Why Does My Collarbone Hurt?

Like a beam spanning two tall posts, your collarbone connects your breastbone (sternum) and shoulder. We actually have two collarbones — one attached to each of your shoulders. Your collarbones frame your chest and help support your neck and arms.

But these long, thin bones can be a source of pain, says orthopaedic surgeon Jason Ho, MD. That pain can be sharp and severe or a dull ache. It may hurt when you move or even breathe.

Why your collarbone is sore

Your collarbone, or clavicle, is slightly s-shaped with joints at either end. Ligaments attach the surrounding muscles to the bone at each joint to hold it in place. The two collarbone joints are:

• Acromioclavicular joint, where your clavicle meets your shoulder blade at the top of your shoulder.
• Sternoclavicular joint, where your collarbone and breastbone come together just below the base of your neck.

Your collarbone may hurt because of an issue with your bone or its joints. Or the pain could be due to injury or disease.

Is collarbone pain normal?

The most common causes of collarbone pain are injuries and arthritis. Less often, you may have a bone infection or a narrowed space between your collarbone and the underlying rib. If you have sudden collarbone pain after a fall or other trauma, get emergency medical care.

Dr. Ho says these are the main causes of collarbone pain:

1. Fractured collarbone

Fractured (broken) collarbones are among the most common bone fractures. They affect about 1 in 1,000 people each year and make up about 10% of all bone breaks.

Most of the time, a collarbone fracture happens when you fall directly on your shoulder or an extended hand. How this happens can vary with age:

• Older adults: Adults over the age of 55 typically break their clavicle due to a fall.
• Teens and young adults: Younger people usually break their collarbone during sports activities. Common scenarios include falling off a bike or taking a direct hit to the clavicle.

Healthcare providers classify collarbone fractures based on where they occur and their severity. About 70% of clavicle fractures occur in the middle section of the bone. This section is the thinnest and doesn’t have any muscles and ligaments to support it. Less often, the fracture occurs near the shoulder end. Rarely, breaks can happen at the end of the collarbone nearest your breastbone.

Pain is the main symptom of a collarbone fracture. You might see the fracture under your skin, or the bone may stick out. Depending on the severity of the break, you may also experience:

• Bruising.
• Inability to move your arm.
• Swelling.

Dr. Ho says some clavicle fractures may require surgery. Most of the time, they can be treated by wearing a sling and gradually increasing your range of motion and strength through physical therapy.

2. Collarbone joint injury

A fall or other trauma may cause one of your collarbone joints to separate. This can happen at the shoulder (acromioclavicular joint) or breastbone (sternoclavicular joint). The symptoms of joint separation are similar to fracture symptoms — pain, swelling and limited movement.

“Treatments like medication, immobilization, steroid injections and physical therapy usually relieve pain and help you move better so you can be fully active,” Dr. Ho shares. We typically consider surgery if other treatments don’t help or for severe joint displacement.”

3. Collarbone osteoarthritis

Arthritis is the breakdown of cartilage — the tissue that cushions your joints and prevents bones from rubbing together. Osteoarthritis is the most common type of arthritis that occurs due to wear-and-tear on your joints.

You can get osteoarthritis in one or more of your collarbone joints. The main symptoms are pain, stiffness and swelling. Lifting heavy weights can also wear away the end of your collarbone where it meets your shoulder, causing arthritis.

You can’t cure osteoarthritis, but treatment like over-the-counter pain relievers and steroid injections can improve symptoms.

Rarely, Dr. Ho says healthcare providers use surgery to treat arthritis in the acromioclavicular joint. But for sternoclavicular joint arthritis, he advises against surgery. “Large blood vessels run just behind the clavicle, making this surgery risky,” he explains. “It’s typically a last resort when other treatments are unsuccessful.”

4. Collarbone infection

A bone infection (osteomyelitis) occurs when bacteria or fungi infect a bone. Bone infections are rare in healthy people. They typically occur due to:

• Spread of an infection from somewhere else in your body.
• Contamination from a traumatic injury or during surgery.

If you have an infection in your collarbone, you may have pain, swelling and other symptoms, such as fever or chills. Factors that increase your risk of osteomyelitis include:

• Diabetes.
• IV drug use.
• Weakened immune system (immunocompromised).
• Previous collarbone trauma or surgery.

Osteomyelitis can cause bone damage, so quick treatment is essential. You’ll likely receive IV antibiotics in the hospital. Your provider may also recommend surgery to clean out the infected area or remove damaged bone tissue.

5. Thoracic outlet syndrome

Your thoracic outlet is the area between your collarbone and underlying rib. Nerves and blood vessels pass through this narrow space as they travel to your shoulder and arm.

In thoracic outlet syndrome, the space between your collarbone and rib tightens. This narrowing can be a result of:

• Bone or muscle abnormality you have at birth, such as an extra rib.
• Fractured collarbone.
• Injury.
• Having obesity.
• Overdeveloped muscles from bodybuilding.
• Poor posture or muscle development.
• Tumors or cysts.

Thoracic outlet syndrome can cause a wide range of symptoms in your shoulder, arm or hand. Symptoms often come and go with certain positions, especially when you raise your arm over your head. In addition to collarbone pain, you may have:

• Tingling, numbness or weakness from pinched nerves.
• Swelling.
• Pain.
• Discolored skin (bluish in light-skinned people and grayish or whitish in dark-skinned people) due to squeezed veins or arteries.

“Because the symptoms are so broad, it’s challenging to diagnose thoracic outlet syndrome,” Dr. Ho notes. “You may see several providers before getting an accurate diagnosis. If you can replicate, or reproduce, your symptoms when you move into certain positions, ask your provider if thoracic outlet syndrome could be the cause.”

Physical therapy is a highly effective treatment for thoracic outlet syndrome. Surgery is usually only an option for severe symptoms.

6. Bone cancer

Most bone cancers spread from cancer in another part of your body (metastatic). Primary bone cancer starting in the bone affects fewer than 4,000 people in the U.S. each year.

“The collarbone is a rare site for bone cancer,” Dr. Ho clarifies. “But if you have a history of cancer, talk to your provider if you have any bone pain or lumps.”

When to seek medical care for collarbone pain

If you have collarbone pain following a fall or other trauma, go to an emergency room. You’ll need a thorough exam and X-rays to determine if your collarbone is fractured.

For less severe symptoms, Dr. Ho recommends rest, ice and over-the-counter anti-inflammatory medications (either the kind you take by mouth or topical ointments). If you don’t notice any improvement for a week or if symptoms get worse, see a healthcare provider and get checked out.

Ongoing pain, swelling, lumps or problems moving are signs that something isn’t right. A visit to a provider can help you find the cause and get started with treatment.