Morning Sternum (Breastbone), Manubrium Pain Upon Waking

Valmontemmanuel Asked :
I have been feeling this pain in the manubrium, occasionally. It resurfaces, sometimes. I felt this when I was first year in college. Now I am in third year and I feel the pain when I wake up from sleep in morning.

I am assuming this is because of my sleeping positions. I move many times and my bed is sort of imbalanced, since it is old already and fragile. When i try to press it, in the middle of the bone which holds the first intercostal bones, it hurts.

What is this and what do I do? Please help. It disappears for 2 weeks, then it comes again. I also feel it when I move, or when i bend down. When I palpate it I just feel the bony prominence.


This question was posted under the Causes of Breast Bone Sternum Pain article.

Any response by the Health Hype team does not constitute a medical consultation and the advice should be viewed purely as a guide. Always consult with your doctor before making any changes to your current treatment program. The information provided in this article is not an authoritative resource on the subject matter and solely intends to guide the reader based on the questions asked and information provided.


Dr. Chris Answered :

Since you have read through the article listing all the causes, it is important to bear in mind that any of these causes are a possibility and should only be excluded once your doctor conducts the necessary tests or advises so. Breastbone pain among students is actually quite common and many cases are linked to muscular causes and costochondritis.

Students tend to sit in awkward positions when studying and if you put your entire body weight on one arm for long periods, this can transfer some of the weight to the sternocostal and costochondral joints. One of the common positions include studying in bed while you use your one arm to prop up your torso.Usually the tenderness is felt on the side of the sternum and many students report a popping sternum noise when they stretch their arms or push out the chest.

This may not necessarily be occurring in your condition but it is useful to keep this in mind. Your posture, especially when you are isolated to one spot for long periods of time, can play a big part in breastbone pain.

It is important to identify if the pain you are experiencing is due to any past injury. Sometimes it may not be as obvious as a car accident or severe chest trauma. It could be an old sports injury or even a fall that did not seem serious at the time which resulted in a fracture (Bone Chest Pain). You will need a chest x-ray to confirm this. There may also be persistent muscle spasm and often this will ease when using muscle relaxants (Muscle Chest Pain).

However, this pain may not be related to the bone or muscle and could involve the organs of the chest. Your past medical history, age and current health status may give some indication towards conditions involving the heart or lungs specifically. Some of these conditions like pericarditis and tracheitis may cause pain when you tilt forward but at this point you should have noticed other signs and symptoms. Refer to the articles on Heart Chest Pain and Lung Chest Pain for more information.

It is important to note that the clavicle (collar bone) attaches to the sternum at this point and your pain could be associated with the clavicle or sternoclavicular joint. Refer to the article on Collarbone Pain. Disorders associated with the phrenic nerve can sometimes cause pain at the clavicle which could be associated with a host of conditions including neurological causes.

As you can see, the possibilities are endless and you should see a doctor about this condition as he/she will be able to do the necessary investigations and make a conclusive diagnosis based on clinical findings. Even a case of acid reflux could account for your symptoms. Refer to Gastric Chest Pain for more information. If you are experiencing any neurological symptoms including tingling and numbness of the arm, you should seek immediate medical attention.

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