Causes of Pain In The Sternum, Symptoms, and Resources
What is the Sternum
The sternum, also called the breastbone, is located in the center of the chest. It connects the ribs in the front. Together with the ribs it forms the thoracic cage which protects the heart and lungs from injury. The upper end of the sternum supports the clavicles (collar bones).
Causes of Pain in the Sternum
Pain in the sternum can be due to any number of causes. It may be from the sternum but it might be emanating from the heart, esophagus, lungs, nerves, muscles, ribs or tendons. In addition, pain from the back, neck or abdomen can also spread toward the chest. Various heart problems can cause heart pain directly behind the sternum. If the heart is not receiving enough oxygen or blood, angina (heart pain) results. This can be manifested as a tightness in the chest, a feeling of pressure or of something inside being crushed or squeezed. Sometimes the pain radiates to the arm, back, jaw or shoulder. Heart attack symptoms are very similar to those of angina. They can include dizziness, nausea, shortness of breath or sweating. Pericarditis, inflammation of the tissue around the heart, can also cause pain in the chest.
Aortic Aneurysm
An aortic aneurysm rupture that produces a severe stabbing pain, is a medical emergency and can be life-threatening due to profuse internal bleeding. In addition to chest pain, there may be pain in the neck, jaw, back or shoulders. There could also be difficulty in breathing.
Lung problems might also result in chest pain. Clots in the lung, pneumonia, pneumothorax (collapse of a portion of the lung) or pleurisy (inflammation of the lining around the lung) all present with sharp pain that intensifies when the person takes a deep breath.
Symptoms of An Aortic Aneurysm
Abdominal aortic aneurysm
The most common symptoms of abdominal aortic aneurysm include general abdominal pain or discomfort other symptoms include:
1. Pain in the chest, abdomen, lower back, or flank (over the kidneys), possibly spreading to the groin, buttocks, or legs. The pain may be deep, aching, gnawing, and/or throbbing, and may last for hours or days. It is generally not affected by movement, although certain positions may be more comfortable than others.
2. A pulsating sensation in the abdomen.
3. A “cold foot” or a black or blue painful toe can happen if an abdominal aortic aneurysm produces a blood clot that breaks off and blocks blood flow to the legs or feet.
4. Fever or weight loss, if it is an inflammatory aortic aneurysm.
Thoracic aortic aneurysm
Symptoms of a thoracic aortic aneurysm may include:
1. Chest pain, generally described as deep and aching or throbbing. This is the most frequent symptom.
2. Back pain.
3. A cough or shortness of breath if the aneurysm is in the area of the lungs.
4. Hoarseness.
5. Difficulty or pain while swallowing.
Costochondritis
Costochondritis, or inflammation of the cartilage that connects to the sternum, is a fairly common condition that causes mild to severe pain. Contact sports increase the chances of injury to the sternum, as does moving heavy items. Tietze syndrome, a similar inflammation, also includes swelling of the cartilage. Although the pain can sometimes be disabling, the condition usually goes away by itself within three months.
Symptoms of Costochondritis
1. Chest pain associated with costochondritis can be preceded by exercise, minor trauma, or an upper respiratory infection.
2. The pain usually will be sharp and located on your front chest wall.
3. The most common sites of pain are the fourth, fifth, and sixth ribs. This pain increases as you move your trunk or take deep breaths.
4. The reproducible tenderness you feel when you press on the rib joints is a characteristic feature of costochondritis.
5. When costochondritis occurs as a result of infection after an operation, there can be inflammation with redness, swelling, or pus discharge at the site of the procedure.
Bone Cancer
Bone cancer and breast cancer can result in pain in the areas of the sternum. If, in addition to the pain experienced in the sternum, a mass is felt in the chest, chondrosarcoma (cancer of the cartilage) or lymphoma might be suspected. Around a quarter of those cancers that start in the bone are chondrosarcomas. When detected at an early stage, the prognosis is good.
Symptoms of Bone Cancer
1. The most common symptom of bone tumors is pain. Depending on the growth of the tumor, those affected may have symptoms for weeks, months, or years before seeking medical advice. In some cases, a mass or lump may be felt either on the bone or in the tissues surrounding the bone. This is most common with MFH or fibrosarcoma but can occur with other bone tumors.
2. The bones can become weakened by the tumor and lead to a fracture after little or no trauma or just from standing on the affected bone. This can occur with both benign and malignant tumors.
3. If the tumor compresses the surrounding nerve it can cause pain, numbness, or tingling in the extremities. If the surrounding blood vessels are compressed, it can affect the blood flow to the extremities.
4. Fever, chills, night sweats, and weight loss can occur but are less common. These symptoms are more common after spread of the tumor to other tissues in the body.
Depending on whether the pain is acute or chronic and if it is accompanied by clicking or crackling sounds, there are different tests a doctor can order to determine the cause of the pain. If the underlying cause is disorders of the heart or lungs or a cancer, these have to be addressed before the patient can hope for relief from the pain. For pain that is due to overexertion, over-the-counter medication should be effective. But one should rule out any of the more serious conditions.
Resources about Pain in the Sternum
MedicineNet.com information about Bone Cancer
Emedicine Health information about Costochondritis
Webmd information about Aortic Aneurysm
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