Sternum Pain: Causes, Symptoms, and Treatment Options

By Robert Lim, PTA

What are the Bones in the Chest or Sternum? 

The bones in the chest are very vital in protecting vital organs from injury, and also provide structural support for the upper body.  The thorax is commonly known as the chest.  The bones in the chest are the thoracic vertebrae, the twelve pairs of ribs, and the sternum.   Connecting the upper ten pairs of ribs to the sternum is the costal cartilage.

Human chest bones anatomy ribcage. JOI Rehab

Human Rib Cage and sternum

Rib Cage

When talking about bones in the chest, let’s first start off with the rib cage.  The human rib cage is one of the body’s best defenses from injury from impact.  The ribs and sternum make up the ribcage.  The rib cage protects major vital organs such as the heart, lungs, and liver from injury.  The rib cage has 24 ribs.  Each rib extends from the spinal cord and wraps around the body.

The Chest Bones Anatomy

Sternum Anatomy

With regards to bones in the chest, the sternum, or also known as the breast bone, is a long flat bone in the center of the chest.  Its big purpose is to protect the heart.  The sternum is attached to the first seven ribs and also to the clavicle, or collarbone.  The sternum is made up of three parts called the manubrium, the body, and the xiphoid process.  The top of the sternum is called the manubrium.

It is connected to the first two ribs of the rib cage.  The body, also called the blade, is right in the middle of the sternum.  It connects to the third through seventh ribs and the eighth through tenth ribs indirectly. The xiphoid process is the bottom tip of the sternum.  Rib pairs one through seven are called ‘true ribs’ because they connect directly to the sternum with costal cartilage.  Rib pairs eight through ten are called ‘false ribs’ because they are connected to the seventh rib.

Bones of the Chest or Sternum

Chest Bones or Sternum

Pain in the Sternum

If you are experiencing pain in the sternum you may think you are having a heart attack. More than likely sternum pain is unrelated to the heart and is caused by problems with the cartilage of the sternum or the sternum itself.  Costochondritis is common in this area of the body.

The most common causes of pain in the sternum are:

  • Muscular strain
  • Collarbone injury
  • Sternum fracture
  • Costochondritis


The clavicle, or also known as the collarbone, extends across the front of the shoulder from the sternum to the scapula, or shoulder blade.  An injury to this bone is commonly is due to an impact on the area such as a fall or hit when playing sports.  It is important to be evaluated to make sure a fracture will heal properly.  Surgery is sometimes required with a fracture to the clavicle.  Symptoms include sharp pain over the bone as well as a deformity with palpation to the bone.

X- Ray of human upper chest bones anatomy clavicle labeled. JOI Rehab

X- Ray of Clavicles

Clavicle Pain

Collarbone pain, also known as clavicle pain can be caused by a fracture, bone infection, or arthritis. Symptoms of clavicle pain include:

  • A bulge over the collarbone
  • Tenderness at the collarbone
  • Pain when moving arm
  • Decreased range of motion of the arm
  • Shooting pain up neck or down arm

Please read this article to learn about Clavicle Fractures.


The scapula, or shoulder blade, is a flat triangular bone located in the back of the shoulder.  It connects with the collarbone in the front of the body.  It is also is connected to the shoulder joint, which brings together the shoulder blade and the humerus, or the large bone of the upper arm. The scapula is often overlooked with injuries to the shoulder.  It is important to make sure that the mobility of the scapula is addresses with any rehab of a shoulder injury.

Watch this VIDEO about why shoulder pain can’t wait for treatment.

X-Ray of human back bones anatomy and the scapula of the upper body. JOI Rehab

X-Ray of the Scapula

Scapula or Shoulder Blade Pain

Often, the shoulder blade sustains injuries in overhead sports such as baseball, softball or tennis.  Muscle strains are common to the muscles that stabilize the scapula or shoulder blade.

  • Strain from lifting a heavy item
  • Injury from fall or accident
  • Working at a computer for long periods
  • Poor posture
  • Sleeping in an odd position

Treatment Options

The treatment options related to injuries to the chest are dependent on a fracture or soft tissue injury.  Most fractures of the bones of the chest result in a period of immobilization and rest.  Sometimes soft tissue injuries to the ribs are harder to recover from versus a fracture.  It is difficult to rest the ribs and intercostal muscles because they move during the breathing process.   Modalities are important to reduce pain and inflammation after the injury.

X-rays can determine a clavicle fracture or break.  It is always important to have a proper evaluation to make sure that your internal organs do not have injuries as well.  The ribs protect the lungs and heart but they can also cause injuries to these vital organs.


In summary, the bones in the chest help make up and define the upper body.  Any injury to any of these structures can be very painful as well as vital to protecting organs.  Therefore, if you feel that you have any injury to these bones in the chest, please consult your doctor or your orthopaedic doctor in regard to proper care and treatment.

By: Robert Lim, PTA

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