Pain in the sternum


Many people in the population suffer from pain in the region of the sternum, i.e. the Sternum. Because important organs such as the heart and lungs are located behind this, most people are unsettled when they see a doctor. However, the cause of the pain often lies in the musculoskeletal system.


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Tension / sore muscles

The chest muscles attach to the sternum. These include the sternal muscles themselves (M. sternalis, without function and not present in everyone), as well as the small (M. pectoralis minor) and large chest muscles (M. pectoralis major).

Physical strain (sport, work) or an improper load can lead to tension in these muscles. A bad posture often results from the shoulders hanging too far forward. The tense muscles press on the sternum and trigger the pain.

Read more on the subject at: Chest pain from tension

Pinched nerve

Poor posture when sitting or standing can lead to a pinched nerve in the back area. If an intercostal nerve is affected, i.e. the nerve that runs along the rib, this can cause pain in the sternum. Certain movements in sports or manual work that are not carried out correctly can also lead to this. The nerve is pinched in the back area, but the pain signal comes from the end of the nerve at the sternum. This phenomenon is known as projected pain.

Read more on the subject at:

  • Pinched nerve on shoulder
  • Chest pain from nerves

Tietze syndrome

The Tietze syndrome describes a rare disease in the area of ​​the cartilage-bone border of the ribs and the sternum. In the technical language this is called Chondropathy designated.Usually the second and third costal cartilages are affected. The resulting pain in the sternum often occurs very suddenly. It was with one Tietze Syndrome no cause for the syndrome found yet. However, inflammatory processes or overuse are suspected.
In addition to the costal cartilage, the syringe of the sternum can also be affected in Tietze syndrome.

Read a lot more information on this topic at: Tietze syndrome

Sternum fracture

In the event of strong direct violence, it can lead to Sternum fracture come. This is very painful and is often accompanied by injuries to neighboring structures such as the ribs.
Contrary to the lay assumption, sternum fractures are relatively common. Usually you don't need any further treatment. Nevertheless, a sternum fracture can have far-reaching consequences.

Read a lot more information on this topic at: Sternum fracture


Behind the sternum is in close proximity esophagus. If one suffers from stomach discomfort and an acidic eructation (heartburn, in technical language "Reflux esophagitis") the pain caused by stomach acid can radiate into the esophagus. Depending on the severity, the pain can also be perceived as sternum pain.

lung infection

Pneumonia can also cause pain in the sternum. However, it is rare for pneumonia to manifest itself through this alone. Other symptoms, such as general fatigue, fever and cough, are usually in the foreground.


The Pain in the sternum are perceived as very uncomfortable. There is often an additional one Pressure or tightness. Most of the time the pain is stabbing itself and worsens when the chest moves. When you breathe in, it becomes maximal because the chest is stretched. When you breathe out, the pain improves. Affected people usually breathe more shallowly so as not to provoke pain. Mainly because of this breath-dependent pain there is a fear that the heart or lung system may be diseased. These fears can have an impact on the person's psyche. In rare cases, the sternum may be swollen.

Caution is advised with the following symptoms: The pain in the sternum occurs suddenly and is massive. There is a in the chest Tightness and the pain radiates into the left arm. There is also paleness, nausea, sweating or shortness of breath. If that is the case, one speaks of anginal discomfort. These should be clarified as quickly as possible (in an emergency), as they indicate something is happening to the heart.

also read: Heart attack symptoms.


In addition to a medical history and physical exam, imaging tests can be useful in making a diagnosis. Any broken bones or pneumonia can be seen on it.

In the case of pain in the sternum, the challenge for the first examiner (usually the family doctor or orthopedic surgeon) is to find out whether the cause is external or internal. That means whether the musculoskeletal system or an organ system is the reason.
To this end, a detailed survey takes place about the symptoms. It is important to find out what the quality of the pain is: whether it is movement and / or breathing dependent and how long has it been there. This is followed by a physical examination of the entire chest. The breastbone is inspected and palpated. In addition, the chest and back muscles are tested to find out whether there is any tension in this area. The physical exam also includes listening to the heart and lungs so that cardiac and pulmonary causes of the pain can be ruled out.

If the examiner suspects a disease of the heart or pulmonary system or the esophagus after the physical examination, he will refer the person concerned to a specialist in these fields.

Read more about the general topic of sternum pain.

Apparatus procedures


If a fracture is to be ruled out as the cause of pain, the chest is x-rayed. in the roentgen the bony structures can be visualized. In addition, the heart and the lungs can also be assessed. For example, pneumonia can be excluded.


The Magnetic resonance imaging of the sternum is suitable as a diagnostic tool if a Tietze syndrome suspected to be the cause of pain. In Tietze syndrome, the X-ray is normal.
However, swelling of the costal cartilage can be detected in the MRI.



The pain is with NSAIDs (Non-steroidal anti-inflammatory drugs) like Ibuprofen or Diclofenac treated. Ibuprofen and diclofenac are not only pain relievers, but also anti-inflammatory. Diclofenac is also available as an ointment, better known by the name Voltaren®.

A herbal ointment that helps is good Arnica ointment.

If the pain is very pronounced, there is a possibility Local anesthetic possibly to inject directly with glucocorticoids (cortisol).


Physiotherapy or physiotherapy helps with massages and exercises against tension or muscle shortening. Claimed regions can taped and be stabilized. You will also learn techniques that you can use at home on your own. Acute relieves warmth a tension.


Good posture and occasional relaxation exercises are particularly important when sitting for long periods of time in order to avoid tension and nerve entrapment.

With the correct posture you can prevent muscle tension and nerve entrapment that lead to pain in the sternum. It is important to maintain an upright posture, with the shoulders hanging loosely and not pulled up. The chest should be extended and the head should be kept straight. There should be no hollow back. The sitting posture should be changed frequently to avoid one-sided stress.

For predominantly sedentary activities (computer workstation) are occasional relaxation exercises important. It makes sense to deal with that Back school familiarize yourself, which is primarily aimed at office workplaces.

Before engaging in physical activity that you are not used to or sporting activities, you should pay attention to your muscles beforehand to warm up and to stretch.


The prognosis for pain in the sternum is usually good. If the therapy (medicinal and physical) is carried out consistently, the symptoms will improve more quickly. Of course, it depends on the cause of the pain whether or not there is complete healing. If, for example, Tietze syndrome is present, it cannot be ruled out that the symptoms will recur.