The collarbone, or clavicle, is a slender, S-shaped bone extending horizontally across the top of the chest. It connects the sternum (breastbone) to the shoulder blade (scapula). The clavicle acts as a strut, providing structural support that holds the shoulder away from the trunk, allowing the arm its wide range of motion. It also protects a narrow passageway of underlying nerves and major blood vessels traveling from the neck into the arm. Given its exposed position and function as a force transmitter, pain in this area is common, arising from causes that range from sudden, traumatic injuries to gradual, chronic conditions.
Acute Pain Causes: Injuries and Fractures
Acute collarbone pain typically begins abruptly following a specific traumatic event, such as a fall or a direct impact to the shoulder. Clavicle fractures are among the most frequent bone injuries, usually occurring in the middle third of the bone, which is its narrowest section. This injury often results from falling directly onto the shoulder or an outstretched hand, transmitting the force up the arm. When the bone breaks, the pain is sudden and intense, often accompanied by swelling, bruising, and an inability to lift the arm.
A fracture may present with a visible bump or deformity, and a grinding sensation (crepitus) may be felt with movement. Another common acute injury is an Acromioclavicular (AC) joint separation, occurring where the clavicle meets the highest point of the shoulder blade (scapula). This injury involves spraining or tearing the ligaments that stabilize the joint, resulting in a painful separation and a noticeable step-off deformity at the top of the shoulder.
A less common but serious acute injury involves the Sternoclavicular (SC) joint, where the clavicle meets the sternum at the center of the chest. While sprains are frequent, a powerful blow can cause a dislocation, classified as anterior (forward) or posterior (backward). A posterior SC joint dislocation is an urgent medical situation because the displaced bone fragment can press against the trachea, esophagus, or major blood vessels directly behind the joint. Acute muscle strains or sprains in the neck and upper shoulder can also cause pain that radiates into the collarbone area.
Chronic Pain Causes: Inflammation and Posture
Pain developing gradually over weeks or months usually indicates underlying issues of wear and tear, inflammation, or repetitive stress. Osteoarthritis is a frequent chronic cause, particularly affecting the AC joint, which endures significant stress during shoulder movement throughout a person’s life. This degenerative condition involves cartilage breakdown, leading to bone-on-bone friction that causes stiffness, tenderness, and a grinding sensation during overhead activities. The SC joint can also develop osteoarthritis, often presenting as swelling and pain centered near the breastbone that worsens with shrugging or arm elevation.
Postural strain is a widespread, non-traumatic source of chronic discomfort, often seen in individuals sitting for long hours at a desk with poor body alignment. A slumped or forward-head posture rounds the shoulders and places continuous, undue tension on the muscles and ligaments attached to the clavicle, such as the trapezius and sternocleidomastoid muscles. This sustained tension can lead to chronic muscle fatigue and myofascial pain perceived as a persistent ache around the collarbone.
Overuse injuries are common in athletes requiring repetitive overhead motion, such as weightlifting or throwing. Constant strain on the joints and tendons can result in conditions like tendinitis or a gradual wearing down of the AC joint cartilage over time, even in younger individuals. Systemic conditions like fibromyalgia can also manifest as chronic, widespread pain and tenderness, often including the muscle attachment points near the clavicle.
Less Common Sources of Clavicle Discomfort
Collarbone pain is sometimes referred from another area or caused by compression of structures passing beneath the clavicle, rather than a problem with the bone or joint itself. Thoracic Outlet Syndrome (TOS) involves the compression of nerves or blood vessels in the narrow space between the clavicle and the first rib. This compression causes localized pain near the collarbone, often accompanied by distinct neurological symptoms like tingling, numbness, or weakness radiating down the arm and into the hand.
TOS can also involve vascular issues, presenting as a change in color, coldness, or swelling in the affected arm due to blood vessel compression. Referred pain from the cervical spine is another possibility, where a pinched nerve in the lower neck sends pain signals interpreted as originating near the collarbone or shoulder. This pain is typically deep, aching, and may be positional, worsening with certain neck movements.
Infections of the bone, known as osteomyelitis, are rare but cause intense, localized pain accompanied by systemic signs. This condition involves a bacterial or fungal infection causing localized warmth, swelling, fever, or chills. Extremely rare causes of persistent, worsening pain include bone cysts or tumors, which can cause discomfort that does not respond to typical rest and anti-inflammatory treatments.
Red Flags and When to Seek Medical Attention
While many causes of collarbone pain can be managed conservatively, certain symptoms warrant immediate professional medical evaluation. A visible, dramatic deformity, such as a large lump or tented skin, suggests a severe fracture or dislocation requiring urgent care. The inability to move the arm, coupled with severe, unmanageable pain, also signals a potentially unstable injury.
Neurological symptoms are significant red flags indicating possible nerve or blood vessel compromise, especially after an acute injury. Immediate medical attention is necessary if you experience sudden numbness, tingling, or weakness in the arm or hand. This urgency also applies if the arm becomes cold, pale, or swollen, suggesting vascular compromise. Pain accompanied by signs of systemic illness, such as fever, chills, or night sweats, could indicate a serious infection like osteomyelitis.
If the pain is mild and lacks these red flags, initial home care includes resting the arm in a sling, applying ice to the painful area, and using over-the-counter anti-inflammatory medications. However, if the pain persists beyond one to two weeks, worsens over time, or significantly interferes with daily activities, consulting a physician is advisable for a formal diagnosis and treatment plan.