Collarbone Pain

What is collarbone Pain ?

The collarbone is a long bone that connects to the scapula and the sternum. As one of the bones that make up the shoulder girdle, it acts to help stabilize the arm and plays a vital role in shoulder mobility and thoracic support. It also protects nerve bundles that run to the upper extremities.

In anatomic terms the collarbone is known as the clavicle, which is derived from the latin word clavicula which means “little key”. The clavicle differs from other long bones in the body in that the shape, size, and placement may be different from person to person depending on varying factors such as age and gender.

The collarbone is connected to seven different muscles and two major ligaments. Since the collarbone is such an important bone for upper body movement and because of it’s location, collarbone pain is very common and can be a symptom of conditions that range from minor problems, such as straining muscles after coughing or throwing up, to very serious health conditions such as being a sign of pericarditis(inflammation of the sac around the heart) or even a sign of a heart attack.

These are some common and uncommon reasons, why one might experience collarbone pain.

Collarbone Fractures: The little broken key

The clavicle is one of the most commonly broken bones in the human body. It only takes about eight pounds of direct pressure to break a collarbone. In contrast it takes around 25 pounds of pressure to break a humerus (upper arm bone). Looking at the great difference in the amounts of pressure these two bones can withstand it is easy to see how impact on an arm can cause collarbone problems. Because the clavicle is one of the most commonly broken bones in the human body, the body actually has some ways that it protects itself if it does ever break. One of those is the Subclavius muscle but more on that later. Now let us take a look at what might cause this bone to break.

Picture of Collarbone fracture

Possible Causes

Some reasons why you may have a broken collar bone:

  • After a fall (from elevated height or a fall from same level)
  • Sports injury
  • Accident involving a vehicle (including bicycles!)
  • Any sudden direct impact on outstretched arm

Signs and Symptoms

According to The American Academy of Orthopedic Surgeons (AAOS), if you experience any of these signs and symptoms it may be safe to suspect a broken collarbone:

  • Tenderness in the clavicular region
  • One shoulder lower than the other
  • Swelling or discoloration
  • A single lump over the painful area
  • A grinding feeling or sound when pressed. This is known as crepitus.
  • These are the common signs of a fracture, however, some collarbone fractures will not show any of the signs listed above.

Treatment

If you suspect a clavicular fracture it is recommended that you consult your physician immediately. These are some treatments that will help in the meantime.

As with any fracture or sprain use the RICE method

R – Rest the area. Limit movement as much as possible. For collarbone or shoulder pain a sling and swath can be used.

I – Ice. Place a cold compress on the affected area. Never place ice directly on skin as this may cause cold burns and superficial tissue damage. Instead wrap an ice pack in a cloth or paper towel. Ice affected areas for around 10 minutes at a time.

C – Compress. The collar bone can be a tricky area to place pressure on to control swelling unlike an extremity which can be wrapped. A sling will also take care of this part of the the home remedy.
E – Elevate the area. Because the collarbone is already in an elevated position, this step just requires you to sit up instead of lying down. Elevating the area will help reduce swelling and control pain.

Anti-inflammatory – The use of anti-inflammatory medications such as acetaminophen (Tylenol) or ibuprofen (Aleve,Excedrin) will also greatly reduce swelling and help control pain.

Muscle and Ligament Pain

At this point maybe you’ve ruled out the possibility of a fracture. So what else can be causing the pain? As said earlier, the collarbone is connected to many different muscles and tendons. Strain of any one of these muscles or tendons can cause pain that may feel even worse than a fracture.

Strains, or pulls, may be caused by overuse, underuse, or traumatic injury of the tissues connected to the clavicle.

Muscles that are connected to the collarbone:

The Deltoid

This muscle is responsible for movement of the entire arm. Along with the deltoid muscles ligaments in the shoulder joint are often injured or strained. One of the most common ligaments that can be damaged is the acromioclavicular joint (the AC joint). Shoulder surgery is often the only way to repair a damaged ac joint.

The Trapezoid

The trapezoid helps in supporting the arm. It is responsible for scapular contractions and also supports the spine.

The Subclavius

This muscle is located exactly where the name suggests, directly underneath the clavicle.This muscle serves to move the joint of the sternum and clavicle
The subclavius also protects underlying blood vessels if the collarbone becomes broken.

The Sternohyoid

This muscles acts to keep the hyoid bone in place. The hyoid is a bone that helps in the act of swallowing and moving the tongue.

The Pectoralis Major

This muscle is responsible for three different planes of movement of the arm. It also helps in keeping the arm attached to the body.

Causes

Sports

Heavy weights and repeatative motion

Athletic activities that involve large amounts of weight being lifted (bodybuilding, powerlifting, etc.) or sports that involve repetitive motions (swimming, tennis, etc.) may all cause problems with the collarbone.

  • If the athlete does not properly warm up, allow time to recover, or have adequate nutrition.
  • If there is improper technique during the “rack” position in olympic lifting.
  • Athletes may also experience collarbone pain while running because of the constant jarring that the runner experiences. This constant impact may make pain from previous injuries more apparent or create new injuries.

Muscles underused

When muscles become underused, muscular imbalances can occur. When Muscular imbalances are present stress is put on nearby muscles and may cause pain.

Coughing

Violent coughing may cause pain in the collar bone. Our bodies are incredible machines that have many different mechanisms to take care of itself. When we cough, our bodies are trying to clear our airways. Sometimes, a violent cough, especially a series of violent coughs may strain the sternohyoid muscle that runs along the neck. This strain in particular is responsible for a lot of clavicular pain after coughing. Other causes of chest pain after coughing can be pleurisy or pericarditis, which will be discussed later.

Throwing up

Like coughing, throwing up causes many muscles to tense at once. Particularly the muscles of the chest, throat, and back. All areas that are connected to the collarbone.

Bad posture

Bad posture closely relates to muscular imbalances. Bad posture can create high amounts of tension in certain muscles and create pain near affected areas.

Treatment

As with fractures the RICE method can be used to treat muscle and tendon pain at home. If you experience pain with any exercise or particular movement it is very important to stop doing that movement. If a muscle or ligament is injured repeatedly, surgery will be the only option available to fix the tissue.

Some other options are available for home remedies:

  • Epsom salt baths can be great to help remedy muscle pain.
  • Icy hot or other mentholated creams
  • Essential oils rubbed on the skin

Referred Pain: Reflections of other Conditions

Referred pain, also known as reflective pain, is pain that occurs when an area of the body is affected by a condition and the pain is present somewhere else. This type of pain can be seen in people who are having heart attacks and they feel pain in their jaw or back.

Causes

Pregnancy

While pregnant the body goes through an enormous amount of changes. One of the changes occurs in the digestive system. During pregnancy digestion slows down. This can sometimes cause the gallbladder to not empty correctly and therefore cause solid deposits to form in the gall bladder. Pain from gallstones can be reflected to cause shoulder pain and collarbone pain. Another condition that may cause pain in the clavicular area is preeclampsia. Preeclampsia is a very serious condition that must be treated by a physician immediately.

Kidney Stones

Like gallstones, kidney stones are solid deposits that are formed in the body. Many different conditions may cause kidney stones but the most common reason they form is because of high uric acid levels in the body and not enough water intake. It has been said that, for men, the pain of passing a kidney stone is comparable to childbirth.

Pleurisy

Pleurisy is the inflammation of the lining of the lungs. This can occur after coughing, throwing up, or when experiencing chest conditions such as pneumonia or COPD.

Pericarditis

The fluid filled sac around the heart is called the pericardium. The pericardium protects the heart and keeps it in place. Sometimes this sac can become inflamed due to injury or illness. This is a very serious and very painful condition that may exacerbate pain near the clavicle. If left unchecked pericarditis may cause something called pericardium effusion. When the pericardium becomes inflamed, fluid increases in the sac around the heart. This causes pressure to be placed on the heart which may make it difficult for the heart to function properly.

Indigestion and Heartburn

Excess amounts of stomach acid or problems digesting that burrito you just ate may also cause pain near the collarbone. This is a very common condition. If you have Gastroesophageal Reflux Disease (GERD) it is very likely that you may experience referred pain after eating. This condition can be so painful that it is often mistaken for cardiac symptoms.

Treatment

Never ignore chest pain. The torso is home to all of our vital organs and failure of any one of them may cause irreversible damage to our bodies or even death. Even if you suspect indigestion or heartburn, it would be wise to at least make an appointment with your doctor. A physician will be able to rule out any serious conditions. It may just be heartburn but if the pain is bad enough that it mimics a heart attack treatments are available that can help.

Other Things That May Cause Collarbone Pain

Cancer

It is very rare that cancer will begin in the clavicle but not impossible. If cancer is present in the clavicle it is likely that it began elsewhere and spread to the collarbone.

Pneumothorax or Hemothorax

A pneumothorax is a condition where the lung has been punctured and air is leaking into the chest cavity. A hemothorax is when blood has leaked into the chest cavity. Either one of these may cause tension in the chest cavity that can create pain near the collarbone. Common signs of pneumothorax are subcutaneous emphysema (air bubbles under the skin). SubQ emphysema can be easily identified as it resembles bubble wrap when you fell it with your hand. Pneumo- or Hemo- thoraces may also cause tracheal deviation.

Stress

Stress manifests itself in many ways. One is tensing of muscles, especially near the shoulders and the neck. If you are under a lot of stress you may have collarbone pain and have no injury at all. Stress can be relieved with exercise, meditation, herbal remedies, and medications.

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