Pain in the sternum is a rather common ailment to the point that everyone in their life has had the opportunity to perceive this annoying sensation.
The painful sensation is mostly localized in the central part of the chest, in correspondence with the sternal bone, but depending on the case it can radiate to the back , shoulders, neck and jaw, and can intensify during the respiratory act, to following a large meal or during physical activity.
The spread of this disorder should reassure its pathological significance, in fact in most cases it is a symptom resulting from digestive difficulties, cold strokes, muscle tears, small blunt traumas or mild respiratory difficulties.
Due to its location in the thoracic area it is very easy to get scared when pain is felt in the sternum , this is because generally with a certain superficiality, that discomfort is linked to a cardiac event, therefore to a myocardial infarction.
This is certainly one of the factors that must be taken into account. However, it is good to immediately clarify that in the event of a heart attack the symptoms are much more intense and associated with other manifestations such as irradiation of pain in the left arm, difficulty in breathing, sweating, pale skin and very acute and persistent painful sensation.
Remember that the thorax is a structure that houses a large number of organs such as: lungs, pleurae (membranes that cover the lungs), bronchi, esophagus, stomach, pericardium (membrane that surrounds the heart), to which all those anatomical structures are added such as nerves, muscles, lymphatic vessels, blood vessels (aorta, superior vena cava, arteries and pulmonary veins), and that therefore pain referred to the chest much more easily affects other organs than the heart.
And above all, it is useful to reiterate that in the vast majority of cases the pain in the sternum is consequent to transitory factors and that they do not have a pathological significance of great importance, especially if the pain is retrosternal .
When to see your doctor
We have said that generally the pain in the sternum is due to minor events, especially if the disorder occurs sporadically and if the symptoms have faded.
Even in these cases it is in any case good to report the episode to your GP. If the symptoms are of greater entity, occur frequently and are associated with other disorders, it is good to contact your doctor quickly, who will evaluate which investigations to submit the patient to.
When instead the pain in the sternumand of the piercing type, and very intense, prolonged, and radiates to the left arm, the subject manifests profuse sweating, loss of balance, breathing difficulties and a sensation of constriction in the chest, and it is necessary to immediately go to an emergency room, or call the 118.
On the next page we will focus on investigating the most common causes of pain in the sternum and we will try to answer the most frequent questions: what can cause pain in the sternum when I breathe
it can be anxiety
because it hurts me when I press
What are the causes of pain in the sternum
The causesthey can be multiple, taking into account all the organs mentioned above, located in the thorax, and of different clinical interest. Let’s see an overview of the most common causes:
It is an inflammation of the gastric mucosa caused by an infection due to Helicobacter pylori or which occurs following the intake of non-steroidal anti-inflammatory drugs (NSAIDs).
It is also found in people who consume large amounts of alcohol and in smokers. Gastritis causes pain in the upper chest, sometimes associated with nausea. If not properly treated (mainly with proton pump inhibitors), gastritis can degenerate into more severe pathological pictures such as chronic atrophic gastritis, gastric ulcer and stomach cancer.
This is a rather common condition which consists in the passage of food material from the stomach to the esophagus in the opposite direction to the normal physiological transit. There are a number of factors that predispose to the development of this disease:
- Obesity which often leads to increased pressure in the stomach;
- Foods: one of the major predisposing factors is the intake of foods that lead to an increase in gastric secretion, such as chocolate, coffee, alcohol, tea, mint and spices;
- Increased production of bile;
- Hiatal hernia .
These are disorders that affect the bone structures (ribs, sternum and vertebrae) and the numerous muscles located in the chest. These cause intercostal pains and sternochondritis (inflammation of the cartilages that connect the breastbone to the ribs). Fractures are obviously also to be remembered among the possible causes of pain in the sternum that radiate up to the back .
Musculoskeletal pains can then be the consequence of minor or severe trauma (even fractures), hernias or as common as cold blows. In these cases, pain can be felt both when pressingon the area and when making movements that require the contraction of the muscles of the rib cage .
Stress and anxiety
Subjects subjected to intense periods of stress and anxiety , due to important study and work sessions, or subjected to strong emotional stress, tend to remain in prolonged postures in which the muscles are perennially contracted. This continuous state of tension leads the subject to perceive pain in the sternum and a sensation of constriction in the chest. Condition that, in an anxious subject, arouses fear that it is a heart attack.
be caused by asthma, bronchitisand pneumonia and are manifested by pain in the sternum that appears when you breathe . The pain in these cases is stabbing and indicates the presence of an irritation / inflammation of the affected area.
Let’s explore the ways in which the diagnosis is made and what are the most effective therapies .
Which elements are taken into consideration for the diagnosis
The methods of diagnosis and intervention take into consideration the symptoms felt and manifested by the patient.
If the patient arrives in the emergency room, the diagnostic procedure will be based on the confirmation of an ongoing cardiac event that can seriously endanger the patient’s life (myocardial infarction, dissecting aortic aneurysm, embolism) and therefore on stabilizing his condition and set up a therapeutic strategy.
This is what happens in a condition of real emergency, but in reality in most cases, as we have said, the pain in the sternum does not have such serious consequences on the state of health of the subject. As reiterated, it is good to talk about the disorder to your GP who will direct you to more specific visits (gastroenterological, cardiological, pneumological or orthopedic.
During the examination, the doctor asks all questions concerning the disorder: when it occurs, if episodic or recurrent, if it intensifies after a large meal or with breathing or by exercising. Obviously, particular attention is paid to the associated symptoms, such as burning sensation, shortness of breath, widespread pain and alterations at the epidermal level.
The doctor will then proceed with the examination by palpating the chest, auscultating the chest and lungs, looking for clues to guide the diagnosis.
Depending on the case, a blood test, instrumental diagnostic investigations such as a chest x-ray, and an electrocardiogram or gastroscopy may be useful.
What are the most effective therapies
As always, the importance of having to turn to medical attention and entrust the diagnosis , and therefore the most appropriate therapy exclusively to the professionalism of a doctor, is reiterated.
In fact, it is not recommended to rely on the information found on some internet site, because these very often have no scientific validity and could seriously compromise the state of health.
As for the most commonly prescribed therapies in case of sternal pain, will be linked to the pathology triggering the symptom. If the disturbance is of a gastric nature, proton pump inhibitors are generally administered; in case of pathologies affecting the musculoskeletal structures, depending on the case, anti-inflammatory therapies or surgery are useful.
As for cardiac or pulmonary pathologies, therapies will be targeted on the triggering pathology and will be identified only after careful evaluation by a specialist doctor.