Breastbone pain

The sternum is located in the thorax and is connected to 10 of the 12 ribs. The sternum is located very superficially so that no muscle is directly above the sternum. However, some of the respiratory auxiliary muscles (for example the pectoralis muscle) originate directly from the sternum and so muscle tension can also cause pain in the sternum.

Inexperienced weightlifters in particular can suffer from pain in the sternum if they strain the muscles in the upper chest area too quickly and too much. The excessive load can lead to so-called muscle soreness, but it can also cause irritation or inflammation of muscle tendons. If the tendon of the pectoralis muscle is affected, this can lead to sternum pain, among other things.

However, it is also possible that it is not anatomical structures that are responsible for the pain in the sternum but rather an organ problem. Very well known is the so-called heartburn (reflux disease). This is a reflux of stomach acid from the stomach into the esophagus.

Since the esophagus runs through the so-called mediastinum, an area behind the esophagus, heartburn can also cause pain in the breastbone. This pain does not occur in the sternum itself, so the sternum is not stressed in heartburn. Rather, the pain is projected from the body into the area of the sternum, similar to the pain in a heart attack, where the pain occurs in the left arm.

Since the heart is located directly below the sternum, it is important to always have a cardiological examination (i.e. an examination of the heart) if pain in the sternum is present. This examination must determine whether there are any abnormalities in the area of the heart, i.e. changes that could lead to the pain in the sternum (for example, an enlarged heart (heart hypertrophy) or, in rare cases, a silent infarction). In very rare cases a so-called Tietze syndrome occurs.

This is a swelling in the area where the ribs are attached. This is where the costal cartilage is located, which connects the ribs and the sternum in an articulated way. In Tietze syndrome, a painful swelling develops for unknown reasons, which can usually be felt in the area of the sternum.

The pain occurs suddenly, not necessarily during stress or physical activity. However, the pain in the sternum usually becomes stronger during physical activity, as there is then usually increased inhalation and the rib cartilage is thus put under increased strain. In general, pain in the sternum is not uncommon and can be associated with a wide variety of diseases, such as pneumonia, contusion of the ribs or even a broken rib. It is therefore important to have sternal pain clarified if it persists for a long time and cannot be explained by a simple “sore muscle”.