Collarbone pain is usually caused by an injury, such as a fracture or joint separation. However, your collarbone (clavicle) can also hurt because of health conditions like arthritis or even certain sleeping positions.
This article discusses common causes of collarbone pain, treatment options, and when to seek medical care.
Fractures and Breaks
You can end up with a broken clavicle (collarbone fracture) if you fall and land on your arm or shoulder. It can also happen if you get into an accident, like a car crash.
Broken collarbones can cause:
- Intense pain
- Difficulty moving your arm
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Acromioclavicular (AC) Joint Separation
The acromioclavicular (AC) joint is a joint between your clavicle and the outermost edge of your scapula. There are ligaments that hold these two bones together. There is also a flexible cartilage disc.
A direct impact to the shoulder or arm can separate the collarbone. This injury affects the scapula at the AC joint. It can cause pain, tenderness, and trouble moving your shoulder.
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The sternoclavicular joint (SC joint) is located between the breastbone and the collarbone.
Arthritis—usually osteoarthritis—makes the cartilage that covers the SC joint wear away. It can cause pain, stiffness, and inflammation.
AC joint osteoarthritis can also cause pain in the collarbone, neck, and shoulder.
AC Joint Arthritis Symptoms and Treatment
If you sleep on your side—especially on the same side all the time—it puts strain on your collarbone and shoulder.
You may just have occasional stiffness and soreness from sleeping in certain positions. However, it's also possible that sleeping on your side can lead to more serious problems, such as:
- Tears in the muscles around the shoulder joint (rotator cuff)
- Inflammation of the tendons (tendinitis) that triggers pain and difficulty with movement
- A pinched nerve (nerve impingement) that causes pain, tenderness, and numbness
Thoracic Outlet Syndrome
Thoracic outlet syndrome (TOS) is a general term for three conditions that affect the top ribs below the collarbone, known as the thoracic outlet.
In TOS, the nerves or blood vessels at the top of the thoracic outlet become compressed by the rib, collarbone, or neck muscles.
TOS can develop as a result of a traumatic injury like whiplash, or repetitive activities like swimming or baseball that require you to raise your arm overhead. It can also be caused by a congenital (present at birth) abnormality, such as a cervical rib formation.
Symptoms vary depending on the type of TOS that you have:
- Neurogenic TOS may cause pain or weakness in the shoulder or arm, tingling in the fingers, or cause your arm to tire quickly
- Venous TOS may cause swelling, blueness, or tingling of the arm, hand, or fingers, and very prominent veins in the shoulder, neck, and hand
- Arterial TOS may cause a cold and pale hand, pain in the hand and arm (especially during overhead motions), a blocked artery in the hand or arm, or aneurysm
The Anatomy of the Thoracic Spine
Rare Causes of Collarbone Pain
Some medical conditions and infections are less common triggers of collarbone pain.
Kehr's sign is a pain in the left shoulder that occurs when blood from a ruptured spleen irritates the diaphragm muscle, which helps with breathing.
The phrenic nerve helps the diaphragm with breathing. When the bundle of fibers senses that the diaphragm is irritated, it transmits pain signals.
Since the nerve runs from the neck to the diaphragm, the pain can be felt in the shoulder. It may feel like an ache in the spot where the top of the shoulder meets the end of the collarbone.
What Is Referred Pain?
Referred pain occurs when you feel the pain somewhere other than where it's actually coming from.
Signs of a Ruptured Spleen
Osteomyelitis is a bone infection that can occur if bacteria or fungi get inside your body. For example, this could happen if you have:
- A broken bone that pokes through your skin (compound fracture)
- A wound near your clavicle
- An infection in your blood (sepsis)
The symptoms of osteomyelitis may include pain, joint warmth, and swelling.
Why Bone Infections Happen
Condensing osteitis is a rare condition that can cause pain and swelling near the collarbone. It is not cancerous (benign) and does not spread to other areas of the body.
The condition has no known cause. The treatment usually includes antibiotics or anti-inflammatory medications.
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Just above the left and right sides of your collarbone are your supraclavicular lymph nodes. Swollen supraclavicular lymph nodes can sometimes signal the presence of lymphoma or a tumor in the lungs, breasts, neck, or abdomen.
Swollen supraclavicular lymph nodes can cause pain just above the collarbone that may radiate across the collarbone itself.
Very rarely, a fracture in the clavicle can be one of the first signs of lung cancer that has spread to the clavicle, resulting in shoulder and collarbone pain.
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Treatment Options for Collarbone Pain
The treatment for collarbone pain will depend on what's causing it. In some cases, treatment can be done at home before you see your provider or go to urgent care.
At-Home Treatment and First Aid
For traumatic cases of collarbone pain—especially if you might have a broken collarbone—you will want immobilize your arm (keep it from moving). You can do this by wearing a sling while you wait for medical care.
You can make a sling from a towel, elastic bandage, or item of clothing. When you're wearing it, your arm should rest against your chest and your hand should be higher than your elbow. It shouldn't feel too loose or too tight.
If your collarbone pain is from a muscle injury or sprain, you can use the R.I.C.E. method: Rest, Ice, Compression, and Elevation.
How Long to Ice?
Do not ice for longer than 20 minutes at a time. Do not place ice or gel packs directly on your skin.
Using the R.I.C.E Method for an Injury
Healthcare Provider Treatment
The medical treatment a provider chooses for a collarbone injury will depend on how you hurt it and how bad the injury is.
Here are a few steps your provider might take if you have collarbone pain:
- Place your arm in a sling
- Give you icing instructions
- Prescribe pain medication
- Show you exercises to do after several weeks of immobilization
If you have an infection, your healthcare provider may prescribe an antibiotic.
The Right Way to Wear a Shoulder Sling
When to See a Healthcare Provider
Pain in your collarbone is not always serious, but there are times when you will need to seek medical care.
Sudden, severe pain from an injury could mean the collarbone is broken or dislocated. It could also have separated from the other bones around it.
If your collarbone is hurt in an accident and you are in a lot of pain, you should go to urgent care right away.
What You Should Know Before Going to the ER
If you hurt your collarbone and the pain is not very bad or if you have gradually started to notice symptoms, it's probably not an emergency.
That said, you should still make an appointment to see your healthcare provider.
When to Call 911
You should seek immediate medical care if:
- You have a major collarbone injury and feel confused and/or short of breath
- You have non-traumatic collarbone pain that gets worse when you lie flat and/or you have stomach pain (possible signs of a ruptured spleen)
- You have pain in your arms, shoulders, collarbone, neck, or back; you feel faint, and you have chest pain
Is Chest Pain Always an Emergency?
Collarbone pain can be caused by injuries, infections, health conditions, and even certain sleeping positions.
There are also rare conditions—like a ruptured spleen, thoracic outlet syndrome, osteomyelitis, and condensing osteitis—that can cause collarbone pain.
Treatment of your collarbone pain depends on the cause. Immobilization and pain medication are common ways to manage collarbone injuries.
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