Sharp or aching pain in the sternum during breathing often signals inflammation, injury, or underlying cardiac or respiratory issues.
Understanding Sternum Pain During Breathing
Pain centered around the sternum, especially when breathing, can be alarming. The sternum, or breastbone, is a flat bone located in the center of your chest. It connects to the ribs via cartilage and plays a crucial role in protecting vital organs like the heart and lungs. When this area hurts during breathing, it often points to irritation or injury involving the chest wall, lungs, heart, or even digestive organs.
The pain might feel sharp, stabbing, dull, or burning and can worsen with deep breaths, coughing, or movement. This discomfort arises because breathing involves expansion and contraction of the rib cage. Any inflammation or damage to the bones, cartilage, muscles, or nerves in this region can cause noticeable pain with each breath.
Identifying the exact cause requires understanding the various structures around the sternum and how they interact during respiration. The sternum itself has no nerves but is surrounded by muscles and cartilage rich in nerve endings that transmit pain signals when compromised.
Common Causes of Sternum Hurts When Breathing
Several conditions may trigger pain at the sternum during breathing. Some are benign and self-limiting; others demand urgent medical attention.
Costochondritis
Costochondritis is inflammation of the cartilage connecting your ribs to the sternum. It’s one of the most frequent causes of chest wall pain. The exact reason for costochondritis is often unclear but can stem from repetitive trauma (heavy lifting), viral infections, or strain after intense coughing.
Symptoms include:
- Sharp or aching pain near the breastbone
- Pain worsens with deep breaths or physical activity
- Tenderness when pressing on affected ribs
Though painful, costochondritis is generally harmless and improves with rest and anti-inflammatory medications.
Muscle Strain
The muscles surrounding your chest wall play a vital role in breathing mechanics. Overuse from heavy lifting, exercise, coughing fits, or trauma can strain these muscles leading to localized pain that intensifies with inhalation.
Unlike internal organ pain which may be diffuse, muscle strain usually presents as localized tenderness that improves gradually as muscles heal.
Rib Fracture or Injury
A direct blow to the chest or severe trauma might fracture one or more ribs near the sternum. Rib fractures cause sharp stabbing pain that worsens with every breath due to movement of broken bone ends.
Such injuries need prompt evaluation because complications like lung puncture (pneumothorax) may arise if untreated.
Pericarditis
The pericardium is a thin sac surrounding your heart. Inflammation here — known as pericarditis — causes sharp chest pain often felt behind or near the sternum. Pain typically worsens with deep breaths and lying down but eases when sitting up forward.
Pericarditis can result from infections (viral), autoimmune diseases, post-heart attack inflammation, or other systemic conditions.
Pleurisy (Pleuritis)
Pleurisy refers to inflammation of the pleura — membranes covering lungs and inner chest wall. Inflamed pleura rub against each other causing sharp stabbing pain aggravated by breathing deeply or coughing.
Causes include viral infections (like pneumonia), pulmonary embolism (blood clot), autoimmune disorders, and lung cancer.
Gastroesophageal Reflux Disease (GERD)
Sometimes burning sensation behind the sternum during breathing may be related to acid reflux irritating the esophagus lining near this area. GERD-induced chest discomfort can mimic cardiac pain but usually relates to meals and improves with antacids.
Cardiac Causes
Though less common in younger individuals without risk factors, heart-related issues must never be overlooked:
- Angina Pectoris: Chest tightness from reduced blood flow to heart muscle.
- Myocardial Infarction: Severe heart attack causing crushing chest pain.
- Aortic Dissection: Tear in aorta wall causing sudden severe chest/upper back pain.
Chest pain from cardiac causes often radiates beyond the sternum into arms/jaw and associates with sweating and shortness of breath — demanding immediate emergency care.
Diagnostic Approach for Sternum Hurts When Breathing
Pinpointing why your sternum hurts when breathing involves a thorough clinical evaluation supported by diagnostic tests tailored to suspected causes.
History & Physical Examination
Doctors start by asking about:
- Pain characteristics: onset, duration, quality (sharp/dull), triggers
- Associated symptoms: fever, cough, palpitations
- Recent injuries or illnesses
- Risk factors: smoking history, cardiac disease family history
Physical exam focuses on palpating chest wall tenderness, listening for abnormal heart/lung sounds and observing respiratory effort.
Imaging Studies
- X-rays: Chest X-ray detects rib fractures, lung infections like pneumonia.
- CT Scan: Provides detailed images for suspected pulmonary embolism or aortic dissection.
- MRI: Useful for soft tissue evaluation including muscle tears.
Electrocardiogram (ECG)
An ECG records electrical activity of your heart helping identify ischemia (reduced blood flow) or pericarditis signs crucial for cardiac-related chest pains.
Laboratory Tests
Blood tests may include:
- C-reactive protein (CRP) & ESR: markers of inflammation for costochondritis/pericarditis.
- Cardiac enzymes: troponin levels rise after heart muscle injury.
- D-dimer test: elevated in pulmonary embolism cases.
These guide diagnosis but must be interpreted alongside clinical findings.
Treatment Strategies Based on Cause
Managing sternum pain depends entirely on its root cause; here are common approaches:
| Condition | Treatment Options | Treatment Duration & Notes |
|---|---|---|
| Costochondritis | NSAIDs (ibuprofen), rest, heat application Physical therapy if chronic |
Usually resolves within weeks Avoid strenuous activities initially |
| Muscle Strain | Pain relievers, Cold/heat therapy, Gentle stretching exercises |
Mild strains heal within days-weeks Severe strains require longer rehab |
| Rib Fracture/Injury | Pain control using NSAIDs/opioids, Breathing exercises, Avoid tight bandaging |
Takes about 6 weeks Monitor for complications like pneumothorax |
| Pericarditis | Aspirin/NSAIDs, Colchicine, Corticosteroids if severe |
Treatment spans days-weeks Hospitalization if complicated |
| Pleurisy | Treat underlying cause: Antibiotics for infection, Analgesics for pain relief |
Treatments vary widely based on cause Close monitoring essential |
| GERD | Lifestyle changes: Diet modification, Antacids/PPI drugs |
Lifelong management possible Symptom control critical |
| Cardiac Causes | Evolving emergency care: Nitroglycerin/aspirin, Revascularization procedures, Surgery if needed |
Surgical intervention may be urgent Long-term cardiac rehab often required |
The Role of Lifestyle Modifications and Prevention Tips
Some causes of sternum discomfort can be minimized through lifestyle adjustments:
- Avoid activities that strain chest muscles excessively.
- If prone to GERD symptoms avoid spicy/fatty foods and eat smaller meals.
- If you smoke—quitting reduces risk of lung infections and cardiovascular disease.
- Keeps good posture to reduce unnecessary chest wall muscle tension.
- If you have recurrent costochondritis episodes consider physical therapy focused on strengthening surrounding muscles safely.
- If you experience sudden severe chest pain accompanied by sweating/dizziness seek emergency help immediately—early intervention saves lives.
- Coughing fits should be managed promptly with appropriate medications to prevent strain injuries.
- Mild injuries should not be ignored; early rest speeds recovery preventing chronic issues.
- Keen observation for worsening symptoms such as difficulty breathing should prompt urgent evaluation.
- Avoid self-medicating long-term without medical advice especially if symptoms persist beyond few days.
Key Takeaways: Sternum Hurts When Breathing
➤ Pain may indicate rib or cartilage injury.
➤ Breathing deeply can worsen the discomfort.
➤ Seek medical advice if pain is severe or persistent.
➤ Rest and avoid heavy lifting to aid recovery.
➤ Inflammation or infection could be underlying causes.
Frequently Asked Questions
Why does my sternum hurt when breathing deeply?
Pain in the sternum during deep breaths often results from inflammation or injury to the cartilage or muscles around the breastbone. Conditions like costochondritis cause sharp or aching pain that worsens with deep inhalation due to movement of the rib cage.
Can sternum pain when breathing indicate a heart problem?
While sternum pain can be related to cardiac issues, it is not always the case. Pain caused by heart problems is usually accompanied by other symptoms like shortness of breath or radiating chest discomfort. It’s important to seek medical evaluation if you suspect a cardiac cause.
How can muscle strain cause sternum pain during breathing?
Muscle strain around the chest wall occurs from overuse, coughing, or trauma. This leads to localized tenderness and pain that worsens with breathing as the muscles expand and contract, making each breath uncomfortable until healing occurs.
Is costochondritis a common cause of sternum hurting when breathing?
Yes, costochondritis is one of the most frequent causes of sternum pain during breathing. It involves inflammation of the cartilage connecting ribs to the sternum, causing sharp or aching pain that intensifies with movement and deep breaths.
When should I see a doctor for sternum pain while breathing?
If your sternum hurts severely during breathing, especially if accompanied by dizziness, sweating, or difficulty breathing, seek urgent medical attention. Persistent or worsening pain also warrants evaluation to rule out serious causes like rib fractures or cardiac conditions.
Sternum Hurts When Breathing | Final Thoughts & Summary
Pain at your breastbone while breathing is never something to dismiss lightly. This symptom spans a broad spectrum—from simple muscle strain or costochondritis to life-threatening cardiac emergencies. Recognizing accompanying signs such as fever, sweating, radiation of pain beyond sternum helps prioritize urgency.
A careful history combined with targeted physical examination guides initial suspicion while imaging studies confirm diagnosis. Treatment varies widely depending on whether inflammation dominates versus structural injury versus internal organ involvement.
If you notice persistent sternum hurts when breathing accompanied by shortness of breath, dizziness or intense pressure-like sensation seek immediate medical attention without delay. For milder cases related to musculoskeletal causes like costochondritis or muscle strain—rest combined with anti-inflammatory measures often provides relief within weeks.
Ultimately understanding potential causes empowers you to act promptly ensuring better outcomes while avoiding unnecessary anxiety over this complex symptom cluster centered around your vital chest area.