Breastbone, as the name suggests, is an organ that covers the heart and chest region. Sternum is the medical term for breastbone and is a flat long narrow bone. The entire thoracic region is stabilized by the sternum. Many muscles that are responsible for moving your head, neck and arms originate from breastbone. Actually, sternum lies as the central point on which the shoulder joints and clavicle fuse together. Sternum lies deep inside the skin and measures roughly 6 inches in length. It encloses vital organs like heart, aorta and vena cava and offers protection and stability for many organs like shoulder, neck and chest.
Sternum or Breastbone has 3 major parts which are detailed below :-
- Manubrium – It is the uppermost part of the sternum resembling the handle of a sword. Coastal cartilages fuse with manubrium joining the clavicles and the first two pairs of true ribs.
- Body – Body of the breastbone is certainly the longest portion of it and the coastal cartilages from 3-10th pair of ribs are connected with it.
- Xiphoid Process – This is the inferior portion of the breastbone and is the smallest of all. Xiphoid process serves as the midpoint for several muscles, diaphragm and cartilages.
When a patient undergoes open heart surgery, the sternum is to be cut into two pieces in the midpoint so that heart can be accessed. Soon after surgery, the two halves are wired back and kept intact. However any stress can affect the broken sternum and is liable to fracture.
Pain In The Breastbone :
Breastbone or sternum pain is harmless in most of the cases. Pain in the sternum may range from mild to severe sharp pain. If you have persistent pain that increases as time passes you should seek medical help ASAP.
- Breastbone pain can be in the form of mild bruises due to accidental injury or trauma.
- Some people may feel the pain while taking a deep breath. For others pain is felt only during coughing.
- A driver, who hits his chest on steering wheel with force, can experience moderate to sharp pain on the sternum.
- In severe cases one can hear a cracking noise from the sternum indicating a popping bone inside.
Causes Of Sternum Pain :
Causes of breastbone pain are varied and discussed in separate headings.
- Cardiovascular Causes – Any disease or serious problem in the heart, heart-valve can cause sternum pain. If there is any infection on the heart like pericarditis (a double layered sac that covers the heart) or myocarditis it can cause pain in the breastbone in addition to other symptoms. Coronary artery disease and aortic dissection can cause pain in the breastbone.
- Respiratory Causes – Severe and chronic infectious diseases like bronchitis, asthma, tuberculosis, and COPD can cause persistent pain in the breastbone. Lung infection like pneumonia can cause inflammation of the lungs leading to breastbone pain.
- Abdominal Causes – Inflammation of pancreas (pancreatitis), peptic ulcers on the stomach and acid reflux disorder can affect the sternum causing breastbone pain. However there may be other major symptoms in addition to sternum pain.
- Musculoskeletal Causes – This is the major cause for sternum pain. Any injury or trauma can cause mild fracture in the parts of breastbone. It can be clavicle fracture, sterna fracture and fracture in any of the bone that fuses with the sternum. Any problem in the ribcage can affect the sternum causing breastbone pain. Costochondritis, joint pain, blocked rib and stress related fracture in the ribs can cause sternum pain. Sometimes, even anxiety can cause chest pain and bone pain of the sternum. Often it would the strained muscle that causes pain in the breastbone.
- Postoperative Cause – Many people may complain of chest pain or breastbone pain after having open heart surgery. Even after proper healing of wounds, any surgery in the heart can cause sternum pain and pain on the ribcages for long time.
Your doctor would listen to the symptoms after completing physical examination. He may feel for swelling or tenderness on the breastbone area. He may order for imaging tests, like chest X-ray or CT scan of the sternum to detect the problem.
In many cases sternum pain is due to costochondritis which resolves automatically. It is enough if you take painkillers for some days. For moderate to severe pain, your doctor may prescribe suitable medications like NSAID or even some narcotics. You can manage mild pain with Ibuprofen or naproxen sodium. Sometimes you need to take anti-inflammatory drugs of prescription strength to get relief from breastbone pain.
Narcotics like Vicodin or Tylox or Percocet can be prescribed but you should take only for prescribed time and not more than that, since people get addicted to it. For some people antidepressant medications like amitriptyline is given to manage persistent pain. This drug can give you quality sleep also during night.
- Physiotherapy :
You can get help from a therapist to learn stretching exercises which may strengthen chest muscles. Grade 1 and grade 2 pain (partial tear) can be managed with physiotherapy after the inflammation is healed thoroughly. In severe cases nerve stimulation process is done with TENS wherein electric current in controlled volts are given through adhesive patches attached to the skin on your chest.
- Surgery :
If the nature of problem is serious and persistent your doctor may consider doing surgery.
Home Remedies :
There is no home remedy for managing breastbone pain. But mild form of pain can be treated with application of ice/hot packs on it. Any inflammation in the chest area may respond to ice therapy quickly. Take complete rest and do not lift any heavy objects even after the pain is gone.
Overall, the trick lies in identifying the real cause of sternum pain. It is easy to treat breastbone pain if the cause is diagnosed. In many cases sternum pain will resolve on its own by taking over the counter painkillers. Most of the cases the pain may be due to other causes like acid reflux or costochondritis.