What Causes Collarbone Pain & When to Seek Care

Shoulder strain

Shoulder strain means that the muscles and/or the tendons in the shoulder have been overstretched to the point of damage and sometimes partial tearing. (A "sprain" means that ligaments have been damaged.)

Because of its wide range of motion, the shoulder is a relatively unstable joint that is vulnerable to injury. A sudden overloading, especially after long periods of overuse, can finally cause some degree of tearing to the muscle fibers and/or the tendons.

Shoulder strains are most often sports injuries, or are caused by strenuous physical labor.

Symptoms include sudden sharp pain followed by swelling, bruising, and ongoing tenderness.

Diagnosis is made through patient history, physical examination, and sometimes ultrasound.

Treatment involves a short period of rest, followed by gradually increasing exercise to regain strength and prevent stiffness and weakness of the muscles and tendons. Physical therapy will be tailored to the individual and some skills, such as for sports, may need to be relearned. Improving posture while sitting, and adjusting techniques for work and sports, can help prevent recurrence of the strain.

Rarity: Uncommon

Top Symptoms: pain in one shoulder, pain in the front of the shoulder, shoulder pain from overuse, shoulder pain from an injury, sports injury

Symptoms that always occur with shoulder strain: pain in one shoulder

Symptoms that never occur with shoulder strain: arm weakness, arm numbness

Urgency: Phone call or in-person visit

Rotator cuff tendinitis

The rotator cuff is an arrangement of muscles and tendons that holds the head of upper arm bone within the shoulder socket. If these muscles become inflamed, the condition is called rotator cuff tendonitis.

The most common cause is overuse, especially with athletes or laborers.

Repeatedly throwing or swinging an object causes extensive wear on the muscles and tendons. It can also happen with an acute injury.

Symptoms include a nagging, aching pain in the upper arm and shoulder that gets worse with raising the arms or reaching backwards.

Diagnosis is made through physical examination, x-ray, and sometimes MRI.

Early treatment involves immediately stopping use of the affected shoulder, applying ice to the painful area, and taking nonsteroidal anti-inflammatory drugs such as ibuprofen to ease pain and inflammation. Careful stretching can sometimes help. Cortisone injections may be tried, as well as ultrasound and therapeutic massage.

Surgery may be advised to remove damaged tissue or any bone spurs. Follow-up care and exercises will be very important in gaining full recovery.

Repetitive strain injury of the shoulder ("swimmer's shoulder")

Repetitive strain injury of the upper arm is caused by consistent repetitive use.

You do not need treatment, just rest from your overuse. Wearing a brace and physical therapy might be helpful.

Rarity: Uncommon

Top Symptoms: shoulder pain from overuse, shoulder weakness, shoulder numbness

Symptoms that always occur with repetitive strain injury of the shoulder ("swimmer's shoulder"): shoulder pain from overuse

Symptoms that never occur with repetitive strain injury of the shoulder ("swimmer's shoulder"): severe shoulder pain, shoulder injury

Urgency: Self-treatment

Recurrent shoulder dislocation

Recurrent subluxation of the shoulder is a condition that results in a persistent partial dislocation of the shoulder joint.

You should visit your primary care physician to confirm the diagnosis and discuss treatment options. Physical therapy is often recommended. If that fails, surgery may be considered.

Rarity: Common

Top Symptoms: shoulder pain from overuse, pain in the front of the shoulder, shoulder dislocation

Symptoms that always occur with recurrent shoulder dislocation: shoulder pain from overuse, shoulder dislocation

Urgency: Primary care doctor

Myofascial pain syndrome

Myofascial pain syndrome is also called chronic myofascial pain (CMP.) Pressure on certain points of the muscles causes referred pain, meaning the pain is felt elsewhere in the body.

The cause is believed to be muscle injury through overuse, either from sports or from a job requiring repetitive motion. Tension, stress, and poor posture can also cause habitual tightening of the muscles, a form of overuse.

This overuse causes scar tissue, or adhesions, to form in the muscles. These points are known as trigger points, since they trigger pain at any stimulus.

Symptoms include deep, aching muscular pain that does not go away with rest or massage, but may actually worsen. There is often difficulty sleeping due to pain.

Myofascial pain syndrome should be seen by a medical provider, since it can develop into a similar but more severe condition called fibromyalgia.

Diagnosis is made through physical examination and applying mild pressure to locate the trigger points.

Treatment involves physical therapy, pain medications, and trigger point injections. In some cases, acupuncture and antidepressants are helpful.

Rarity: Common

Top Symptoms: dizziness, spontaneous shoulder pain, pain in the back of the neck, tender muscle knot, general numbness

Symptoms that always occur with myofascial pain syndrome: tender muscle knot

Urgency: Primary care doctor

Frozen shoulder (adhesive capsulitis of the shoulder)

Frozen shoulder is also called adhesive capsulitis of the shoulder. The "shoulder capsule" is the strong web of connective tissue which holds the ball joint of the upper arm inside the socket of the shoulder blade. If this connective tissue is damaged, scar tissue – or adhesions – may form and cause the shoulder capsule to become tight, painful, and inflexible.

The condition can happen if an injury to the shoulder forces it to stay immobilized while healing. Additional risk factors may be diabetes, thyroid abnormalities, and heart disease.

Symptoms include gradual worsening of the ability to move the shoulder, due to increasing pain and stiffness in the outer shoulder and upper arm.

Diagnosis is made through physical examination, with simple tests to measure how far the shoulder can move, as well as imaging such as x-ray or MRI.

Treatment involves physical therapy to help restore range of motion; over-the-counter, nonsteroidal anti-inflammatory drugs to ease pain; and sometimes cortisone injections to the shoulder joint. Surgery may be needed in some cases.

Rarity: Common

Top Symptoms: spontaneous shoulder pain, stiff shoulder, dull, achy shoulder pain, shoulder pain that gets worse at night, difficulty moving the shoulder

Symptoms that always occur with frozen shoulder (adhesive capsulitis of the shoulder): stiff shoulder

Urgency: Primary care doctor

Biceps tendonitis

Biceps tendinitis, also called biceps tendonitis, is an inflammation of one of the upper tendons of the biceps muscle in the upper arm.

The biceps is anchored at its lower end near the elbow. About halfway up the arm it divides into two parts, one a little longer than the other. One part, the "short head" or shorter of the divided muscles, attaches to the shoulder blade. The other, the "long head," attaches to the top of the shoulder.

Biceps tendinitis is usually caused by overuse, especially repetitive throwing-type motions of the arm. It is primarily a sports injury.

Symptoms include a throbbing, aching pain in the shoulder that may radiate down the arm. Any throwing, lifting, or pulling movement may produce pain in the shoulder.

Diagnosis is made through physical examination and ultrasound, and possibly with CT scan and/or MRI.

Treatment begins with rest, ice, over-the-counter pain relievers, and physical therapy. It may also include injections of local anesthetic and/or corticosteroids into the biceps tendon sheath. Surgery may be needed in some cases.

Acute costochondritis (chest wall syndrome)

Acute costochondritis is also called anterior chest wall syndrome. It is an inflammation of the flexible cartilage that connects each rib to the breastbone.

Costochondritis is caused by excessive coughing or by straining the upper body, as with weightlifting. It is a common occurrence and is seen in children, teenagers, and adults.

Symptoms include a sudden, sharp, aching pain anywhere in the chest wall, especially near the breastbone where it connects to the ribs. The pain gets worse with deep breathing or with almost any movement.

Any sort of chest pain should be seen by a medical provider, especially if the person is over 35 and/or has had any cardiopulmonary symptoms. Heart attack symptoms can be mistaken for costochondritis in some cases.

Diagnosis is made through physical examination. X-rays or CT scans may be done to rule out any other causes for the pain.

Treatment involves rest along with over-the-counter, nonsteroidal anti-inflammatory drugs. Injection of corticosteroid medication to ease pain and inflammation is occasionally done.

Acromioclavicular (ac) shoulder joint injury

The shoulder is made up of three bones - the shoulder blade (scapula), collar bone (clavicle), and arm bone (humerus). The acromioclavicular (AC) joint is a joint that is in the front of the shoulder, where the collar bone and shoulder blade meet. This joint is stabilized by ligaments, which can tear if the two bones are separated from one another. AC shoulder joint injury is most commonly caused by falling on the shoulder.

You should visit your primary care physician within the next 24 hours. AC joint injuries are usually treated non-surgically with pain medications and wearing a shoulder sling. Your doctor may coordinate care with a physical therapist as well.

Rarity: Rare

Top Symptoms: constant shoulder pain, pain in one shoulder, shoulder pain from an injury, shoulder pain near the end of the collarbone, difficulty moving the shoulder

Symptoms that always occur with acromioclavicular (ac) shoulder joint injury: shoulder pain near the end of the collarbone, constant shoulder pain

Urgency: Primary care doctor

What can cause shoulder pain without injury?

Pain in the shoulder is often a sign of injury. Shoulder pain can be due to overexertion of the shoulder through activity or exercise, a pulled nerve along the neck or spine usually in concert with activity, or even a rash affecting the skin like a sunburn. It is also possible to experience shoulder pain because of injury to the abdomen and referred pain to one or both shoulders.

How long does it take for a broken collarbone to stop hurting?

How long your pain will last depends on the location of the break. The first, second, and third portions of the clavicle require different healing processes. If the middle of the clavicle is broken, it can take up to 12 weeks to heal. The far third of the clavicle may take up to six weeks to heal, and the third portion of the clavicle may take as long as eight weeks to heal. Your physician will explain your unique healing time.

Can you dislocate your collarbone?

The collarbone, or clavicle, attaches the acromion, a portion of the shoulder blade, to the sternum or chest bone. It is most commonly dislocated at its connection to the shoulder, the acromioclavicular joint. Injuries can range from mild sprains and dislocations to dislocations and fractures.

Can you move your arm with a broken collarbone?

Yes, it is possible to move your arm with a broken collarbone; however, it will be quite painful. Moving may cause the sharp portions of the collarbone to protrude through the skin, necessitating urgent surgery. Accordingly, most people hold their arms very still to avoid additional pain or injury.

Why does my collarbone hurt when I sleep?

If you have strained the joints attached to your collarbone, commonly from overhead or forward weighted motions, it is possible to exacerbate the strain placed on the joint by sleeping on this side. If you have a connective tissue disorder, you may also be able to damage your collarbones. Sleeping with collarbone or shoulder injuries can be painful because of sleeping position in general. Some people find it more comfortable to sleep in a recliner chair.

Questions your doctor may ask about collarbone pain

• How would you explain the cause of your shoulder pain?
• Can you fully move your shoulders around?
• Where exactly is your shoulder pain?
• Do you require a wheelchair to move around?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.