Collarbone Pain: Causes, Treatment and When to See a Doctor

01Anatomy

The collarbone and its joints

The clavicle runs from the breastbone (sternum) to the shoulder blade (acromion). At the inner end it forms the sternoclavicular joint, and at the outer end the acromioclavicular (AC) joint. It acts as a strut that keeps the shoulder out to the side and transmits forces from the arm to the trunk.

Muscles such as the trapezius, deltoid, pectoralis major and sternocleidomastoid attach to it, and important blood vessels and nerves run just beneath it.

02Fracture

Broken collarbone

• Usually caused by a fall onto the shoulder, a fall onto an outstretched hand or a direct blow in sport or cycling.
• Pain, swelling and a bump or deformity over the bone, and difficulty lifting the arm.
• Most fractures in the middle of the bone heal in a sling without surgery.
• Surgery is considered when the bone ends are widely separated, shortened, pierce the skin or press on nerves or vessels.
• Healing takes about 6 to 12 weeks in adults and less in children.

03AC joint

AC joint injuries and arthritis

An AC joint sprain, sometimes called a separated shoulder, happens after a fall onto the point of the shoulder. Pain is at the outer end of the collarbone and there may be a step or bump. Most sprains recover with a sling, ice and physiotherapy within weeks.

Gradual pain at the AC joint is common in weightlifters (bench press, dips), manual workers and people with arthritis. It hurts when reaching across the body, lying on that side and lifting overhead. See also frozen shoulder.

04Inner end

Pain at the inner end of the collarbone

• Sternoclavicular joint sprain or arthritis: pain and swelling where the collarbone meets the breastbone, worse with shrugging or reaching.
• Costochondritis: inflammation of the rib cartilage near the breastbone; see costochondritis.
• Infection: rarely, the joint becomes infected, with fever and redness.

05Other causes

Other causes of pain around the collarbone

• Muscle strain from lifting, carrying heavy bags or new gym exercises.
• Neck problems referring pain into the collarbone area.
• Thoracic outlet syndrome, with arm tingling and heaviness when lifting the arm.
• Swollen lymph glands above the collarbone, which need prompt assessment.
• Rarely, pain from the heart, lungs or gallbladder felt in this area.

See also shoulder blade pain and shoulder labral tear.

06Treatment

Treatment and self-care

• Rest the arm in a sling after a fracture or AC sprain, as advised.
• Use ice for 15 to 20 minutes several times a day in the first days.
• Take simple painkillers if appropriate.
• Sleep propped up on pillows in the first weeks after a fracture.
• Avoid lifting, pushing and contact sports until healed.
• Move the elbow, wrist and hand regularly to prevent stiffness.

07Rehab

Physiotherapy and recovery

Once the pain settles or the fracture has started to heal, a physiotherapist guides gentle shoulder movement, then progressive strengthening of the rotator cuff and shoulder blade muscles, and finally return to lifting, work and sport. Contact sports are usually avoided for at least 3 months after a fracture.

For AC joint pain without injury, modifying exercises such as reducing bench press depth and dips, and strengthening the upper back often helps. See rotator cuff exercises.

08Children

Collarbone injuries in children

The collarbone is one of the most commonly broken bones in children, often after a fall from a bike, trampoline or play equipment. Children’s fractures heal quickly, usually in 3 to 6 weeks, and a lump of new bone may be felt for months as it remodels. Newborn babies can occasionally break the collarbone during birth; this also heals well.

10Summary

Key points to remember

• Falls are the main cause of collarbone fractures and AC joint sprains.
• Most collarbone fractures heal in a sling in 6 to 12 weeks.
• Gradual pain often comes from the AC or sternoclavicular joints.
• Lumps above the collarbone, chest symptoms or arm numbness need prompt assessment.