What’s Causing My Collarbone Pain?

Your collarbone (clavicle) is the bone that connects the breastbone (sternum) to the shoulder. The collarbone is a fairly solid, slightly S-shaped bone.

Cartilage connects the collarbone to a part of the shoulder bone (scapula) called the acromion. That connection is called the acromioclavicular joint. The other end of the collarbone connects to the sternum at the sternoclavicular joint. Check out a BodyMap to learn more about the anatomy of the clavicle.

Collarbone pain can be caused by a fracture, arthritis, a bone infection, or another condition related to the position of your clavicle.

If you have sudden collarbone pain as the result of an accident, sports injury, or other trauma, get to an emergency room. If you notice a duller pain developing in one of your clavicles, make an appointment to see your doctor.

Most common cause: Collarbone fracture

Because of its position in the body, the collarbone is susceptible to breaking if there’s a serious force against the shoulder. It’s one of the most commonly broken bones in the human body. If you fall hard on one shoulder or you fall with great force on your outstretched arm, you run the risk of a collarbone fracture.

Other common causes of a broken collarbone include:

• Sports injury. A direct hit to the shoulder in football or other contact sport can cause a collarbone fracture.
• Vehicle accident. An automobile or motorcycle crash can damage the shoulder, sternum, or both.
• Birth accident. While moving down the birth canal, a newborn can break a collarbone and have other injuries.

The most obvious symptom of a collarbone fracture is sudden, intense pain at the site of the break. Usually the pain worsens as you move your shoulder. You may also hear or feel a grinding noise or sensation with any shoulder movement.

Other common signs of a broken collarbone include:

• swelling
• bruising
• tenderness
• stiffness in the affected arm

Newborns with a broken collarbone may not move the injured arm for a few days after birth.

To diagnose a collarbone fracture, your doctor will carefully examine the injury for bruising, swelling, and other signs of a break. An X-ray of the clavicle can show the exact location and extent of the break, as well as whether the joints were involved.

For a minor break, treatment consists mainly of keeping the arm immobilized for several weeks. You’ll probably wear a sling at first. You may also wear a shoulder brace that pulls both shoulders back slightly to help make sure the bone heals in its proper position.

For a severe break, surgery may be necessary to reset the clavicle. You may need pins or screws to make sure the broken parts of the bone heal together in the right way.

What other causes are common?

There are other causes of collarbone pain unrelated to fractures. These include:

Osteoarthritis

Wear and tear on the acromioclavicular joint or the sternoclavicular joint can cause osteoarthritis in one or both of the joints. Arthritis can result from an old injury or just from everyday use over a period of many years.

Symptoms of osteoarthritis include pain and stiffness in the affected joint. Symptoms tend to develop slowly and get progressively worse over time. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) or naproxen (Aleve), can help reduce pain and inflammation associated with osteoarthritis.

Injections of corticosteroids may also help ease inflammation and pain over a longer period of time. You may want to avoid activities that trigger pain and stiffness. Your doctor may recommend surgery to repair the joint in rare cases.

Thoracic outlet syndrome

Your thoracic outlet is a space between your clavicle and your highest rib. The space is filled with blood vessels, nerves, and muscles. Weak shoulder muscles can allow the clavicle to slide down, placing pressure on the nerves and blood vessels in the thoracic outlet. Collarbone pain can result, even though the bone itself is not injured.

Causes of thoracic outlet syndrome include:

• injury to the shoulder
• poor posture
• repetitive stress, such as lifting something heavy many times or competitive swimming
• obesity, which puts pressure on all your joints
• congenital defect, such as being born with an extra rib

Symptoms of thoracic outlet syndrome vary depending on which nerves or blood vessels are affected by the displaced collarbone. Some symptoms include:

• pain in the collarbone, shoulder, neck, or hand
• muscle wasting in the fleshy part of the thumb
• tingling or numbness in an arm or fingers
• weakened grip
• arm pain or swelling (indicating a blood clot)
• change in color in your hand or fingers
• weakness of your arm or neck
• a painful lump at the collarbone

During a physical examination, your doctor may ask you to move your arms, neck, or shoulders to check for pain or limits on your range of motion. Imaging tests, including X-rays, ultrasound, and MRI scans, will help your doctor see which nerves or blood vessels are being compressed by your collarbone.

The first line of treatment for thoracic outlet syndrome is physical therapy. You’ll learn exercises to improve the strength and flexibility of your shoulder muscles and to improve your posture. This should open up the outlet and ease pressure on the blood vessels and nerves involved.

In more serious cases, surgery can be done to remove part of the rib and widen the thoracic outlet. Surgery to repair injured blood vessels is also possible.

Joint injury

Your shoulder can be injured without any bones being broken. One injury that can cause considerable collarbone pain is a separation of the acromioclavicular (AC) joint. An AC joint separation means the ligaments that stabilize the joint and help keep the bones in place are torn.

AC joint injuries are usually caused by a fall or direct blow to the shoulder. A mild separation can cause some pain, while a more serious ligament tear can put the collarbone out of alignment. In addition to pain and tenderness around the collarbone, a bulge above the shoulder can develop.

Treatment options include:

• rest and ice on the shoulder
• a brace that fits over the shoulders to help stabilize the joint
• surgery, in severe cases, to repair torn ligaments and possibly trim a portion of the collarbone to make it fit properly in the joint

Sleeping position

Sleeping on your side and putting unusual pressure on one clavicle can also result in collarbone pain. This discomfort will usually wear off. You may also be able to avoid it altogether if you can get in the habit of sleeping on your back or your other side.

Less common causes

Collarbone pain has some potentially serious causes unrelated to fractures or changes in the position of your clavicle or shoulder joint.

Osteomyelitis

Osteomyelitis is a bone infection that causes pain and other symptoms. Potential causes include:

• a break in which an end of the collarbone pierces the skin
• pneumonia, sepsis, or another type of bacterial infection elsewhere in the body that makes its way to the collarbone
• an open wound near the collarbone that becomes infected

Symptoms of osteomyelitis in the clavicle include collarbone pain and tenderness in the area around the collarbone. Other signs can include:

• swelling and warmth around the infection
• fever
• nausea
• pus draining through the skin

Treating osteomyelitis starts with a dose of antibiotics. At first you may get antibiotics intravenously in the hospital. Oral medications may follow. Antibiotic treatment could last a few months. Any pus or fluid at the site of the infection must be drained, too. The affected shoulder may have to be immobilized for several weeks while it heals.

Cancer

When cancer causes collarbone pain, it may be because the cancer has actually spread to the bone or because nearby lymph nodes are involved. You have lymph nodes throughout your body. When cancer has spread to them, you may notice pain and swelling in the nodes above the collarbone, under the arm, near the groin, and in the neck.

Neuroblastoma is a type of cancer that can affect the lymph nodes or move into the bones. It’s also a condition that can affect young children. In addition to pain, its symptoms include:

• diarrhea
• fever
• high blood pressure
• rapid heartbeat
• sweating

Cancers growing in a collarbone, shoulder, or arm may be treated with radiation therapy or surgery, depending on the nature of the disease and how far it has progressed.

What can I do at home?

Mild collarbone pain that may be related to a muscle strain or a minor injury can be treated with a modified version of the RICE method at home. This stands for:

• Rest. Avoid activities that will put even minor strain on your shoulder.
• Ice. Place ice packs on the sore area for about 20 minutes every four hours.
• Compression. You can easily wrap an injured knee or ankle in a medical bandage to help limit swelling and internal bleeding. In the case of collarbone pain, a medical professional can wrap your shoulder carefully, but don’t try to do it on your own. Keeping your arm and shoulder immobilized in a sling may help reduce further injury.
• Elevation. Keep your shoulder above your heart to help reduce swelling. That means don’t lie down flat for the first 24 hours. Sleep with your head and shoulders slightly elevated if possible.

Shop for medical bandages.

When to see a doctor

Pain that lingers for more than a day or gets progressively worse should prompt a visit to the doctor as soon as possible. Any injury that causes a visible change in your collarbone position or your shoulder should be treated as a medical emergency. If you delay in medical attention, you may make the healing process more difficult.