Cracking Sternum

Costochondritis
The second through the fifth costochondral junctions typically are involved.

More than one junction is involved in more than 90% of patients.

Patients may not be aware of the chest wall tenderness until examination.

Costochondritis has no palpable edema.

Pain may be described as follows:

Exacerbated by trunk movement, deep inspiration, and\or exertion.

Lessens with decreased movement, quiet breathing, or change of position.

Sharp, nagging, aching, or pressure like.

Usually quite localized but may extend or radiate extensively.

May be severe and/or debilating.

May wax and wane.

Costochondritis when associated with RPC is best controlled through RPC medications and non-exasperation of the inflammed joints. Active inflammation and pain is a symptom of flaring.



Nonsteroidal anti -inflammatory drugs (NSAIDs) are useful. Used typically for the relief of mild to moderate pain and inflammation. The affects of NSAIDs in the treatment of pain and inflammation tend to be patient specific. Chronic episods of costochondritis may indicate the need for DMARD's and is some cases pain medications.



NSAIDs for pain control.

Avoid repetitive mis-use of muscles.

Modify improper posture or ergonomics of the home or work place.

Local heat or ice packs.

Local infiltration of local anesthetic, steroid, or intercostal nerve block

(reserved for refractory cases).

Gentle stretching of the pectoralis muscles 2-3 times a day may be beneficial.

Primary care follow-up with persistent symptoms.



Imaging studies:



No specific studies exist for costochondritis. The clinical scenario and the most likely differently diagnosis should guide lab orders. Obtain a chest radiograph in the workup of the differential diagnoses. Bone (gallium) scans have been used in the United States, although these are not ED studies.

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Costochondritis is an inflammatory process of the costochondral or costosternal joints that causes localized pain and tenderness. Any of the 7 costochondral junctions may be affected, and more than 1 site is affected in 90% of cases. The second to fifth costochondral junctions most commonly are involved costochondritis is a benign cause of chest pain and is an important consideration in the differential diagnosis. Although the term costochondritis often is used interchangeably with fibrositis and Tietze syndrome, these are distinct diagnoses. The condition's course may be self-limited, but the patient often experiences recurrent or persistent symptoms and pain. Severe cases may be complicated by dislocation of the clavicles and ribs, or a flailed chest was secondary to lysis of costosternal cartilage.



The onset is often insidious in Relapsing Polychondritis. Chest wall pain with a history of repeated minor trauma or unaccustomed activity (e.g., painting, moving furniture) is common. Pain with palpation of affected costochondral joints is a constant finding in costochondritis.
Polychondritis Educational Society, 2003 copyright
Differentials:

Abdominal Trauma,

Blunt Acromioclavicular Injury

Anxiety

Gout and Pseudogout

Herpes Zoster

Neoplasms, Lung

Sternoclavicular Joint Injury.

Myocardial ischemia or infraction.

Tietze's syndrome.

Infection from pyogenic organisms, tuberculosis, fungal or viral associated with trauma, a sternotomy incision or drainage from intrathoracic or peritoneal foci.

Chest wall irradiation, and deep chest wall burns (particularly of electrical origin).

Costochondritis secondary to hematogenous seeding of Candida albicans in intravenous drug abusers has become increasingly recognized.

Other Problems to be Considered:

Pericarditis

Pleurodynia

Fibromyalgia



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This page was last updated: August 20, 2008

It is a bit extensive explanation for cracked sternum, don't you think? The most important thing that you need to know about this are the symptoms. Usually, patients with a cracked sternum or any other sternal fracture experience a sudden chest pain at the time of injury and after, of course. This type of pain is often sharp and intense and may increase while you are taking a deep breath, when you are coughing, even laughing or sneezing. 

You should not think a lot about this, you should do x -ray test. An X-ray is required to confirm the diagnosis and it can also confirm how serious the damage is, and did this damage caused some damage to other organs such as the lungs.

pops all the time. I go to yoga and it is almost a relief as it seems to crack as I bend backwards and twist. It really sucks, especially when sneezing, hurts like HELL.

Anyways, if anyone else's sternum or chest seems to be cracking or popping lets keep the discussion going.

I asked my Doctor about this and he told me it's "nothing to worry about". Still it didn't used to happen, and based on my experience with cars, ignoring strange sounds is usually a recipe for disaster.

I've had this problem for about 4 months now. I'm a 24 yo male/5'9, 200 lbs.
It started out of the blue. It honestly feels wonderful when I crack it. Well, sometimes it's a crack (sometimes two cracks in succession...once even three haha), and sometimes it's just a loud hollow pop. It happens after I slouch for too long. It has become a pretty big habit. I even go out of my way to try and crack/pop it now, sometimes I succeed, most times I don't. I have to wait for the pressure to build up, and throw my arms behind my back, and puff out my chest, and low and behold that wonderful feeling emerges.
Probably not healthy by any means... so I'm going to go get an X-Ray of my chest soon.

I am 26 and have lost about 40lbs in the last 6 months. About 2 months into it, at about 195 or so, I started getting this cranking sound in my chest!! The guy above me describes it perfectly!! No idea what it is but it doesn't get in my way. Just feels good when it cracks. Might have something to do with workouts.

I developed this same pain in my sternum at the beginning of March. At first it only hurt when I twisted my body but now it hurts constantly. The Dr. has me taking anti-inflammatories to help it. I had chest x-rays taken and the Dr. said that the reason for my pain was that my upper sternum and lower sternum have never fused together. There is a gap and supposedly the two peices slide and overlap (thus causing the pain) and then the cracking is made when it is forced back to the intented position (thus causing the relief). I can clearly see the seperation in my sternum in a lateral x-ray. Dr. said the only thing to be done would be to have a surgery to fuse the two pieces together but I don't think i will take that risk. Hope you all find an answer to your mysterious cracking.

I'm 29, 6'3, and 200 and I've had this same issue for about a year now. I don't think its from weight loss or age as some people have mentioned. I only say this based on the comments posted have come from all sizes and shapes. Mine was initiated from a slight fracture in my sternum (bench pressing).

To be honest, the posture suggestion would make a lot of sense (esp. if you sit behind a desk for a living or slouch). The popping is great and I would be interested to hear the results of an MRI if anyone goes and gets one.

wow, didn't know so many people had this same problem
unfortunately I think my being able to crack chest/sternum is because I have a neuro-muscular disease. I've noticed muscle wasting, have spasticity, fasciculations etc.
so I think it's the chest muscles that are shrinking, thus the cracking.
I can crack my chest roughly 20 times a day. I don't even have to throw my arms back. I can just puff out my chest and it cracks loudly. It feels wonderful. No pain associated at all. But I'm quite aware of what it is related to...because now my shoulders crack, my back cracks, my ankles crack. areas that never used to before, but now have less muscle.

so yeah. I can crank out some pretty loud sternum cracks If I've been slouching over the computer long enough. Loud enough to gross out most people, anyway.

Hey everyone, I'm 38 yrs. old and the cracking has been going on for almost 2 years. I'm 6'2, 224 lbs. so i'm about 20 lbs. overweight. I've also had plenty of stress for the past 2 years and I play basketball a couple of times a week.
At first the cracking felt relieving and I went to the doc about it and he said "nothing to worry about". Well here I am 2 years later and for the last 2-3 months it is very painful and is affecting more of my chest. I can't live like this!!
It is riuning my quality of life! I am going back to my doc next week and if he doesn't give me answers, I am changing to someone who CAN give me answers! Any advice would help and PLEASE KEEP THE CONVERSATION GOING.

Thanks,

I can not beleive that out of all of these posts... nobody talks about going to a chiropractor to check if they have a spinal subluxation. I've read from other forums online that it could be from that!!!

first off... dont take drugs. go to a chiropractor and see if you need an adjustment to reduce or eliminate spinal subluxations.

I have had this problem for about 6 years. it can be quite depressing as it usually coincides with other symptoms such as muscle stiffness, tightness of the throat, headaches and anxiety. these have a profound effect on my life and i have found some relief with chiropractic adjustments. although not a panacea, it definately helps me and my symptoms are gone for a couple of weeks. they usually return over the course of 1-2 weeks, then its back to the chiropractor to get myself adjusted again. i have noticed fluctuations in frequency and i have found that if i am active and happy, the symptoms are non existent. however if i am stressed, bored or sedentary the cracking and aching of the sternum slowly creeps back. ive spend thousands seeing the chiropractor, but i feel that i have become dependant on the relief that i get from this awful affliction. it also affects my clarity of mind and my ability to relax, so much so that i have a different personality and i am constantly suffering and trying to crack myself free. as soon as my spine has been adjusted i am restored to my true self. its quite amazing the difference this makes.

basically, it is caused by tight muscles brought on by bracing. you will find instant relief when your back is adjusted by a chiropractor or osteopath so i recommend finding a good one. also, postural work and stress management is a good recommendation.

Tietze syndrome

Look this up

I have found a way to rehabilitate my popping sternum and pain.

How did the popping and pain started:
I am 29 years old now. I am a small framed relatively muscled male, with high conditioning level and high strength performance rate considering my size. I have been into sport activities since I was 22 including kickbox training and some basic gymnast exercises.
Perfectly healthy three years ago I was doing some real deep dips on the gymnast rings most probably not enough warmed up and the day after I woke up with a nice surprise. I could not move my hands and connect my palms in front of me due to a strong pain in my sternum and chest, I was sure that I teared, pulled or damaged something in the middle of my chest. The pain was so hard and sharp that I was starting to panic but I did not went to a doctor. I have waited a week and the pain slowly diminished, but after that I had a dull pressure in my chest and feel for a need to pop my sternum. I could not do a pop for a week or more, which was the worst stadium of this injury. I did not do any sport activities for my upper body as I remember more than a month after that.

I was living with this state for about two years then I visited a doctor who was looking me just as the others described : strange and surprised. They have never heard about this problem. I cannot believe that no one from the doctors heard about this. What a modern science and medicine. Way to go. I searched the internet and found no useful info's about my state. I was mad of course and I realized that I am left to rely on my own knowledge and health care.

I see that most of the people here with this problem is between the age of 15 and 30, that is, those are the years when we are the most physically active in our lifetime. I noticed that we all get the injury by doing some exercises or the other case which is less common that is to get it due to some external force, pressure or hit on the chest. Any of these ways you acquired the injury, it is the same result, you have pulled or teared your muscle/tendon that connects to the sternum and it will be always under inflammation cause you always use your chest, you always move your arms, push or pull something, sleep and push pressure on it so it is impossible for it to heal.

The rehabilitation process:
I thought that with rest it is gonna heal. Maybe it would if we would put our whole upper body in a plaster for a few months. Instead of that solution I went for a swim. The magic keyword for healing this sternum condition is "swimming". I have come to this conclusion by following injury sport statistics and seeing that swimmers and any sport activity players have the less or none of injuries in their careers. Swimming gives your body a weightless motion putting your joints in their natural movement without any or very little resistance, which helps heal injuries and ignite joint fluids to be produced. Hell, even race horses are being put into swimming pools to rehabilitate and heal from time to time.
I started swimming more often and often from the last year, I swim now once or two times weekly and I swim 500 meters or 1000 meters weekly, that is 3000 meters monthly, (or even more in the summertime) plus I do some water exercises, arm swings and various torso movements. After just two or three months of my regular swimming schedules my pain started to disappear totally and the popping gone less and less, however did not disappeared totally. Then I incorporated pushups, bodyweight pullups and not to forget everyday stretching in my training session. I was avoiding dips and I still avoid them as vampire avoids the cross. Have to note that I started the bodyweight exercises real gradually and with maximal caution, when I felt pain I stopped immediately.

Today I am totally back on my training schedule and doing any, I said any exercise except the dips which has led me to this injury, but I am planning pretty soon to get back to those exercise too. I did not used any medicaments nor any oils or substances to repair my injury. All I did is train on the right way. You should search google for chest stretching exercises and follow them. I forgot, I do every morning the yoga good morning position on the floor to stretch out my chest, and I do sometimes "the chest opener" exercise on the chair but not too often.

At this moment I have absolutely NO pain in my sternum area nor I cannot pop it, even if I wanted to do it.When I remember how it was 3 years ago it sounds unbelievable. There are times when I sleep very long, like for about 12 hours together continuous then I get a little pressure feeling in my sternum and I can pop it once when I wake up, but that is all.
I do not know what will happen if I stop swimming or training, but I guess I will never stop to find that out :-)

Maybe I forgot some detail to mention I am not sure now, after all this all happened 3 years ago and last for three years now but I am sure now that sternum pain and popping CAN be healed and can be rehabilitated, maybe not 100% but at least 95% which is good enough.
I am not a doctor, not even close to that, all I have wrote is from my own experience and what I managed to read on to learn on the internet.

If anyone have any question ask, I will following this topic I guess....
Hope I helped a little at least.