What is the Clavicle?
The clavicle or the collarbone is the bone that runs across the top of the chest, between the neck and shoulder. It is roughly around 13cm, rests above the ribs and links the sternum and the shoulder blade. The clavicle supports the upper limbs and muscles of the bodies and supports the distribution of weight for the hands and the arms. Hence, when1 the clavicle is injured, this weight distribution is affected and it results in excruciating pain.
Causes of Clavicle Pain
1. Collarbone Fracture – A fracture of the clavicle is the most common cause of its pain. This often happens to athletes, hockey players and football players who often get their collarbone injured on the field. The clavicle gets a fracture when the person falls on their shoulder or when there is an accident. This leads to excruciating pain and swelling where the injury has happened.
There are two types of fractures that can occur here. A simple fracture happens when there is a break in the bone without damage to any of the other organs around the clavicle. A compound fracture happens when the break in the bone damages the other organs and may even tear through the skin.
Signs of a fractured collarbone:
- Shoulder slumps where the bone has broken
- Tenderness and swelling in that area
- Limited motion
- Sudden, sharp and shooting pain in the collarbone area
- A popping, clicking or grinding sound made when air enters the broken bone area.
- A bulge in the site of injury
- Bleeding in the case of severe injury
2. Excessive exercise – This often happens when strenuous workouts are done for the torso, chest, upper arms and shoulders. Due to poor technique and no proper warm ups and cool downs before and after exercising, small microfractures can occur. This causes a noticeable amount of pain and if the person continues to work out with this pain, there are chances of further injury.
A condition called distal clavicular osteolysis occurs when heavy pressure is put on the shoulders while lifting weights. This is commonly known as weightlifter’s shoulder. The distal end of the clavicle painfully deteriorates due to tiny fractures that occur along its end. This results in osteolysis or a complete degeneration of the bone.
3. Acromioclavicular joint injury – This joint connects the three main bones of the shoulder. When the acromioclavicular joint gets injured, the ligaments near the joint start getting strained and this causes clavicle pain. This pain can be noticed when you are trying to reach overhead or when you are pushing or pulling.
4. Shoulder dislocations – Due to a fall or an injury, the arm of the shoulder may pop out of its socket. This causes mild to severe pain. If this injury is severe, it can affect the clavicle.
5. Infections of the clavicle – Any infection in this area would affect the surrounding organs and tissues. Hence it is to be taken very seriously, especially as the lungs are also situated nearby. The symptoms of the infection would include pain, a fever, swelling, and redness.
6. Cancer – Bone cancer can originate in the collarbone or could have come from a surrounding area. Although this is rare, it cannot be ruled out as cancer may be malignant. It can be detected through pain and swelling in the clavicle. The shoulder may also be stiff and the person will find it difficult to move the shoulder. This is often seen in elderly people more.
7. Arthritis – Arthritis is a common condition which can develop in joints in the body. The acromioclavicular joint can develop arthritis from overexertion as well as from previous injuries. There will be pain and a popping sound will be there when the joint is moved around. There could also be discomfort in reaching overhead or turning while sleeping.
8. Thoracic Outlet Syndrome – The thoracic outlet is the space between the collarbone and the upper ribs. This space contains many muscles, nerves, ligaments and blood vessels. If the muscles get weak or the nerves get pinched, pressure can be put on the clavicle, resulting in pain. The other symptoms include tingling, numbness in arms, aching sensation and swelling.
9. Bad posture – Having a bad posture can cause damage to the joints. The clavicle area has one of the most complex networks of muscles, tendons, and ligaments. Sitting in front of a computer all day or slumping shoulders can cause the bones to go out of alignment and also allows cartilage to break.
10. Bursitis – The joints contain small fluid-filled sacs or bursae which help in the movement of arms freely without friction. They also help relieve pressure when heavy objects are lifted. When these bursae are excessively used, it can get inflamed and swollen. This can make even basic day to day activities and lifting painful.
11. Sleeping position – Certain sleeping position cause throbbing in the lower neck area and below the collarbone. The position may have caused the nerves to be pressed, resulting in the pain. Sleeping on one side also aggravates distal clavicular osteolysis which is mentioned above.
Treatment for Clavicle pain
The treatment for clavicle pain differs according to what caused the pain. X rays may be necessary to figure out the extent and severity of damage.
- For those who have fractures and injuries, immobilization of the arm and shoulder is recommended. There are clavicular support devices available which will not let the bone move and will stabilize the area. These devices include the back brace and the clavicle support brace.
- In the case of infections, antibiotics will treat the infection and reduce the inflammation. But in certain cases, surgery is necessary if the infection spreads to other organs.
- In the rare case of cancer in the collarbone, the doctor will prescribe the kind of treatment which is required. Surgeries, radiotherapy, chemotherapy and certain medications may be prescribed.
- There are anti-inflammatory drugs that are used to reduce pain and swelling, especially in the case of arthritis.
- There are certain precautionary measures to be taken while sleeping. Sleeping on one side for too long is not recommended as it may strain the muscles of that area. Extra pillows can also be used to reduce any sudden impact on the shoulders and back while tossing in the night during sleep.
- Application of ice packs helps reduce the pain. The ice should be wrapped in a clean towel and needs to be applied to the affected area for 20-30 minutes at a time. This has to be repeated every 4 hours or so according to the pain. This process, when continued for a few days, helps relieve the pain considerably and reduce the swelling.
- Rest – It is important for the injured muscles and joints to receive rest. If this does not happen and the muscles are strained further, the resulting injuries could be far worse. If the injury is aggravated, the healing and recovery process will be greatly delayed.
- Application of moist heat packs is soothing in the case of osteoarthritis. The moist heat reduces the pain and swelling of the inflamed joints. A cloth can be dipped in very hot water, taken out and wrung to remove excess water. After it cools a bit, it can be applied to the area of discomfort to provide a soothing sensation. If this is done for 15-20 minutes every 4 hours, within a few days, the pain greatly reduces.
- Natural pain relief – Applying certain oils and ointments bring about natural pain relief. Comfrey ointments have been used to relieve the pain from aching joints and muscles for centuries. Certain oils which contain peeper and capsaicin have anti-inflammatory properties that help reduce inflammation and ease the pain in the sore areas. Ginger can also be a natural anti-inflammatory agent as it contains compounds that are highly effective in reducing arthritis.
- Physical therapy which involves stretches and exercises that are not strenuous will allow the ligaments to be strengthened. Physical therapy eases the pain and helps the movement and rotation of the shoulder. The exercises are designed to prevent stiffness and weakness around the collarbone and will strengthen the muscles and ligaments around them.
- Adopting a good posture while sitting, standing and walking, sleeping on the back and avoiding activities which could aggravate the pain are some modifications to be made.
Clavicle pain has a number of causes. Fractures are the most common cause of clavicle pain. While injuries and inflammation can happen anywhere, some rare cases of clavicle pain are seen in cancer that originates in the clavicle. Treatment options are varied but it is recommended to keep the shoulder in a brace so that it doesn’t move or cause more pain. Surgery, medications, natural remedies and physical therapy help relieve the symptoms of the pain but taking adequate rest is what actually allows the bone to repair and heal.