A broken sternum causes significant, sharp pain right in the center of your chest that most people rate between 7 and 9 out of 10 in the first few days. The pain is constant at rest but spikes dramatically with any movement that engages your torso, especially coughing, deep breathing, laughing, or twisting. It’s one of the more painful fractures because the sternum is connected to your ribs and moves every time you breathe, meaning there’s no true rest position for the bone.
What the Pain Feels Like
The initial pain is sharp and localized to the front of your chest, directly over the breastbone. Many people describe it as a deep, pressure-like ache at rest that turns into a stabbing sensation with movement. Unlike a broken arm or leg, which you can splint and immobilize, your sternum shifts slightly with every breath you take. That constant micro-movement keeps the pain active around the clock.
Touching or pressing on the fracture site produces immediate, intense tenderness. Swelling and bruising over the chest are common and can make even the weight of a seatbelt or shirt feel uncomfortable. Some people also feel a clicking or grinding sensation at the fracture site when they move, which is unsettling but not necessarily a sign of a serious complication.
Movements That Make It Worse
Deep breathing and coughing are the two biggest pain triggers. Because your sternum anchors the front of your ribcage, any expansion of the chest pulls directly on the fracture. Sneezing, laughing, and even yawning can cause sudden, sharp flares. Rolling over in bed, pushing yourself up from a lying position, and reaching overhead all engage the chest muscles that attach to the sternum, and each of these movements can feel like a fresh injury in the first couple of weeks.
Lifting anything heavier than a few pounds is typically off the table for weeks. Even holding a phone up to read or carrying a bag of groceries can strain the area enough to spike your pain significantly.
Why Breathing Through the Pain Matters
The natural instinct with a broken sternum is to take shallow breaths to avoid the pain. This is understandable but dangerous. Shallow breathing over days and weeks can lead to a partial lung collapse or pneumonia, because air isn’t reaching the deepest parts of your lungs. Inadequate pain control is the main driver of these respiratory complications, and they’re the reason doctors take sternal fracture pain management seriously.
You’ll be encouraged to take one deep breath or cough at least once every hour, even though it hurts. Holding a pillow firmly against your chest while you do this braces the fracture and noticeably reduces the pain. Breathing exercises using a simple handheld device (an incentive spirometer) help you track how deeply you’re inflating your lungs and serve as a measurable way to monitor your recovery. Studies on chest wall fractures show that patients who get adequate pain relief early on achieve better lung function and have fewer complications.
How Long the Pain Lasts
The worst pain is in the first one to two weeks. During this window, most people need prescription pain relief to function. Anti-inflammatory medications like ibuprofen or naproxen are typically the first choice for mild to moderate pain, often combined with acetaminophen. For more severe pain, stronger options that combine acetaminophen with an opioid component may be used short-term. Since sternal fractures take weeks to heal, doctors generally don’t hesitate to provide adequate pain relief throughout the recovery period.
By three to four weeks, the sharp pain usually fades to a dull ache that flares mainly with exertion or sudden movements. Most people notice a significant improvement by six weeks, though the bone continues to remodel for several months. Full healing, where you can return to heavy lifting, contact sports, or high-impact activity, generally takes 8 to 12 weeks. Some people report lingering soreness or weather-related achiness at the fracture site for six months or longer.
Sleeping With a Broken Sternum
Sleep is one of the hardest parts of recovery. Lying flat puts pressure on the chest and makes breathing harder, which increases pain. Most people find that sleeping in a reclined position works best, either in a recliner chair or propped up with several pillows at about a 30 to 45 degree angle. Sleeping on your back is generally more comfortable than side-sleeping, since lying on either side shifts the ribcage and tugs on the fracture.
Placing a small pillow over your chest can help if you tend to roll in your sleep, providing a buffer and a reminder not to twist. Getting in and out of bed is often the most painful moment, so rolling to one side and pushing up with your arms (rather than sitting straight up using your core) reduces the strain on the sternum considerably.
Injuries That Can Accompany a Broken Sternum
A broken sternum doesn’t just hurt on its own. It sits directly over the heart and lungs, and the force required to fracture it (usually a car accident, a fall, or a direct blow) can damage those organs too. Heart bruising occurs in 8% to 10% of sternal fracture cases, which is why an electrocardiogram is standard after this injury. Collapsed lung occurs in about 2% of cases, and bleeding around the lung in about 7.4%. These complications can appear up to 14 days after the initial trauma, so new or worsening shortness of breath, irregular heartbeat, or chest pain that changes character in the days after your injury warrants immediate medical attention.
How It’s Diagnosed
A chest X-ray is usually the first imaging test, but its ability to detect sternal fractures is limited. CT scanning is considered the gold standard and performs well, particularly on side-view (sagittal) images where it approaches 100% sensitivity. However, some fractures can be missed even on CT if only front-to-back and cross-sectional views are taken. Ultrasound has emerged as a surprisingly effective tool for sternal fractures, with studies showing it can catch fractures that both X-ray and CT miss. If your imaging comes back negative but the pain and tenderness strongly suggest a fracture, an ultrasound may provide the answer.
What Recovery Looks Like Day to Day
Most sternal fractures heal with conservative treatment: pain management, rest, and gradual return to activity. There’s no cast for this bone. You won’t be immobilized, but you’ll be limited. Expect to need help with basic tasks like cooking, dressing, and driving for the first two to three weeks. Driving is particularly difficult because gripping the steering wheel and braking engage your chest muscles, and a sudden stop with a seatbelt across the fracture is both painful and potentially harmful.
By week three or four, daily activities become manageable with some discomfort. Light walking is encouraged early to prevent deconditioning and blood clots, but anything that loads the upper body should wait. Most people can return to desk work within two to four weeks, while physically demanding jobs may require six to twelve weeks off. The key measure of progress is your ability to breathe deeply without significant pain, which both signals bone healing and protects your lungs.