What Causes Collarbone Pain & When to Seek Care
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Pain in the collarbone most likely occurs from a traumatic injury like a fracture, dislocation, or strain. Other common causes of clavicle pain include a frozen shoulder, rotator cuff tendonitis, or even a shoulder strain. Read below for more information on causes and how to treat pain in the collarbone and shoulder.
Symptoms of collarbone pain
Believe it or not, the collarbone is the most commonly broken bone in the body. Also known as the clavicle, the collarbone is the relatively straight bone that runs horizontally from the top of your sternum (breastbone) to your shoulder. It provides stability and protection for the delicate structures underneath. Many of the muscles that allow you to move your arm attach to bony structures around the collarbone, and nerves and blood vessels run deep around the bone as well. Pain in this region can be from an injury of the collarbone itself or from irritation of the structures that surround it. However, there are some conditions that may mimic shoulder pain but are due to a different, serious issue.
Common accompanying symptoms
If you're experiencing collarbone pain, it's also likely to experience the following.
- Tenderness over the collarbone
- Diminished range of motion of your arm
- Pain when moving your arm
- Shooting pain up your neck or down your arm
- A bulge or protrusion over the collarbone
What causes collarbone pain?
The majority of collarbone pain occurs after a traumatic injury. The collarbone is vulnerable to during falls on an outstretched hand or shoulder because of the way force impacts the bone. Additionally, direct blows to this area can break the collarbone or dislocate the joint.
Musculoskeletal and traumatic causes
Pain in the collarbone is also commonly caused by muscular injury to your shoulder. Your shoulder contains a number of muscles and tendons that can be strained or torn from overuse or trauma. It is often difficult to describe this pain other than "shoulder pain".
- Fracture: Fall or direct blows to the collarbone can break the bone.
- Dislocation: Falls or direct blows to the shoulder can dislocate the shoulder joints and is especially painful.
- Muscle strain: Overuse of the arm and shoulder muscles can cause painful tears and strains.
Systemic disease may result in collarbone pain, such as the following.
- Autoimmune: Many inflammatory diseases that result in the body attacking itself can attack joints and bones.
- Wear and tear: A lifetime of use can cause pain from wear-and-tear of the protective cartilage in joints of the shoulder.
- Tumors: Cancers can cause pain in bones or directly compress nerves.
Other causes of collarbone pain include the following.
- Nerve pain: Compression of the nerve bundles beneath the collarbone can cause shooting pain.
- Heart disease: Heart disease can cause pain in the front of your chest or shoulder.
- Lung disease: Certain lung conditions can cause pain around your collarbone.
- Referred pain: Disorders of certain organs in your abdomen can paradoxically cause pain in the shoulder because they share the same nerves.
This list does not constitute medical advice and may not accurately represent what you have.
Frozen shoulder (adhesive capsulitis of the shoulder)
Frozen shoulder is also called adhesive capsulitis of the shoulder. The "shoulder capsule" is the strong web of connective tissue which holds the ball joint of the upper arm inside the socket of the shoulder blade. If this connective tissue is damaged, scar tissue – or adhesions – may form and cause the shoulder capsule to become tight, painful, and inflexible.
The condition can happen if an injury to the shoulder forces it to stay immobilized while healing. Additional risk factors may be diabetes, thyroid abnormalities, and heart disease.
Symptoms include gradual worsening of the ability to move the shoulder, due to increasing pain and stiffness in the outer shoulder and upper arm.
Diagnosis is made through physical examination, with simple tests to measure how far the shoulder can move, as well as imaging such as x-ray or MRI.
Treatment involves physical therapy to help restore range of motion; over-the-counter, nonsteroidal anti-inflammatory drugs to ease pain; and sometimes cortisone injections to the shoulder joint. Surgery may be needed in some cases.
Top Symptoms: spontaneous shoulder pain, stiff shoulder, dull, achy shoulder pain, shoulder pain that gets worse at night, difficulty moving the shoulder
Symptoms that always occur with frozen shoulder (adhesive capsulitis of the shoulder): stiff shoulder
Urgency: Primary care doctor
Shoulder strain means that the muscles and/or the tendons in the shoulder have been overstretched to the point of damage and sometimes partial tearing. (A "sprain" means that ligaments have been damaged.)
Because of its wide range of motion, the shoulder is a relatively unstable joint that is vulnerable to injury. A sudden overloading, especially after long periods of overuse, can finally cause some degree of tearing to the muscle fibers and/or the tendons.
Shoulder strains are most often sports injuries, or are caused by strenuous physical labor.
Symptoms include sudden sharp pain followed by swelling, bruising, and ongoing tenderness.
Diagnosis is made through patient history, physical examination, and sometimes ultrasound.
Treatment involves a short period of rest, followed by gradually increasing exercise to regain strength and prevent stiffness and weakness of the muscles and tendons. Physical therapy will be tailored to the individual and some skills, such as for sports, may need to be relearned. Improving posture while sitting, and adjusting techniques for work and sports, can help prevent recurrence of the strain.
Top Symptoms: pain in one shoulder, pain in the front of the shoulder, shoulder pain from overuse, shoulder pain from an injury, sports injury
Symptoms that always occur with shoulder strain: pain in one shoulder
Symptoms that never occur with shoulder strain: arm weakness, arm numbness
Urgency: Phone call or in-person visit
The rotator cuff is an arrangement of muscles and tendons that holds the head of the upper arm bone within the shoulder socket. Rotator cuff tendinitis is the resulting condition when these muscles and tendons become inflamed or damaged.
Biceps tendonitis is a painful inflammation of the tendon connecting the biceps muscle to the bones of the shoulder. Biceps tendonitis is usually caused by overuse, especially repetitive throwing-type motions of the arm. It can also be caused by pre-existing shoulder injuries, sudden f..
Acromioclavicular (ac) shoulder joint injury
The shoulder is made up of three bones - the shoulder blade (scapula), collar bone (clavicle), and arm bone (humerus). The acromioclavicular (AC) joint is a joint that is in the front of the shoulder, where the collar bone and shoulder blade meet. This joint is stabilized by ligaments, which can tear if the two bones are separated from one another. This is most commonly caused by falling on the shoulder.
Top Symptoms: constant shoulder pain, pain in one shoulder, shoulder pain from an injury, shoulder pain near the end of the collarbone, difficulty moving the shoulder
Symptoms that always occur with acromioclavicular (ac) shoulder joint injury: shoulder pain near the end of the collarbone, constant shoulder pain
Urgency: Primary care doctor
Repetitive strain injury of the shoulder ("swimmer's shoulder")
Repetitive strain injury of the shoulder is caused by consistent repetitive use.
Top Symptoms: shoulder pain from overuse, shoulder weakness, shoulder numbness
Symptoms that always occur with repetitive strain injury of the shoulder ("swimmer's shoulder"): shoulder pain from overuse
Symptoms that never occur with repetitive strain injury of the shoulder ("swimmer's shoulder"): severe shoulder pain, shoulder injury
Myofascial pain syndrome
Myofascial pain syndrome is also called chronic myofascial pain (CMP.) Pressure on certain points of the muscles causes referred pain, meaning the pain is felt elsewhere in the body.
The cause is believed to be muscle injury through overuse, either from sports or from a job requiring repetitive motion. Tension, stress, and poor posture can also cause habitual tightening of the muscles, a form of overuse.
This overuse causes scar tissue, or adhesions, to form in the muscles. These points are known as trigger points, since they trigger pain at any stimulus.
Symptoms include deep, aching muscular pain that does not go away with rest or massage, but may actually worsen. There is often difficulty sleeping due to pain.
Myofascial pain syndrome should be seen by a medical provider, since it can develop into a similar but more severe condition called fibromyalgia.
Diagnosis is made through physical examination and applying mild pressure to locate the trigger points.
Treatment involves physical therapy, pain medications, and trigger point injections. In some cases, acupuncture and antidepressants are helpful.
Top Symptoms: dizziness, spontaneous shoulder pain, pain in the back of the neck, tender muscle knot, general numbness
Symptoms that always occur with myofascial pain syndrome: tender muscle knot
Urgency: Primary care doctor
Recurrent shoulder dislocation
Recurrent subluxation of the shoulder is a condition that results in a persistent partial dislocation of the shoulder joint.
Top Symptoms: shoulder pain from overuse, pain in the front of the shoulder, shoulder dislocation
Symptoms that always occur with recurrent shoulder dislocation: shoulder pain from overuse, shoulder dislocation
Urgency: Primary care doctor
Acute costochondritis is the inflammation of the flexible cartilage that connects each rib to the breastbone. Costochondritis is caused by excessive coughing or by straining the upper body, as with weightlifti..
Collarbone pain treatments and relief
When to see a doctor
Collarbone pain most commonly occurs from direct injuries and sets in quickly. With injuries like these, you should see a physician to rule out a fracture, especially if you are having trouble moving your arm . Additionally, you should consider going to a hospital if you experience sudden-onset severe shoulder pain without any clear triggering event.
Your physician may recommend the following to treat your collarbone pain.
- Imaging: X-rays will be performed to ensure there are no broken bones.
- Range of motion testing: A doctor may test moving your arm to assess the function of individual muscles in the shoulder.
- EKG: A doctor may perform an EKG (electrocardiogram) to ensure your heart is not the cause of your shoulder pain.
- Prescription medication: Pain medication may be used to control your pain symptoms.
- Immobilization: In many cases of a broken collarbone, a sling is used to heal the bone without surgery.
- Surgery: In more complicated fractures, surgery may be required to fix a broken bone.
The following treatments may provide relief at home.
- Rest: Rest can help muscle soreness associated with overuse or minor trauma.
- Pain medication: Acetaminophen (Tylenol) and NSAIDs such as ibuprofen (Advil, Motrin) can help reduce collarbone pain and discomfort.
- Ice or heat: A heat pack, ice-pack or cool washcloth can help with the discomfort associated with minor trauma or overuse injury.
- Stretching: If your pain is muscular and not the result of direct trauma to the shoulder, arm stretches can help slowly relieve collarbone pain.
When it is an emergency
FAQs about collarbone pain
What can cause shoulder pain without injury?
Pain in the shoulder is often a sign of injury. Shoulder pain can be due to overexertion of the shoulder through activity or exercise, a pulled nerve along the neck or spine usually in concert with activity, or even a rash affecting the skin like a sunburn. It is also possible to experience shoulder pain because of injury to the abdomen and referred pain to one or both shoulders.
How long does it take for a broken collar bone to stop hurting?
How long your pain will last depends on the location of the break. The first, second, and third portions of the clavicle require different healing processes. If the middle of the clavicle is broken, it can take up to 12 weeks to heal. The far third of the clavicle may take up to six weeks to heal, and the third portion of the clavicle may take as long as eight weeks to heal. Your physician will explain your unique healing time.
Can you dislocate your collarbone?
The collarbone, or clavicle, attaches the acromion, a portion of the shoulder blade, to the sternum or chest bone. It is most commonly dislocated at its connection to the shoulder, the acromioclavicular joint. Injuries can range from mild sprains and dislocations to dislocations and fractures.
Can you move your arm with a broken collarbone?
Yes, it is possible to move your arm with a broken collarbone; however, it will be quite painful. Moving may cause the sharp portions of the collarbone to protrude through the skin, necessitating urgent surgery. Accordingly, most people hold their arms very still to avoid additional pain or injury.
Why does my collarbone hurt when I sleep?
If you have strained the joints attached to your collarbone, commonly from overhead or forward weighted motions, it is possible to exacerbate the strain placed on the joint by sleeping on this side. If you have a connective tissue disorder, you may also be able to damage your collarbones. Sleeping with collarbone or shoulder injuries can be painful because of sleeping position in general. Some people find it more comfortable to sleep in a recliner chair.
Questions your doctor may ask about collarbone pain
- How would you explain the cause of your shoulder pain?
- Can you fully move your shoulders around?
- Where exactly is your shoulder pain?
- Do you require a wheelchair to move around?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
Jesse Passman is a PGY-1 surgery resident. He graduated from Rice University with a BS in Ecology and Evolutionary Biology and received his MD from the University of Pennsylvania Perelman School of Medicine. During medical school, Jesse performed work in public health and surgery, taking a year-out to pursue an MPH at the University of Pennsylvania and do research in global surgery and the public health implications and clinical outcomes of trauma. In his free time, Jesse likes to travel, hike, backpack, and cycle.
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