The chest bone, known as the sternum or breastbone, connects the two sides of your rib cage together. It protects the many major organs in the chest and gut that sit behind it, including the hearts, lungs and stomach. This proximity to vital organs means that chest bone pain may be the result of many conditions that have little to do with the sternum itself. For this reason, the cause of a sore sternum may be hard to pinpoint.

Is My Chest Bone Pain a Heart Attack?

The first reaction to chest bone pain – especially acute or persistent pain – is to think it is a heart attack. But in many instances, chest bone pain has nothing to do with the heart, and is more likely caused by issues with the bones, muscles or digestive tract. This is particularly true in those who are under 40 and don’t have any underlying health conditions.

Conditions that May Cause Chest Bone Pain

Costochondritis

Costochondritis is a condition that is often responsible for a sore sternum and regularly mistaken for a heart attack or other heart condition. It is not, however, a serious condition, and occurs when the cartilage connecting the ribs to the sternum becomes inflamed. Symptoms may include sharp pains or aches to the side of the sternum, or pain or discomfort in one or more of the ribs. Pain may intensify when coughing, breathing deeply or moving the upper body. Costochondritis, also referred to as chest wall pain syndrome, costosternal syndrome or costosternal chondrodynia, cannot always be linked to a specific cause, but it is most likely the result of strain from physical activity, a chest injury, or joint conditions such as osteoarthritis.

Sternoclavicular Arthritis

Osteoarthritis involves the breaking down of joint cartilage over time due to wear and tear. The sternoclavicular joint (SC joint) connects the top of the sternum to the clavicle, and this hardworking joint may become painful if affected by osteoarthritis. Chest bone pain may be experienced at the top of the sternum, pain may worsen with activity or radiate into the arms, and swelling and tenderness may be present as well.

Traumatic Injury

Fracturing the sternum can induce intense pain and is usually the result of blunt force injury to the chest. It may be painful to breathe in or cough, swelling, pops and grinding noises may be experienced with arm movement, and there may be stiffness in the joint and shoulder. A sore sternum caused by injury to the SC joint or clavicle (collarbone) trauma will likely be accompanied by similar symptoms.

Muscle Strain

Pulling or straining a muscle in the chest wall through repetitive movement, increased activity level or a sudden, improper movement can result in chest bone pain. This may also occur during an illness that induces severe coughing or vomiting. Pain may be sharp or achy, worsen with movement, or be accompanied by muscle spasms or bruising and tenderness.

Hernia

Hernias occur when an organ pushes or pulls from the area where it normally sits. The most common form is a hiatal hernia, where the stomach moves into the chest cavity, past the diaphragm. In addition to a sore sternum, symptoms of a hiatal hernia may include heartburn, gas, trouble swallowing and fullness, amongst others.

Heartburn and Acid Reflux

Conditions that affect the esophagus, stomach and intestines may contribute to chest bone pain. Heart burn is a passing burning sensation in the throat, chest or abdomen caused by stomach acid. When this happens frequently, it can be a sign of acid reflux, where the lining of the esophagus begins to wear away from ongoing stomach acid.  Both heart burn and acid reflux are common gastrointestinal causes for chest bone pain.

Stomach Ulcer

A stomach ulcer (peptic ulcer) refers to an open sore on the lining of the stomach or bottom of the esophagus. In addition to stomach pain on an empty stomach and other symptoms, chest bone pain may be experienced.

Respiratory Issues

Conditions affecting the respiratory system such as pleurisy (inflamed tissue around the lungs), pneumonia (lung infection) and bronchitis (inflamed bronchial tubes) may also contribute to a sore sternum and accompanying symptoms in the chest area.

Panic Attack

A sudden onset of irrational fear or panic is referred to as a panic attack. Often a result of stress or a symptom of mental health conditions, panic attacks may be accompanied by chest bone pain that may be mistaken for a heart attack.

Heart Attack

A heart attack refers to a blockage in an artery of the heart, preventing blood and oxygen from reaching that area. Chest bone pain is a common symptom of a heart attack, specifically chest pain in the middle or left side of the chest. Accompanying symptoms may include pain or discomfort in other areas of the upper body, including arms, shoulders and jaw, feeling dizzy or lightheaded, trouble breathing, sweating and nausea. A heart attack is life-threatening and requires emergency medical attention. In some instances of chest bone pain, over-the-counter medication or a change in diet may be enough to ease symptoms. But long-term treatment may be needed if there is a more serious underlying condition. Seeking out a doctor’s diagnosis for your chest bone pain will better help you to address your symptoms.