Causes of Collarbone Pain

Introduction

The collarbone, medically known as the clavicle, is an anterior S-shaped long bone of the shoulder present in the lower part of the neck. It extends between the upper part of the breastbone (sternum) and the shoulder blade (scapula). When people wear a shirt, the collar comes around this bone, which is why it is called the collarbone. There are two collarbones, one on either side of the body. It is the only long bone that lies horizontally in the body. It can be palpated along its length, and in thin people, it is visible under the skin. This bone can be reduced or absent in some people from birth. The collarbone is a common site of the fracture, usually the midsection of the bone. Collarbone fracture can occur due to injury or outstretching of the arm puts sufficient pressure on the bone that it breaks. Clavicle fractures are one of the most common causes of collarbone pain. This article discusses in detail the causes of collarbone pain.

What Are the Commonly Associated Symptoms of Collarbone Pain?

Some of the commonly associated symptoms of collarbone pain include:

• Tenderness in the area surrounding the collarbone.

• A protrusion or bulge over the collarbone.

• Shooting pain up the neck or down the arm.

• Diminished range of motion of the arm.

• Pain on moving the arm.

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What Are the Possible Causes of Collarbone Pain?

Collarbone pain is caused due to various reasons, such as trauma, arthritis, and sleeping positions, to name a few. The causes can be broadly divided into traumatic and non-traumatic reasons.

Traumatic Causes: Traumatic causes generally result in sudden and severe pain that is felt at the time of injury. These include

• Fractures.

• Dislocation.

• Joint injury.

• Muscle strain.

Non-traumatic Cause: Non-traumatic causes tend to come gradually and may not hurt much unless people try to move their arms or shoulder. They include

• Osteoarthritis.

• Sleeping position.

• Thoracic outlet syndrome.

• Osteomyelitis.

• Cancer.

Here, the article discusses some of the common causes in detail and starts with the most common cause of collarbone pain, collarbone fracture.

Fractured Collarbone - Since the collarbone is a common fracture site, it can get fractured easily if a person falls and lands on his arm or shoulder. It can occur due to an accident, sports injury, or birth accident (a newborn can break its collarbone while moving down the birth canal). The most obvious symptom of a fractured collarbone is sudden and severe pain, which worsens when the person tries to move his shoulder. Pain is associated with swelling, tenderness, and bruising around the area. Physical examination and an X-ray help in giving a confirmed diagnosis of the broken collarbone. The concerned doctor decides the treatment plan based on the severity of the injury. People with fractures in which the bone remains in place may be advised to wear a sling for some days and rest the arm. Those with severe fractures may require surgery to fix the bone in place.

Joint Injury - The shoulder can be injured without any bones getting broken or fractured. One such injury that can cause significant collarbone pain is the separation of the acromioclavicular (AC) joint. AC joint is a shoulder joint where the collarbone and the shoulder blade meet. When the ligaments that stabilize this joint are torn due to injury, it leads to the separation of the AC joint. Mild joint separation can cause pain, while severe ligament tear can misalign the collarbone. Along with pain and tenderness around the collarbone, a bulge can also develop on the shoulder. It can be treated with rest and ice packs or a brace that fits over the shoulder to stabilize the joint, or in severe cases, surgery may be needed.

Thoracic Outlet Syndrome - Thoracic outlet is the space in the lower neck between the highest rib bone and the collarbone, filled with nerves, blood vessels, and muscles. Due to weak shoulder muscles, the collarbone can slide down into the thoracic outlet, putting pressure on the blood vessels and nerves. Hence causing collarbone pain, even though the collarbone is not injured. The associated symptoms vary depending on which blood vessel or nerve is affected. The diagnosis of this syndrome involves physical examination, X-rays, ultrasound, and magnetic resonance imaging (MRI) scans. It can be treated with physical therapy involving exercises to improve the shoulder muscles' flexibility and strength, and posture. In severe cases, surgery is needed to repair the injured blood vessels and nerves.

Osteoarthritis - There is a protective tissue present at the place of meeting of two bones. When this protective tissue breaks down, it leads to osteoarthritis. It usually occurs due to normal wear and tear associated with aging. Sometimes, it can be due to injury. Osteoarthritis causes pain in the collarbone region that gets worse gradually and stiffness and pain in the AC joint. It can be managed with nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, and lifestyle changes. Rarely, there may be a need for surgery to treat osteoarthritis.

Sleeping Position - Sleeping in fixed positions can cause pain in the collarbone, neck, or back. Sleeping in one specific position for too long can also cause pain. This pain is generally not severe and eases during the day. Most cases can be managed without any specific treatment. Some may need over-the-counter (OTC) painkillers to get some relief from pain. It can be prevented by changing sleeping positions and using new pillows or mattresses.

Cancer - Cancer is a less common cause of collarbone pain. Cancer can advance to lymph nodes in the collarbone region from other parts of the body and cause pain in the region. Neuroblastoma is one such cancer that affects bones and lymph nodes. The associated symptoms include fever, high blood pressure, sweating, diarrhea, and rapid heartbeat. When cancer spreads to the collarbone, it can be treated by surgery or radiation therapy.

Osteomyelitis - Osteomyelitis is a bone infection, and if the collarbone is infected, it can cause severe pain. But it is a less common cause of collarbone pain. Osteomyelitis is usually caused due to bacterial infections, infections occurring after a collarbone fracture punctures the skin or when an infection spreads from a neighboring wound. The associated symptoms include swelling, nausea, fever, pus oozing from the skin, and tenderness. It is usually treated with intravenous antibiotics.

How to Manage Collarbone Pain at Home?

Collarbone pain requires immediate treatment by a doctor. However, mild collarbone pain due to minor injury or muscle strain can be managed at home with the modified RICE method. RICE implies rest, ice, compression, and elevation.

• Rest - Complete rest to the affected side of the collarbone helps to heal it quickly and avoid making the pain worse.

• Ice - Placing ice packs on the affected area for about 20 minutes every four hours helps relieve the pain.

• Compression - The affected shoulder can be wrapped carefully and immobilized in a sling to help prevent further injury.

• Elevation - Keeping the affected shoulder above the heart and not lying flat for the first 24 hours helps reduce the swelling. Try sleeping with the head and shoulder slightly elevated.

Conclusion

Collarbone pain can occur due to multiple causes. While some collarbone pain can be managed at home, some severe cases of collarbone pain require emergency treatment by doctors. Any pain that lingers for days or worsens progressively should prompt a visit to the doctor. Delays in getting medical attention can make the healing process difficult. Hence, it is important to get the right and immediate treatment for collarbone pain.