Pain Below Sternum

What is Sternum?

Sternum is also known as the breastbone. It is a long and flat bone located in the center of the chest. Sternum has the shape of a necktie. Together with the ribs on the sides and the vertebral column on the back, it helps form the rib cage. It helps protect vital organs like the heart, lungs and the major blood vessels from any possible injury.

What Are the Possible Causes of Pain Below Sternum?

Different medical conditions can cause pain below the sternum, which may originate from the rib cage or the abdominal area. The pain can be acute or chronic, mild, moderate or even severe depending from its cause. Some of the most common causes of pain below the sternum include:

Esophagitis – is the inflammation of the esophagus. Esophagus connects the mouth with stomach, which helps transport food. There are different causes of esophagitis like infections, reflux of the stomach acid, allergies, oral medications, etc. Signs and symptoms of esophagitis include painful and difficult swallowing, heartburn, acid regurgitation, food impaction, chest pain, especially behind the sternum or even below the sternum. The pain usually occurs while eating. The treatment of esophagitis varies from its cause. Usually antacids are prescribed in order to reduce stomach acidity. Antibiotics are also prescribed for treatment of possible infections.

Heartburn and GERD – is considered the pain behind or below the breastbone, which gets worse when lying down or even when bending over. The pain is like a burning sensation. A bitter taste in the mouth and throat also occur very often. GERD is the gastroesophageal reflux disease. Normally, the lower esophageal sphincters prevent the reflux of the food and the stomach acid. However, if for any reason these lower esophageal sphincters function abnormally or get weaken, the stomach acid flows back into the esophagus causing the sensation of a burning pain in the sternum. Heartburn and GERD can be easily managed and maintained under control with a change of the daily routine, elimination of certain types of food and by maintaining a healthy weight. Antacids are also often prescribed in order to reduce the signs and symptoms of heartburn.

Abdominal Muscle Strain – an abdominal strain is a tear or a rupture of any part of the abdominal muscles. Usually, abdominal muscle strain occurs at the point where the abdominal muscles attach to the pelvis. These muscle strains usually occur due to lifting up heavy things, excessive physical activity, twisting the body sharply, etc. Due to a damage of the muscle fibers, among other signs and symptoms severe pain is also noticed. The treatment includes bed rest, painkillers and gentle stretching exercises.

Respiratory Disorders – like asthma, bronchitis, pneumonia, etc., can cause chest pain and pain that occurs below the sternum. Other signs and symptoms in these cases include fever, chills, cough, difficulty breathing, generally ill feeling, etc. The treatment depends from its cause. Smoking usually worsens the signs and symptoms of respiratory disorders.

Lower Lobe Pneumonia – Pneumonia is an acute infection that affects the lungs. The infection can affect any lobe of the lungs, one or both lungs, sometimes, a whole lung. When pneumonia affects the lower lobe of the lungs, the pain can be felt below the sternum. Other signs and symptoms of pneumonia include fever, chills, generally ill feeling, cough, etc. It will take around 2 weeks for the lung infection to heal.

Acute Pancreatitis – is an acute inflammation of the pancreas, which is very painful. The pancreas is located in the abdomen, behind the stomach and near the small intestine. The role of the pancreas is to produce insulin, digestive enzymes and other hormones. Acute pancreatitis occurs suddenly, causing swelling of the epigastric region, accompanied by indigestion, clay-colored stools and pain which can be felt as the pain on the epigastric region, below the sternum. The pain usually gets worse when lying down. The causes of pancreatitis vary, like for example: gallstones, pancreatic or gallbladder damage due to an injury or surgery, excessive fats, cystic fibrosis, Kawasaki disease, Reye’s syndrome, certain medications, etc. The treatment depends from the cause of acute pancreatitis. It usually requires hospitalization and sometimes even surgery is necessary in order to remove the infected or dead tissue of the pancreas.

Breastbone Fracture – is characterized by chest pain. Usually a fracture of the sternum occurs due to car accidents, when the chest hits the steering wheel. In this case it is very important to get medical help and get necessary medical evaluation of any further deeper injuries to the vital organs located below the breastbone.

Other possible causes of pain below the sternum include stomach ulcer, hiatal hernia, lung abscess, lung cancer, excessive belching, etc.

You should seek medical help and get a total check-up, especially when the signs and symptoms do not go away after a day or two, or when these signs and symptoms tend to get worse. Your doctor will probably run tests like: complete blood tests, X-ray of the chest, MRI (magnetic resonance imaging) and CT (computed tomography) scan in order to diagnose the underlying condition of the pain below the sternum.


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