What’s Causing My Collarbone Pain?

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Clavicles are two tubular bones located above the first rib and connecting the upper limbs with the ribs and rest of the body. Bones provide the necessary range of movement and transmission of neuromuscular control from the hands to the axial skeleton. Collarbone covers the cavity between the arm and the neck, where vital anatomical structures pass.

If you experience pain in the collarbone or between the bones do not tolerate it and seek for urgent medical aid.

Fractures

The position of the collarbone makes it predispose to breaking in case of extreme strain against the shoulder. Fractures of the clavicle occur frequently and constitute about 15% of all bone fractures.

Often patients complain of pain or discomfort in the left or right clavicle or in the shoulder joint. The prevalent factors of the collar bone pain are the bumps in the clavicle or the sternum, falling on the outstretched hand/arm resulting in fracture. Every so often the fracture of clavicle occurs in consequence of a car accident, sport injury or birth trauma. In some cases, the cause of a clavicle fracture is a sharp contraction of muscles. Painful sensations are associated with:

  • hemorrhage;
  • local swelling;
  • apparent misalignment of the bone splinters;
  • stiffness.

When the physician checks the patient, he might find that the shape of the collarbone has changed. The shoulder on the injured side is lower than on the healthy one. The patient holds up the injured limb with his elbow or forearm of a healthy hand.

To confirm fractures of the clavicle and set up a treatment plan the patient should undergo the X-ray examination. It will indicate the location and measures of the break, whether the joints have been affected. The radiologic investigation will also show the extent of operation if needed.

For a simple fracture, a patient is ought to keep the arm in rest and immobilized for 3-7 weeks. A shoulder brace helps the bones to heal in its correct position.

For a compound fracture or to fasten multiple framesets surgery is required. The bone is cemented by a metal structure, the choice of which is determined by the character of the fracture.

Other causes

Joint dislocation

The acromial extremity of clavicle is dislocated at most. Injury occurs when you fall on your shoulder or as a result of a punch in your collarbone or shoulder. The dislocation might result in ligament rupture, since fiber bands join the clavicle with the scapula.

The patient may be assigned additional X-ray examination directly in the anterior and posterior projection to confirm the final diagnosis.

First aid

  • Immobilize the limb. Secure the injured joint by applying a bandage or splint.
  • Place ice or a cloth soaked in cold water to the injured collarbone. This will reduce swelling.
  • To ease pain, take Naproxen or Ibuprofen.

The tactics of treatment are determined by the severity of the dislocation. Conservative treatment includes immobilizing the arm with a kerchief bandage for 2-4 weeks, until the pain disappears. In addition to immobilizing a hand with a bandage dressing to relieve pain, conservative treatment sometimes involves wearing a special clavic at the end that presses the acromial end of the clavicle with enough power to correct it, but certainly not so much to cause pain or damage. Later rehabilitation is aimed at restoring mobility and strength of the hand. Some types of dislocations require surgical treatment.

Sleeping position

Sleeping on the side puts extreme pressure on the left or right clavicle. This might trigger the collarbone pain. To avoid the discomfort change the sleeping habits.

Diseases of the spinal column

Impairments of the vertebral column are frequently bound to the nerve compression. This may lead to adverse neuromuscular effect, abnormal sensation, clavicle pain and movement disorders.

The key clinical features of cervical osteochondrosis:

  • Neck and collarbone pain
  • Muscle weakness
  • Increased sweating
  • Numbness in hands
  • Violation of coordination
  • Vertigo
  • Impairment of vision and hearing
  • Increased blood pressure
  • Headaches

At the initial stages of the disease the treatment of the cervical osteochondrosis include drugs, therapeutic exercise, massage, physiotherapy, cervical collar. The last stage – if there is a serious destruction of the osteochondral structures, the surgical intervention might be beneficial.

Brachialgia

Pain under the collarbone on might be caused by rib-tip syndrome or the insult of the brachial plexus. Pains might be aching, blunt, acute, burning, or even appear periodically in the form of shoots. The muscle spasms provoke sweating and skin redness. Deep breathing provokes severe collar bone pain.

For the treatment of brachialgia – rest, therapeutic exercises, massages and NSAIDs are used.

Diseases of the viscera

The referred pain in the right collarbones might trouble due to disorders of the liver or gallbladder. Pathological processes in the stomach and pancreas might trigger soreness in the left collarbone. Angina pectoris and heart attack burst acute pain radiating to the left collarbone.

Diagnostic producers and treatment are determined by the exact reason of the collarbone pain.

Osteomyelitis

Bone marrow inflammation after injuries and operations makes 6.5% of all diseases of the musculoskeletal system. Clinical hints include:

  • swelling and warmth around the infected collarbone;
  • fever;
  • nausea;
  • pus draining through the skin;
  • inflammation of the regional lymph nodes.

Treatment includes long-term of antibiotics, drainage or the injury and the immobilization of the infected shoulder.

Cancer

The collarbone pain might be the result of metastasis in the bone or nearby lymph nodes. Radiation therapy and surgery might be beneficial.

Thoracic outlet syndrome

The disorder occurs due to the compression in the interstitial space of the nerves of the brachial plexus and subclavian arteries and veins. Edema, cyanosis and pain in the upper limb while moving or at rest allow to suspect the syndrome.

Triggers of thoracic outlet syndrome:

  • shoulder injury;
  • impaired posture;
  • lifting heavy weight (endurance sports);
  • competitive swimming;
  • obesity;
  • extra ribs;
  • vicious union of the fracture.

Signs:

  • color change of the skin (blue or sallow);
  • clavicle muscle pain;
  • pain and swelling in the hand;
  • cold fingers, arms or hands;
  • fatigue;
  • muscle weakness;
  • tingling sensation.

Physical examination includes the evaluation of joint mobility, X-rays, ultrasonography, and MRI scans to define damaged nerves or blood vessels.

Treatment plan includes physical therapy to improve the strength and plasticity of your joints and muscles and plasticity. In severe cases, surgery is advised to remove extra ribs or to repair damaged blood vessels.

What should be done at home

Collarbone pain might be treated with the RICE method at home:

  • Rest. Try not to strain your shoulder.
  • Ice. Put ice packs on the sire region for 20 minutes.
  • Compression. Immobilize the joint with a medical bandage to limit swelling and internal bleeding and reduce further damage.
  • Elevation. In order to reduce swelling, keep your shoulder joint above the level of the heart. Elevate you head and shoulders while sleeping.

Medical aid

See the doctor as soon as possible if the pain troubles you more than a day or if it worsens. If you see any changes in the position of your clavicle or shoulder, seek medical attention.

References:

  1. Lin, Mu-Yen, et al. “Bronchial rupture caused by blunt chest injury.” Annals of emergency medicine 25.3 (1995): 412-415.
  2. Lin, Chen Chiang, and Jinn Lin. “Brachial plexus palsy caused by secondary fracture displacement in a patient with closed clavicle fracture.” Orthopedics 32.10 (2009).
  3. Harper, Phil. “No pain, no gain: pain behaviour in the armed forces.” British journal of nursing 15.10 (2006): 548-551.

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