Collar bone (medically termed as "clavicle") pain is actually a very common problem and can be caused and aggravated by a number of different problems.
The bone itself (known as the clavicle) may be broken
(fractured collar bone) or suffering from wear and tear, the surrounding ligaments can be injured or
occasionally there may be something more sinister going on.
Here let's look at the most common causes of clavicle pain, what causes them, how they differ and the best treatment options.
The clavicle or collarbone is roughly 15 cm long and connects our arms to our body through two joints:
of these joints are surrounded and supported by very strong ligaments that secure and hold them in place and a
number of the neck and shoulder muscles attach to the clavicle.
Any damage to the collar bone or surrounding soft tissues can cause or aggravate clavicle pain.
Let's look at the most common causes of collar bone pain in this article.
Clavicle fractures are by far the most common cause of collar bone pain, and the most common bone to break.
Fortunately, though they are usually
simple to treat and in most cases will have healed within three months, more or less.
Most commonly it's due to a direct fall onto the shoulder or on an outstretched arm or less often a direct blow to the collar bone or an motor-vehicle accident.
In most cases clavicle fractures are treated non-surgically with a sling and clavicular and shoulder physical therapy, but in some cases surgery may be required to fix the broken pieces back together
Our clavicle bone typically heals in 4-8 weeks in children, 6-12 weeks in adults. People usually make a full recovery by around 3 months, give or take.
Our acromioclavicular joint (ACJ) is held in place by four strong ligaments, and any damage to any of these ligaments can cause instability and clavicle pain.
These ligaments may be
Again, it's typically caused by falls -
Minor injuries will be treated with a sling for 3-4 weeks and shoulder physical
therapy. If the acromioclavicular ligaments have completely ruptured causing dislocation
of the clavicle then patients may have to undergo corrective surgery.
Ligaments usually take longer to heal the bone as they have a poor blood supply (note: ligaments have no direct blood supply hence have slow healing rate and higher reinjury rates).
It can take months to recover fully from acromioclavicular ligament injuries.
Inflammation and degeneration (arthritis) of the cartilage and bones of the ACJ is another cause of collar bone pain.
With arthritis, the space between the two bones
reduces and the surfaces of the bone may become bumpy instead of smooth. Over time, this eventually leads to friction and pain.
Typically it's caused by normal wear-and-tear and aging process, or it can be caused by diseases, activities or injuries.
In children and young adults, the joint space (space
between the two bones) is usually around 1-3mm. By the age of 60, this
has usually reduced to around 0.5mm or less.
Aging, repetitive or prolonged over-head activities such as weightlifting or construction work and contact sports
Mild to moderate collar bone pain over the distal end of the clavicle (nearest the shoulder) which may spread to the shoulder and chest.
The clavicular pain may get worse if you reach across your chest, known as horizontal adduction as that particular movement compresses the acromioclavicular joint
After surgery you will need to wear a sling for a few days
and patients will definitely need 2-3 months at least of physical therapy
Degenerative changes to the cartilage and bone cannot be reversed but with physiotherapy for strengthening the muscles and ensuring good posture you can take the pressure of the AC joint and reduce pain and inflammation either altogether or to a manageable level.
After surgery, you can usually return to work after a week or so but you should avoid any overhead activities for 3 months. It can take a year to make a full recovery
Distal Clavicular Osteolysis is a condition where tiny fractures (breaks) develop in the distal end (nearest the shoulder) of the clavicle.
Repetitive forces through the bone, e.g. from frequent training, mean it doesn’t get a chance to heal completely and properly.
Over time, the bone gradually breaks down and is reabsorbed, known as Osteolysis, faster than it can be repaired.
Repetitive trauma from heavy overhead activities such as weightlifting and plastering and excessive traction on the acromioclavicular joint in activities where the elbows end up behind the body such as bench presses
Collar bone pain usually directly over the acromioclavicular joint, usually a dull ache. Shoulder movement is not usually affected but it will be painful to cross the arm across the chest.
Pain gets worse with
Weightlifters Shoulder usually resolves completely within a couple of years essentially by avoiding aggravating activities.
Medication, injections and shoulder physiotherapy can help reduce the symptoms of clavicle pain.
If symptoms fail to resolve the condition, then surgery may be performed to remove a small portion of the distal clavicle followed by physical therapy to restore range of movement and strength
It can take up to two years to recover from Weightlifters Shoulder, and even then, collar bone pain often returns if you start doing any aggravating activities regularly again
Osteomyelitis refers specificly to an infection that develops in the bone and is a very rare cause of collar bone pain.
Infection may develop after an injury to the bone or may pass into the bone through the bloodstream after an infection (usually bacterial) somewhere else in the body.
It is also a rare side effect of head and neck surgery.
Intravenous antibiotics, usually for around 4-8 weeks.
Early treatment is vital to stop the progression of the disease. In severe cases surgery may be required to remove any infected or dead tissue
Collar bone pain from Osteomyelitis will usually settle after a month or two of antibiotics, but can return, usually if the patient has an underlying medical condition such as poor circulation or a weakened immune system
Injuries to the proximal end of the clavicle where it joins the sternum is another rare cause of collar bone pain.
Ligaments hold the joint together and occasionally one or more
of these ligaments may get over stretch or rupture completely which can
lead to dislocation, usually anteriorly (forwards), of the
A significant blow to the shoulder (front or back) or to the top of the collarbone e.g. from an awkward sporting tackle or car accident
Proximal clavicle pain (near the breastbone), visible lump over the joint
Usually a combination of rest from aggravating activities and physical therapy. Fortunately patients rarely surgery may be required.
It usually takes a few weeks for the collar bone pain to settle but it may take a few months to make a full recovery
Other possible causes of collar bone pain include: