Sternum Pain: Common Causes and When to Seek Care

Reviewed by Dr. Marshall Luck, DC | Last updated: September 28, 2026

Pain near the sternum, or breastbone, can come from muscles, rib joints, cartilage, injury, digestive problems, the lungs, the heart, or other conditions. Because chest pain has many possible causes, it should not be assumed to be musculoskeletal without an appropriate evaluation.

When chest pain is an emergency

Call 911 for new, severe, or unexplained chest pain, especially when it feels like pressure, squeezing, or heaviness, or occurs with shortness of breath, sweating, nausea, faintness, or pain spreading to the arm, jaw, back, or shoulder. Prompt medical care is also important after significant trauma, or when pain occurs with fever, coughing blood, or worsening breathing difficulty.

Common musculoskeletal causes

After serious causes have been excluded, tenderness near the sternum may relate to a muscle strain, irritated rib or chest-wall joint, or costochondritis. Symptoms can follow coughing, lifting, sports, a direct blow, or a sudden change in activity. Pain that is reproducible with touch or movement can suggest a chest-wall source, but it does not by itself rule out a medical problem.

Evaluation and conservative care

A clinician may ask about the onset, location, pattern, breathing symptoms, medical history, and movements that change the pain. Depending on the findings, medical testing or referral may be needed before conservative care is considered.

For an appropriate musculoskeletal diagnosis, care may include temporary activity changes, gentle mobility, progressive exercise, ergonomic guidance, or manual therapy. Treatment should be individualized, and forceful chest manipulation is not appropriate for every patient. Evidence varies by diagnosis and results cannot be guaranteed.

Schedule in San Francisco

If a medical emergency has been ruled out and you are seeking an evaluation for a musculoskeletal concern, learn more about chiropractic care in San Francisco or view current appointments in Jane.

How sternum pain is assessed

An evaluation considers the onset of sternum pain, recent exercise or coughing, tenderness with touch or movement, breathing symptoms, and cardiovascular risk factors. A musculoskeletal examination may include the ribs, upper back, chest muscles, and posture. Because chest discomfort has many possible causes, the history and associated symptoms guide whether conservative care is appropriate.

When sternum pain is urgent

Call emergency services for chest pressure or pain accompanied by shortness of breath, sweating, nausea, fainting, or discomfort spreading to an arm, jaw, or back. New unexplained chest pain should be medically assessed rather than assumed to be a joint or muscle problem.

Evidence and further reading

Pain around the sternum may come from muscles, joints, cartilage, the digestive system, lungs, heart, or other causes. Because chest discomfort sometimes needs urgent medical evaluation, new, severe, unexplained, or worsening symptoms should be assessed promptly, especially with shortness of breath, sweating, fainting, nausea, or pain spreading to the arm, jaw, or back. For a general overview, see MedlinePlus: Chest Pain.