do not delay if your symptoms are getting worse – go to the ER at your local hospital.

  • Kaylie

    Hi, I am a 17 yr old female. I have this hard spot on my sternum right in between my breasts. This lump comes and goes . It is hard and usually painful. What could cause this?

  • diala

    Hi, Im a 21 years old female. I’ve been experiencing pain in a bone in my chest in the right side but the bone isn’t in the middle its like between the upper middle and the right of my chest. when i touch it, it hurts and i can feel that its infected. Other than that lately i’ve been experiencing a rash in the upper area of my chest, and around my mouth and redness around my nose, and i have a feeling that my hair isn’t as thick as it was! help me please

  • Hi Diala. It is difficult to say whether all these symptoms (chest pain, face rash and thinning hair) are related or not. However, it is a possibility that a systemic condition may be responsible and you have to see a doctor for this as soon as possible. Shingles is one possibility that needs to be considered here. However, there are a host of different conditions, particularly skin diseases, that could be causing these symptoms. It is possible that the chest pain has nothing to do with bone but is rather just a skin problem. It is advisable that you see a doctor ASAP.

  • Brittany Streeter

    Hi, I’m 22 years old, and over the past 3 weeks I’ve been experiencing dull pain above my right breast and around my sternum area when swallowing food or hiccuping. Also, sometimes it just aches in general, but only when I’ve been outside in the cold and shivering. A couple days before Christmas, I had a couple ski falls, which I didn’t think much of, but in both cases my arms were pulled pretty violently uphill while my legs were being pulled downhill (my skis didn’t pop off). A couple weeks after that (January 10), I went bouldering with my family, It was after the bouldering that I noticed the dull pain when swallowing food or hiccuping. Is it likely that I have some irritation/inflammation?

  • Hi Brittany. Yes, it is very likely that some soft tissue injury related to your falls could be causing these symptoms. Given your age you are not usually in the high risk group for some of the more serious conditions that may be attributed to these symptoms. This is not to say that the injuries that you have sustained are not serious. Hopefully you did see a doctor after your falls, had an x-ray and started anti-inflammatory drugs shortly thereafter to minimize the inflammation and discomfort. If not, then you should see your doctor ASAP.

  • Brittany Streeter

    I did got to my doctor, had a chest x-ray (which was normal) and have been taking anti-inflammatories (ibuprofen). The frequency and intensity seems to be improving. I still feel the discomfort on occasion. I’ve been pretty anxious about it, so now I’m hypersensitive to everything I feel when swallowing. Sometimes it feels uncomfortable around the throat area when swallowing, but I’m not sure if it’s simply because I’m paying attention to it. My husband says that swallowing isn’t necessarily comfortable, but unless he’s focused on the motion that he doesn’t feel any discomfort. What would you say swallowing is supposed to feel like? I also have neck pain (around the sternocleidomastoid) area particularly when in bed. I’m a stomach sleeper, I also have a forward head posture and rounded shoulders from that. I often get an aching feel from my neck area to my ears. Is it possible to feel some “deep throat” discomfort when swallowing if one has tight and sore sternocleidomastoids? Interestingly, I learned that those muscles also connect to the sternum…wonder if it’s related to my chest discomfort? Not sure how I should proceed. Not sure if I’m overreacting or I should be checked out further. I’ve also read about hyoid bone syndrome…

  • julie

    Hi, I have pain that starts at the start of my left breast all the way to end. The pain is under my breast when I seem to push in on this area. Had xray but found nothing with my ribs

  • Hi Briittany. Swallowing is not supposed to be a painful experience. You asked what swallowing should feel like but it is important to realize that sensations are subjective and furthermore vary by the situation. In other words swallowing a partially chewed carrot is going to be uncomfortable as to swallowing yogurt. You have many concerns and you should be directing this to a doctor in a face-to-face consultation. If you are not satisfied with your doctor then seek a second opinion from another doctor, or ask for a referral to a specialist. It’s always good to be cautious as something serious could start off slowly with non-specific symptoms. We are not in a position to say whether this is serious or not and as an online platform we have to rely on subjective information that you offer. So there could be much more at play here that even you may not realize. Rather not attempt to self-diagnose (unless you have an extensive medical background) and see a doctor in person.

  • Hi Julie. Hopefully you have consulted with a gynecologist as it may be a breast issue and not necessarily a bone problem. Pain on its own without any other symptom is difficult to interpret, especially on an online platform. You need to follow up with your doctor and then see a gynecologist. Hopefully you have been having your annual mammograms. Your doctor will be able to advise you further.

  • Tammy

    Hi, I’m a 56 year old experiencing pain in my chest. I think it is in my 1st and 2nd ribs. It only hurts upon movement and if I press on it. Yesterday the pain was in my sternum. Also, upon waking this morning, I had back and flank pain that went away after I was up and about. Not sure if they are related. (Looked at a urine sample: clear and no weird odor.) Any insights?

  • Laugh Goblin

    HI Doctor,

    I am not sure if this forum is still active. But 3 days ago I was horse playing with my cousin and I hit my chest pretty hard a few times. Next day I noticed a swelling on my breast bone. Then the next day it felt bruised, and I could feel my heart beat. I noticed I felt myself gasping for a deeper breath, and pressure when breathing, and eating. I went to my DR for X-rays but the nurse called back the next day and said everything looks normal. I still feel discomfort. Both times I have visited this DR after being recommended by a friend he seemed a little impatient with me due to my hard of hearing. I found it difficult to ask him anything with out him losing his patients with me. He prescribed me some IBUPROFEN 800MG. Said it would help with pain and swelling. But I was still left with questions that I did not want to hassle him with.

    I would like to know… If I just maybe bruised my chest? Are the symptoms I am feeling normal? Will it heal on it’s own? Should I take the IBUPROFEN even if I am not in pain?. I just feel discomfort in eating, and breathing and discomfort when I sleep, and sometimes a painless pinching feeling in the bruised area.

  • Hi Cora. We cannot answer the questions specific to your case because we are not overseeing your case. However, in general terms if the x-ray was clear then it is likely that this was soft tissue injury. It would explain most of the symptoms you are experiencing. Most injuries of this sort heal on its own over time but anti-inflammatory drugs like ibuprofen are usually prescribed to aid with reducing the inflammation. But this may not necessarily be the issue in your case. Seek a second opinion to be sure.

  • Laugh Goblin

    Thank you.

  • Alice

    Hi Dr

    I am 27 years old and I always sleep on my stomach and one night I woke up with pain in my sternum. It has been 3 days the pain hasn’t gotten worse but it hasn’t significantly improved either. It hurts when i stretch or lean forward or backwards. Please let me know of any advice or hypotheses. Thanks

  • Greta

    Hi,
    I’m an active 22 year old and have been experiencing some pain in my chest for a few days–mainly middle right side. The pain isn’t unbearable, but it does get a bit worse with certain movements. When I am laying down, it gets hot on the site. I have been doing more push-ups than usual right before the pain started. But, my hubby and I were also wrestling around and he put his weight on my chest before the pain started as well. What could this be? Is it from the work out, or did my hubby accidentally mess something up?

  • Greta

    I’m an active 22 year old and have been experiencing some pain in my chest for a few days–mainly middle right side. The pain isn’t unbearable, but it does get a bit worse with certain movements. When I am laying down, it gets hot on the site. I have been doing more push-ups than usual right before the pain started. But, my hubby and I were also wrestling around and he put his weight on my chest before the pain started as well. What could this be? Is it from the work out, or did my hubby accidentally mess something up?

  • Hi Alice. This is possibly just musculoskeletal where there is pressure being placed on the chest wall for long hours since you sleep on your abdomen. There are other possibilities like acid reflux which will worsen by your sleeping position. Speak to your doctor about it if it hasn’t resolved as yet and see if it still occurs when you change sleeping position. It is difficult to say for sure through an online platform but rather be safe than sorry and have it investigated by a medical professional.

  • Mandie Saunders

    I am a 35 year old woman and have had pain in my sternum (right in the middle of my chest) for a four or five days now it hurts if it gets pushed on and I sneezed a few min ago and felt like i was getting kicked from the inside out.

  • Taylor

    HealthHype: I have a question that is of concern. Directly at the line in the middle of my chest where your cleavage would start is extremely tender to the touch. It feels almost as if it is bruised inside it. I am confused because it’s not necessarily my chest or my breast or what? I am starting to get worried about it. Any suggestions?

  • Prem Dhungyel

    Hi Doctor,
    I am Prem Dhungyel from Bhutan. I have been suffering from chest pain for the last 14 years and it never gets well. The main pain is felt in the left chest particularly the pain in bones while touching around the breast. It also gives difficulty in breathing and I get lots of pain while I am hungry. Please can you suggest me what actually it means. I did lots of test for heart attacks like CT scan, ECG, X-ray and all and Doctors found that the heart is in perfect condition.

  • micki

    Hi, I am 40 years old. I have been sick with I guess it’s a cold, nasal drainage and clogging, had a sore throat for the first 2 days, I cough up a little phlegm here and there. Sometimes it’s kind of brown. But it doesn’t feel like it’s in my lungs, but I have pain in my sternum more so to the left but still in the middle. It hurts when I move around and sometimes if I breathe deeply. It feels more like the bone is bruised or something. So I was wondering is it because I’m sick and should I wait until I get over my cold and see if it goes away or should I see someone now. I’ve been sick for 6 days it started hurting the second day and is still bothersome. It’s more annoying than anything. But I am getting concerned. I am feeling better but not over it yet.

  • Brandi

    I’m 22 have 1 kid I woke up in the night and noticed that between my breast I have a swollen spot more on the left side close to my breast on the left?? Does anybody know what this could be

  • Rochelle

    Dear doctor, my name is Rochelle I’m 22 years old and I’ve been experiencing moderate to severe cramps in my chest ever since I was a toddler (according to my mom) and so far no doctor that I went to has come to make a diagnosis. I also have a burning sensation in the middle of my chest and sometimes there’s a itching under my ribcage as well. The itching comes and goes, so does the cramping and sometimes the cramping gets so severe that I can hardly take a breathe. Please help cause I don’t know what else to do. Pain medication doesn’t work either because I’m allergic

  • HI Brandi. There are many possible causes but this could be a swollen lymph node. You should definitely have this checked up as soon as possible. Speak to your doctor. Further investigation may be necessary to conclusively identify the underlying cause. It may not be anything serious but it is better to have it checked as early as possible.

  • Melissa Orr

    I am a 48 yr old female and have a swelling or lump on the xiphoid process it is sore and tender to the touch. My doctor wants me to have a mammogram but why a mammogram if this soreness is on my sternum? Should I b concerned? I thought maybe an xrays or something would be the case not mammogram

  • José Felicié

    doctor? Mi name is José and i am 18 years old. Today i was wrestling with a friend for fun on a trampoline. During this my friend landed on my chest with his shoulder. I started feeling a dull pain on my chest when i breath and move my left arm too much. It isnt unbearable. And when I touch the area i dont feel very sore. But when i apply presure it causes the dull pain. This pain happens at both my back and chest. I am hoping that it will go away tomorrow. I dont believe it was a fracture because it isnt that painfull. (Ive never experienced a broken bone before either.) Please. Is there anyway to treat this? If the pain doesnt get better by tomorrow i wll go to a doctor.

  • Jade

    Hi, I’m a 22 year old female. I don’t quite know if it’s anything serious but I’ve woken up this morning and the bones above my breasts along my chest are very tender to touch. Clothing and the slightest amount of pressure touching certain areas are very painful. I can’t recall injuring myself to the extent the pain is. I was wondering if the pain will subside or whether I need to go to my doctors to be checked over?

  • Hi Jade. In situations like these, with such severe tenderness, you should definitely consult with a doctor. Hopefully by now you have done so. Sudden onset of pain and tenderness is often associated with an injury and sometimes and infection but it could also be due to other conditions. The lack of any preceding injury does not mean that it may still not be a serious problem. Hopefully this is not the situation in your case.

  • rose

    For the past year I have gone to the doctors for shoulder blade pain and also breast pain. When I breathe some part along my shoulder blade it pops. I would say the popping goes through my ribs 1-6, sometimes even my neck. It is very painful or it is a highly unpleasant feeling. This happens throughout the whole day, everyday, more than 17 times of popping ,and I have no control of it. I had an X-ray done and the doctors said it was normal. Then they gave me therapy and they blamed it on my bad posture. 2 weeks later, there was no improvement on the popping even with the practice of “good posture”. I cannot sleep at night and it is driving me crazy. What should I do? Should I demand an MRI or a CT Scan?