Collarbone Pain: Causes by Where It Hurts

Collarbone pain (clavicle pain) usually comes from one of the two joints at either end of the bone, or from the bone itself. Pain at the inner end, next to the breastbone, often comes from the sternoclavicular (SC) joint or the rib cartilage just below it. Pain along the middle is usually a fracture after a fall, or less often a stress injury. Pain at the outer end, on top of the shoulder, usually comes from the acromioclavicular (AC) joint. Pain just above the collarbone can come from the neck.

Where exactly it hurts narrows the likely causes. This page helps you narrow them down; it does not diagnose you.

First: the signs that skip the queue

Call your local emergency number or go to the emergency department if

An open or tenting injury: after a fall or collision, the bone breaks the skin or presses up hard against it.
Changes in the arm after injury: the arm or hand turns cold, pale, blue or numb.
Inner-end injury with breathing or swallowing trouble: after a blow near the breastbone, difficulty breathing or swallowing, a hoarse voice, or a dent where the joint should be.
Chest pressure: pressure or heaviness in the chest that spreads toward the collarbone, jaw or arm, with sweating, nausea or breathlessness.

See a doctor today if

A fall onto the shoulder: with a bump on the bone, a grinding feeling, or you cannot lift the arm.
A hot, swollen joint: redness, heat and swelling over either end of the collarbone, especially with fever.
A swollen, heavy arm: the whole arm swells and feels heavy or looks bluish, often after hard or repeated overhead use.

Get it checked soon if

A lump above the collarbone: one that is still there after 2 to 3 weeks, feels hard or fixed, or keeps growing.
A lump with other symptoms: night sweats, fever, weight loss you cannot explain, or a long-standing cough.
Bone pain at night: a deep ache in the bone that does not change with movement and is worse at night.

Inner end, next to the breastbone

Pain at the knob where the collarbone meets the breastbone, sometimes with a visible bump. It tends to be worse reaching across your body, pushing, shrugging, lifting the arm overhead, or lying on that side.

SC joint sprain: follows a fall onto the shoulder or a blow from the side. Tender right on the joint, sometimes with clicking.
SC joint arthritis: a gradual ache and a firm bump on one side, more common over 50 and in people who have done heavy manual work.
Rib cartilage pain (costochondritis): tenderness along the cartilages just below and beside the joint, often at several levels, worse with deep breaths and pressing. Usually no swelling.

The guide to SC joint pain covers the joint in detail, and costochondritis covers the cartilage below it.

Along the middle of the bone

Pain on the shaft, between the two ends, where you can press on the bone itself.

Fracture: after a fall onto the shoulder or an outstretched hand, or a hit in sport or a bike crash. There is often a bump or step in the bone, bruising, and pain lifting the arm. Most adult fractures in the middle of the bone heal without surgery, typically over 6 to 12 weeks.
Stress injury: no fall, but a gradual ache on the bone after a jump in training, seen in rowers, gymnasts and lifters. Pressing on the bone is sore. It may not show on a plain X-ray in the early weeks.

For the weeks after a break, broken collarbone recovery goes through the stages.

With collarbone pain, the end matters. Inner end, middle and outer end each point to a different set of causes.

Outer end, on top of the shoulder

Pain at the bony point on top of the shoulder, where the collarbone meets the shoulder blade. It is worse reaching across your body, reaching behind your back, lying on that side, or pressing down on a bench or a table.

AC joint sprain: a fall onto the point of the shoulder, often in cycling, rugby or skiing. There may be a step or bump at the joint.
AC joint arthritis: a gradual ache, more common over 40, worse with reaching across and at night lying on that side.
Weightlifter’s shoulder (distal clavicle osteolysis): the end of the collarbone becomes sore and thins under heavy, repeated pressing. It builds over weeks in people who bench press, dip or do many push-ups, and settles when that load is reduced.

A fall onto the shoulder is covered in separated shoulder (AC joint sprain). If the pain builds with lifting, shoulder pain from bench press and overhead lifts covers the training side.

Just above the collarbone

Pain or a lump in the hollow above the collarbone, at the base of the neck.

The lower neck: an ache here that changes when you turn or tilt your head, sometimes running toward the shoulder blade or arm.
Nerve or blood vessel compression (thoracic outlet syndrome): tingling into the ring and little fingers, and a heavy, tired arm when it is raised for long or when carrying a bag on that shoulder.
A swollen lymph node: a soft, tender, movable lump after a sore throat or cold usually shrinks within 2 to 3 weeks. A node above the collarbone that is hard, fixed, painless or still there after 2 to 3 weeks needs a doctor to look at it.

Arm tingling with a heavy arm is covered in thoracic outlet syndrome.

Where else this could be coming from

The shoulder joint: rotator cuff and biceps problems cause pain at the front and top of the shoulder that can feel close to the outer collarbone. Shoulder pain by location sets these apart.
The heart: on the left, pressure near the collarbone that comes with effort and settles with rest needs a doctor first. The guide to left shoulder pain: heart or shoulder explains the differences.
The chest muscle: a sudden pull during a heavy press can strain the pec where it attaches near the armpit, with bruising across the front of the chest.

Still not sure

Get assessed by a doctor or physical therapist if the pain is not clearly easing after about one to two weeks, if you cannot lift the arm, or straight away if any sign from the first section appears. After any fall with a bump on the bone, an X-ray is usually the first step.

Before you go, press gently along the bone from the inner end to the outer end and note where it is sorest. Note what set it off too: a fall, a change in training, a cold or sore throat, or nothing at all.