Pain at the bottom of your breastbone (sternum) can be a concerning symptom, but it's often not caused by a problem with the breastbone itself. Instead, the discomfort frequently originates from the muscles, cartilage, or bones located near the sternum, or even from organs situated just behind or below it, such as those in the digestive system. Understanding the common culprits can help you determine the next steps.
Common Causes of Lower Breastbone Pain
Pain felt just behind or below the sternum is often referred to as substernal pain. This type of pain can arise from various sources, broadly categorized into musculoskeletal issues and gastrointestinal problems.
Musculoskeletal Issues
Musculoskeletal causes are among the most frequent reasons for discomfort in the chest area, particularly around the sternum. These involve the structures that support and surround your breastbone.
Costochondritis
One of the most common causes of sternum pain, including at the bottom, is costochondritis. This condition involves inflammation of the cartilage that connects your ribs to your breastbone.
- Symptoms: Sharp, aching, or pressure-like pain that typically worsens with deep breaths, coughing, sneezing, or certain movements. The pain is usually localized and tender to the touch.
- Location: Can affect any part of the sternum, including the lower portion where the ribs connect.
- Causes: Often unknown, but can be linked to chest injury, strenuous exercise, viral infections, or even severe coughing.
Muscle Strain or Injury
Muscles in the chest wall, such as the pectorals or intercostals (between the ribs), can be strained or injured, leading to pain around the breastbone.
- Symptoms: Dull ache or sharp pain, especially when moving the arms, twisting the torso, or breathing deeply.
- Causes: Heavy lifting, strenuous exercise, trauma, or repetitive movements.
Gastrointestinal Problems
Pain behind or below the breastbone can also be a tell-tale sign of issues within your digestive system.
Acid Reflux (GERD)
Gastroesophageal Reflux Disease (GERD) occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus).
- Symptoms: A burning sensation (heartburn) often felt behind the sternum, which can extend to the throat. Other symptoms may include difficulty swallowing, a sour taste in the mouth, or a chronic cough.
- Location: Pain can feel like it's coming from the bottom of the breastbone, especially after eating or when lying down.
Esophageal Spasms or Ulcers
Less common, but conditions like esophageal spasms (abnormal contractions of the esophagus) or ulcers in the esophagus or stomach can also manifest as pain behind or below the sternum.
- Symptoms: Esophageal spasms can cause sudden, intense chest pain that may feel like a heart attack. Ulcers might cause a burning or gnawing pain, often relieved by food but returning shortly after.
Other Potential Causes
While less common for isolated pain at the bottom of the breastbone, other conditions can cause chest discomfort that might be mistaken for sternum pain:
- Anxiety or Panic Attacks: Can cause chest tightness and pain, often accompanied by shortness of breath or a racing heart.
- Shingles: Before a rash appears, nerve pain from shingles can be felt in the chest wall.
- Heart-Related Issues: While chest pain is a classic symptom of heart problems, pain specifically localized to the bottom of the breastbone is less commonly the primary presentation for conditions like angina or a heart attack. However, any chest pain should be evaluated by a medical professional to rule out serious conditions.
Quick Glance at Common Causes
Here's a summary of potential reasons for discomfort at the bottom of your breastbone:
| Cause Category | Specific Condition | Key Characteristics |
|---|---|---|
| Musculoskeletal | Costochondritis | Localized tenderness, sharp pain with movement/breathing. |
| Muscle Strain/Injury | Pain with specific movements, often from exertion. | |
| Gastrointestinal | Acid Reflux (GERD) | Burning sensation, often after meals, relieved by antacids. |
| Esophageal Spasms/Ulcers | Sharp, intense pain or burning/gnawing pain. |
When to Seek Medical Attention
While many causes of lower breastbone pain are not life-threatening, it's crucial to seek medical advice for proper diagnosis, especially if:
- The pain is severe, sudden, or crushing.
- The pain spreads to your arm, jaw, or back.
- You experience shortness of breath, dizziness, sweating, or nausea.
- You have a history of heart disease.
- The pain persists or worsens over time.
- You have difficulty swallowing or persistent heartburn.
A healthcare professional can conduct an examination and recommend appropriate tests to identify the underlying cause and ensure you receive the correct treatment.
