The collarbone, also known as the clavicle, connects the shoulder with the chest wall (sternum). Collarbone pain can follow an injury, such as a fall, or develop gradually. So what causes clavicle pain, and how do we treat it?
Causes of collarbone pain
The most common cause of collarbone pain is an acute injury to the clavicle. But pain around the collarbone can also come from tissue elsewhere, such as the chest or abdomen.
Trauma causing collarbone pain
During a fall or a collision, forces are transmitted directly to the middle and ends of the collarbone, causing a break in the bone or a dislocation of the joints at either end.
Fractured collarbone
A broken clavicle makes up about 5% of all fractures in adults. A break is felt immediately, causing severe pain and swelling, and a simple X-ray usually detects it. Treatment depends on whether the break is in the middle or at the ends, and on how far apart the two ends are. Breaks in the middle with little separation are treated with a simple sling, while breaks at the ends with greater separation may need surgery.
Dislocated AC joint
The AC joint connects the collarbone with the shoulder. A fall onto the tip of the shoulder or an outstretched hand can pull the ends apart, dislocating the joint — producing pain, swelling, and a visible lump on top of the shoulder. An X-ray confirms it and rules out a break. Treatment depends on the grade: grade 1–2 dislocations are treated with physiotherapy, while grade 3 and above may need surgery.
Rib fracture causing collarbone pain.
Less commonly, a fall or direct trauma fractures a rib close to the collarbone. People report sudden pain and swelling below the collarbone, sharp and worse with breathing or coughing.
Non-traumatic collarbone pain
Pain in the collarbone without a fall is usually due to joint arthritis,or excessive training in the gym or sports.
AC joint arthritis
As we age, the AC joint can develop arthritis. Combined with excessive activity, this causes inflammation and pain at the outer end of the collarbone. Treatment consists of NSAID tablets such as ibuprofen, physiotherapy, and occasionally a cortisone injection.
Sternoclavicular joint arthritis
The sternoclavicular joint — which joins the collarbone to the middle of the chest wall (the sternum) — can also develop arthritis, though less commonly than the AC joint. People report pain and swelling near the top of the sternum, at the base of the neck. Treatment is the same as for AC joint arthritis: NSAIDs, physiotherapy, and sometimes a cortisone injection.
Distal clavicular osteolysis (weightlifter’s shoulder)
Weightlifters and bodybuilders place a high load on the collarbone, which can cause excessive stress and swelling at its outer end — distal clavicular osteolysis, or weightlifter’s shoulder. We treat it with rest from heavy weights, physiotherapy, and NSAIDs, and occasionally a cortisone injection.
Referred pain to the collarbone
Inflammation in the abdomen — such as gallstones or appendicitis — can trigger pain elsewhere, and one of the more common areas of referred pain is the outer end of the collarbone. Heart pain can also radiate to the neck, near the collarbone. Collarbone pain accompanied by other symptoms — abdominal pain, breathlessness, chest tightness, or feeling unwell — requires prompt medical assessment.
Treatment of collarbone pain
Treatment depends on the specific cause. The history explains whether the pain follows trauma or overuse, and there’s often a tender collarbone lump whose position gives a clue to the diagnosis. We usually suggest an X-ray if we think the pain is coming from the collarbone, and in some cases, an MRI or bone scan helps determine the cause.
Frequently asked questions about collarbone pain.
Why does my collarbone hurt without an injury?
The usual causes are AC or sternoclavicular joint arthritis, distal clavicular osteolysis (from heavy gym training), or referred pain from the abdomen or heart. The location of the pain and any tender lump help point to the cause.
When should I worry about collarbone pain?
Most collarbone pain is musculoskeletal, but seek prompt medical attention if it comes with pain on breathing or coughing (possible rib injury), abdominal pain (which can refer to the collarbone from the gallbladder or appendix), or chest tightness, breathlessness, sweating, or pain spreading to the neck or jaw — as heart pain can refer near the collarbone. These need urgent assessment rather than a sports-injury review.
Is my collarbone broken, or is it the AC joint?
A fracture usually causes immediate, severe pain and swelling over the middle or end of the bone after a fall. An AC joint injury causes pain and a visible lump right on top of the shoulder, at the tip of the shoulder. An X-ray tells them apart.
Why does my collarbone hurt from lifting weights?
Heavy, repetitive loading — bench press, dips, overhead work — can cause distal clavicular osteolysis (weightlifter’s shoulder), with pain at the outer end of the collarbone. It settles with rest from heavy weights, training modification, and sometimes a cortisone injection.
How is collarbone pain treated?
It depends entirely on the cause — a sling or surgery for a fracture, physiotherapy for an AC joint dislocation, NSAIDs and sometimes a cortisone injection for arthritis, and rest and load modification for a weightlifter’s shoulder. An accurate diagnosis comes first.
Final word from Sport Doctor London about collarbone pain
Collarbone pain is most often due to a fall, which makes the diagnosis reasonably straightforward. Without trauma, it can be more complex — arthritis, overuse, or occasionally referred pain from elsewhere. See a doctor experienced in musculoskeletal injuries to ensure an accurate diagnosis.
If you have persistent collarbone pain, Dr Masci can assess you in London, including an ultrasound in the clinic. Contact the team here or call +44 (0) 203 488 0350.
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