Why does my sternum hurt when I press on it or lift my arms?

Why does my sternum hurt when I press on it or lift my arms?

Feeling pain or tenderness in your sternum—the flat bone at the center of your chest—can be unsettling. This discomfort often shows up when you press on your chest or raise your arms. Understanding the possible reasons behind sternum pain can help you decide whether simple self-care will do or if you need medical evaluation.

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Anatomy of the sternum

The sternum (breastbone) is a central anchor for your ribs and several muscles. Key points:

• Sternal regions: manubrium (upper), body (middle), xiphoid process (tip).
• Attachments: ribs via costal cartilage, clavicles (collarbones), pectoral muscles.
• Functions: protects heart and lungs, supports upper body movement.

Any strain or inflammation where these structures meet can cause localized pain when you press on the sternum or move your arms.

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Common musculoskeletal causes

Most cases of sternum pain are related to muscles, cartilage, joints or minor injuries. They include:

Costochondritis

• Inflammation of the cartilage connecting ribs to the sternum.
• Symptoms: sharp or aching pain along the front of the chest, worsened by pressing or deep breaths.
• Often follows coughing spells, repetitive upper-body movement or a minor injury.
• Self-care: rest, over-the-counter NSAIDs (ibuprofen), gentle stretching.

Muscle strain

• Overuse or sudden movement can strain pectoral or intercostal muscles.
• Symptoms: tenderness, pain triggered by arm movements, lifting or twisting.
• Common in weightlifters, athletes, or during heavy lifting at home.
• Self-care: ice for 15–20 minutes, rest, gradual return to activity.

Sternoclavicular joint issues

• The joint where your collarbone meets the sternum can become sprained or arthritic.
• Symptoms: localized pain that may radiate to the shoulder, clicking or restricted motion.
• Self-care: gentle range-of-motion exercises, heat therapy, NSAIDs.

Tietze syndrome

• Similar to costochondritis but with visible swelling at one or more cartilage joints.
• Symptoms: swelling, redness, tenderness over a single joint.
• Less common than costochondritis; may require prescription pain relief.

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Less common but important causes

Although musculoskeletal issues are the usual suspects, a few other conditions can cause sternal pain. Stay alert to additional signs.

Acid reflux (GERD)

• Stomach acid irritates the esophagus behind the sternum.
• Symptoms: burning chest pain, especially after eating; may worsen when bending or lying down.
• Management: avoid trigger foods, eat smaller meals, elevate head while sleeping, speak to a doctor about antacids or prescription options.

Pericarditis and pleurisy

• Pericarditis: inflammation of the sac around your heart.
• Pleurisy: inflammation of the lining around your lungs.
• Symptoms: sharp pain that can intensify with deep breaths, coughing or lying flat; may improve when sitting up.
• These conditions can follow viral infections or immune reactions. Medical evaluation is recommended.

Cardiac causes (angina, heart attack)

• Pain may feel like pressure, squeezing or burning under the sternum.
• Often triggered by physical activity or emotional stress; may radiate to the jaw, shoulder or arm.
• Associated signs: shortness of breath, sweating, nausea, lightheadedness.
• Although rare in younger people without risk factors, any chest pain with these warning signs requires immediate medical attention.

Sternum fracture or injury

• Direct trauma (fall, car accident) can crack the sternum.
• Symptoms: severe pain, bruising, swelling, difficulty breathing deeply.
• Fractures are uncommon without significant impact; X-ray or CT scan confirms the diagnosis.

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When to seek immediate medical help

While many causes of sternum pain improve with rest and home care, you should seek emergency care if you experience:

• Crushing chest pain, pressure or tightness lasting more than a few minutes.
• Pain spreading to your jaw, shoulder, arm or back.
• Sudden shortness of breath, cold sweat, nausea or lightheadedness.
• High fever, rapid heart rate or difficulty breathing (signs of infection, pericarditis or pleurisy).
• Pain so intense that you can’t take a deep breath or move your arms.

If you’re ever in doubt about the seriousness of your symptoms, don’t wait—call emergency services or go to your nearest emergency department.

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Self-care and prevention

For musculoskeletal sternum pain, the following steps often help:

• Rest and protect
  Avoid activities that trigger or worsen pain, especially heavy lifting or repetitive chest motions.
• Ice and heat therapy
  Ice packs in the first 48 hours to reduce inflammation; switch to heat (warm compress) to relax muscles.
• Over-the-counter pain relief
  NSAIDs (ibuprofen, naproxen) or acetaminophen can ease pain and swelling. Follow dosing instructions.
• Gentle stretching and strengthening
  Once pain decreases, perform slow chest and shoulder stretches. Strengthen upper-body muscles to reduce future strain.
• Posture and ergonomics
  Maintain good posture when sitting, standing and lifting. Adjust your workspace to avoid hunching.
• Avoid tobacco and limit alcohol
  Smoking delays healing of inflamed tissues; excessive alcohol can increase acid reflux and interfere with sleep.

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Next steps

If your sternum pain persists beyond two weeks, worsens or you notice new concerning signs, consider further assessment. You might consider doing a free, online symptom check, using the doctor approved Ubie Symptom Checker to help clarify possible causes and next steps.

Always remember: any chest pain that feels severe, different from your usual ache, or comes with alarming symptoms warrants a prompt evaluation. Speak to a doctor right away if you suspect anything could be life threatening or serious. Your health is important—never hesitate to get the care you need.