Sternum Pain: Causes, Symptoms, and Treatment Options - Pulmonology

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Sternum pain, particularly when associated with symptoms such as high blood pressure fluctuations, can be concerning and warrants a thorough evaluation. Based on your description, it seems that you have been experiencing this pain for two weeks, and it has been accompanied by episodes of elevated blood pressure. You also mentioned that the pain is localized and can be exacerbated by pressure, which may suggest a musculoskeletal origin, such as costochondritis (inflammation of the cartilage connecting the ribs to the sternum).


Causes of Sternum Pain
1. Costochondritis: This is one of the most common causes of sternum pain. It occurs when the cartilage connecting the ribs to the sternum becomes inflamed. The pain is typically sharp and can worsen with movement or pressure on the area.

2. Muscle Strain: Overexertion or injury to the chest muscles can lead to pain in the sternum area. This is often felt during physical activity or when lifting heavy objects.

3. Gastroesophageal Reflux Disease (GERD): Sometimes, acid reflux can cause a burning sensation in the chest that may be mistaken for sternum pain. This is often accompanied by heartburn or regurgitation.

4. Cardiac Issues: Although you mentioned that your pain is localized and does not radiate, it is crucial to rule out any cardiac conditions, especially given your history of hypertension. Chest pain can sometimes be a sign of angina or other heart-related issues.

5. Anxiety and Stress: Psychological factors can also manifest as physical symptoms, including chest pain. Stress and anxiety can lead to muscle tension and exacerbate pain sensations.


Symptoms to Monitor
- Pain Characteristics: Note whether the pain is sharp, dull, or throbbing, and if it radiates to other areas (like the arms or back).

- Associated Symptoms: Keep track of any additional symptoms such as shortness of breath, sweating, nausea, or palpitations, which could indicate a more serious condition.

- Response to Medication: You mentioned taking over-the-counter pain relief (like Tylenol) and blood pressure medications. Monitor how these affect your symptoms.


Recommended Actions
1. Consult a Specialist: Given the complexity of your symptoms, it would be advisable to see a healthcare provider who specializes in internal medicine or cardiology. They can perform a thorough evaluation, including a physical examination and possibly an electrocardiogram (ECG) or echocardiogram to rule out any cardiac issues.

2. Imaging Studies: Depending on your physician's assessment, imaging studies such as a chest X-ray or MRI may be warranted to evaluate the sternum and surrounding structures for any abnormalities.

3. Pain Management: If costochondritis is confirmed, treatment may include nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, or corticosteroid injections to reduce inflammation.

4. Lifestyle Modifications: Managing stress through relaxation techniques, regular exercise, and a balanced diet can help improve overall health and potentially alleviate some of your symptoms.

5. Follow-Up: Regular follow-up appointments will be essential to monitor your blood pressure and adjust medications as necessary, especially since you are experiencing fluctuations.


Conclusion
In summary, your sternum pain could be related to several factors, including musculoskeletal issues, gastrointestinal problems, or even anxiety. It is crucial to seek a comprehensive evaluation from a healthcare professional who can guide you through the appropriate diagnostic steps and treatment options. Keeping a detailed record of your symptoms and any triggers can also be beneficial for your healthcare provider in determining the best course of action.