Pain under the collarbone makes you think even if it is of a traumatic nature. Although in the vast majority of cases, a thorough diagnosis reveals that there is no traumatic tissue damage. In childhood, pain in the front under the collarbone can be associated with both a traumatic fracture and a very dangerous disease, leukemia. In the first case, the integrity of the hollow bone, which has not yet fully formed in the baby, is violated. In the second case, internal pressure is exerted on the collarbone due to enlargement and inflammation of the thoracic lymph nodes (mediastinum). They put pressure on the collarbone on one or both sides.
Therefore, parents whose child aged 3–6 years complains of pain in the collarbone area should immediately contact a pediatrician and have blood tests done. A consultation with a traumatologist and an x-ray are also indicated. It is very difficult to notice the moment a baby gets injured. But even an unsuccessful fall on the shoulder or outstretched arm can lead to the acromial or lateral end of the clavicle coming out of the articular cavity.
In an adult, pain under the collarbone in front is almost always associated with arthrosis of the sternoclavicular and clavicular-scapular joints. In approximately half of the cases the pain is false. This is associated with radicular syndrome against the background of cervical osteochondrosis. The patient feels pain radiating from the neck and collar area under the collarbone. For diagnosis, it is enough to collect a thorough history of the disease and take an x-ray of the cervical and cervicothoracic spine.
If you have pain under the collarbone, we recommend that you consult an experienced doctor as soon as possible. Such diseases are treated by an orthopedist or a neurologist. You can get a free consultation with these specialists in our manual therapy clinic. Call the administrator and sign up for a free initial appointment.
Causes of pain under the collarbone
All potential causes of pain under the collarbone can be divided into several groups: inflammation, deformation, trauma, tumors, irradiation. Let's look at them all in order in more detail.
Let's start with the “classics of the genre” - traumatic influence. These can be dislocations, blows, bruises, hematomas in the periosteum, cracks and fractures of bone tissue. Occurs when falling, awkward movements, or during active game sports.
The second most common cause of pain under the collarbone is deformation of cartilage and bone tissue. There are several important aspects to know here:
- the collarbone has two joints (the first attaches it to the sternum, the second to the scapula);
- both bone joints have some mobility;
- with insufficient work and physical activity of the pectoral muscles, the process of degeneration and thinning of the cartilage tissue covering the distal heads of the clavicle begins;
- after the destruction of cartilage tissue, deformation of bone tissue begins;
- cracks appear on it, which are filled with deposits of calcium salts in the form of rough growths and thorns.
When making any movements in the shoulder joint when the bone tissue of the clavicle is deformed, sharp pain occurs due to the fact that soft tissues are injured. The sternoclavicular joint is most often affected. The pain is localized at the point where the collarbone attaches to the sternum. the acromial joint with the scapula gives another localization of pain - in the area of the shoulder joint and under the armpit.
Inflammatory processes in the area of the attachment points of the collarbone can be caused by a number of specific factors:
- consequences of sprain of the ligamentous and tendon apparatus, which caused internal hematomas;
- infectious tissue damage (with the generalized spread of pathogens from foci of chronic or acute inflammation through the blood or lymphatic fluid);
- an autoimmune process such as rheumatism and destruction of cartilage tissue due to improper functioning of the immune system;
- damage to the outer skin;
- development of arthritis or exacerbation of chronic arthrosis;
- inflammation of the synovial cartilaginous membrane;
- myositis, tendonitis and other diseases.
The tumor nature of the development of pain in the clavicle area is common mainly in childhood. Metastasis to the lymph nodes often leads to a sharp increase in their size. They begin to put pressure on the bone structure of the collarbones. This causes a dull, stabbing pain.
Irradiation of pain under the collarbone can occur with damage to the cervical and cervicothoracic spine. Often a similar symptom occurs with cervical osteochondrosis, instability of the position of the vertebrae, their displacement, the development of uncovertebral arthrosis, etc. When the root nerves are damaged, a disruption of the innervation of the soft tissues of the neck and clavicle area occurs. In this case, accompanying symptoms may be present, such as a sore throat, a feeling of increased volume of the tongue, and difficulty swallowing.
There are other symptoms of pain in the collarbone area. However, the factors listed are the most common. They should be excluded first during differential diagnosis.
Causes
The most common cause of shoulder and neck pain is damage to soft tissues, including muscles, ligaments, and tendons. Such injuries can occur from whiplash or other injuries. With degenerative arthritis in the cervical spine, compression of the roots and the appearance of neck pain may occur, radiating to the shoulder and arm. With degenerative changes in the intervertebral discs, there may be local pain or radiating pain during disc herniation, when the root is compressed by the disc herniation. Pain in the neck and shoulder can also be caused by various pathologies of the spinal cord, lungs of the heart, and sometimes even due to diseases of the abdominal organs.
For example, in conditions such as:
- Clavicle fracture. As a rule, a collarbone fracture occurs when falling on an outstretched arm (for example, this is often found in cyclists).
- Bursitis. When the joint capsule is injured, inflammation occurs, causing pain and stiffness.
- A heart attack (angina or heart attack) may present with pain in the neck and/or shoulder, and the pain is referred.
- Fracture of the scapula. As a rule, scapula fractures occur when there is a forced impact on the scapula.
- Damage to the rotator cuff. The rotator cuff is a group of tendons that provide support to the shoulder. These tendons can be damaged by heavy lifting, sports that involve throwing or repetitive movements. Long-term repetitive stress leads to pain when moving the shoulder and the development of impingement syndrome and, over time, to a significant decrease in the range of motion in the shoulder (frozen shoulder).
- Shoulder separation. The collarbone and shoulder blade are connected by ligaments, and when an injury occurs, the ligaments can stretch or tear.
- Whiplash injury. This is damage to the ligamentous and muscular structures of the neck and shoulder, which occurs during sudden hyperextension, for example in a car accident.
- Tendinitis. Tendons attach muscles to bones. When a tendon is sprained, inflammation of the tendons occurs, which can cause pain.
- Cholecystitis. Inflammation of the gallbladder can cause pain in the right shoulder.
- Inflammation of the diaphragm due to various reasons can also be a source of referred pain.
What is the difference between pain under the left and right collarbone?
It is important to understand that pain under the left collarbone in some cases can be associated with myocardial diseases. These are angina pectoris, coronary heart disease, atherosclerotic lesions of the coronary blood vessels, valve disease, myocardial infarction, etc. Also, false pain under the left clavicle can occur with the cardiac type of vegetative-vascular dystonia. therefore, if such a symptom appears, you should immediately contact your doctor and ask for a referral for an ECG.
This examination will exclude organic, vascular and neurological damage to the heart muscle. Next, you should consult a neurologist regarding the diagnosis of vegetative-vascular dystonia. And only after this should you look for pathology of the musculoskeletal system (arthrosis, arthritis, deformity, traumatic damage to the acromial or sternal joint).
The first difference between pain under the right collarbone is the exclusion of vascular and cardiac pathology. When such a symptom appears, you can immediately begin diagnosing diseases of the bone and cartilage, articular and spinal structures. It is important to exclude the following pathologies step by step:
- arthritis of the sternoclavicular or acromioscapular joint (manifested by severe pain on palpation, inflammation and swelling of the joint capsule);
- arthrosis of similar joints (manifested by a characteristic crunch when moving, pain on palpation, limited mobility in the shoulder joint);
- habitual dislocation of the collarbone (often occurs in people who are accustomed to actively gesturing with their hands during an emotional conversation; the displacement of the collarbone is visible to the naked eye in the form of a deformation of the chest in this area);
- inflammation of the lymph nodes;
- rheumatism, inflammation of joints and bone tissue;
- bone tuberculosis and other dangerous infections.
Only an experienced doctor can detect the exact cause of pain under the collarbone. Already during the collection of anamnesis and the initial examination, he will be able to make a preliminary diagnosis and prescribe additional examinations. Do not waste time, do not engage in self-diagnosis and treatment. Sign up for a free initial consultation with our orthopedist.
Aching and nagging pain under the collarbone when inhaling
Quite often, pain under the collarbone appears when inhaling through movement of the chest. A characteristic clinical sign is that when inhaling using the movement of the diaphragm (stomach), there is no pain under the collarbone.
In order to find out the cause of such aching pain under the collarbone, it is necessary to exclude pathologies of the intercostal muscles, neuralgia, diseases of the lung tissue and bronchial tree. Usually, it is enough to collect the patient’s history and complaints. With diseases of the respiratory system, shortness of breath, cough, and general weakness will be present. And with pathologies of the intercostal muscles and neuralgia, it is certainly possible to detect pain on palpation of the chest.
If the nagging pain under the collarbone is provoked by cervical osteochondrosis with radicular syndrome, then the following accompanying signs can be detected:
- pain on palpation of the neck and collar area;
- muscle tension in the collar area and shoulders;
- difficulty moving the head;
- pain spreads along the entire nerve fiber, i.e. may be observed in the forearm, shoulder, wrist, etc.
For diagnosis, it is necessary to take an x-ray, ECG, MRI or CT examination. The primary diagnosis can be made by an orthopedist, neurologist or chiropractor. You can get their free consultation at any time that is convenient for you in our manual therapy clinic.
Diagnostics
In most cases, the diagnosis can be made based on the history and physical examination. However, instrumental examination methods are prescribed when it is necessary to verify the diagnosis, depending on the nature of the injury, the location of pain and other symptoms.
X-rays are ordered if there is tenderness to palpation of the bones of the spine or shoulder, a history of trauma, the presence of a deformity, or if problems in the lungs or heart are suspected.
ECG - electrocardiography can be prescribed for chest pain, breathing problems and the presence of risk factors for coronary artery disease (high blood pressure, diabetes, high cholesterol, smoking).
tests are prescribed in cases of chest pain, shortening of breathing, and in cases where the doctor suspects the presence of inflammatory diseases.
CT. Computed tomography is prescribed when greater detail of changes in tissues is needed or if there is suspicion of diseases of the chest organs.
MRI. As a rule, MRI is prescribed only in cases where it is necessary to differentiate between various conditions.
How to treat shoulder and chest pain under the collarbone?
Before treating shoulder pain under the collarbone, it is necessary to conduct a differential diagnosis and identify the potential disease that causes it. Already during the initial examination, the doctor will be able to make a preliminary diagnosis. So, if pain appears under the collarbone when you press on certain points of its attachment to the sternum or scapula, then there is a high probability of violating the integrity of the joint capsule. In this case, pain can be relieved if their integrity is restored. A chiropractor or osteopath can help in this matter. Then a specialist in kinesiotherapy and therapeutic exercises will strengthen the muscle frame and prevent relapse of the disease.
If chest pain under the collarbone is caused by cervical osteochondrosis and its complications in the form of protrusion and hernia, then traction traction is sufficient for the initial relief of the attack. This procedure eliminates compression of the radicular nerves. The patient experiences a significant improvement in his condition. However, this is not a complete treatment. In the future, it is necessary to complete the entire course of therapy, developed individually by a chiropractor or neurologist.
This will allow you to completely heal the cervical spine, remove pain under the collarbone and regain freedom of movement.
It is not recommended to treat such conditions at home without medical help. First of all, you will not be able to independently find out the cause of the pain under the collarbone. Accordingly, the treatment may be completely wrong and only cause harm to your health. Don't risk it. Contact experienced specialists for an appointment.
Diagnosis of pain in the collarbone
Specialists at the CELT Pain Clinic do not recommend self-medication, as it can cause irreparable harm to your body. In order for the treatment to be successful, it is necessary to identify the reason why the collarbone hurts and direct all efforts to eliminate it.
In addition to being examined by a doctor and taking a medical history, diagnosing collarbone pain includes the following:
- radiography of the collarbone;
- CT scan;
- Magnetic resonance imaging.