What you need to know about the xiphoid process
The name xiphoid derives from the Greek word for “straight sword” as the structure has a sharp tip, resembling a sword. It is also known by other names including the metasternum, xiphisternum, and xiphoid cartilage.
In this article, we discuss symptoms, causes, and treatment options for xiphoid process pain.
- Pain in the xiphoid process is described as tightness in the lower sternum (breastbone).
- Medically speaking, this pain is called xiphoid syndrome or xiphodynia.
- The xiphoid process can typically heal itself of minor damage with little intervention.
What is the xiphoid process?
This diagram shows the xiphoid process in red.
Image credit: Anatomography, November 3, 2012
The xiphoid process is a tiny bone structure located at the center of the chest, just below the lower part of the sternum.
At birth, the xiphoid process is formed from cartilage that eventually develops into bone.
During a person’s early life, the xiphoid process rarely causes any discomfort given its soft cartilage structure. However, as it hardens, it can cause some discomfort in later life for many reasons.
Symptoms of xiphoid process pain
Discomfort can range from mild to severe. A person may feel pain in muscle groups connected to the xiphoid process around the abdomen and chest.
Symptoms tend to come and go, making it a challenge to diagnose. It is also possible for the area to become inflamed, causing a lump to develop around the lower sternum.
This lump is a result of inflammation but can often be mistaken for a more serious medical condition, such as a tumor.
Causes of xiphoid process pain
Lifting heavy objects may cause xiphoid process pain.
A common cause of xiphoid process pain is acute chest trauma that has damaged the structure.
The xiphoid process is not protected or supported by surrounding structures, making it vulnerable to damage. This damage can occur during cardiopulmonary resuscitation (CPR) when a person applies too much pressure to the lower sternum.
Less common causes of xiphoid process pain can include:
- acid reflux
- lifting heavy objects or weights
- repetitive strain on the torso
People who have felt pain in their lower sternum for more than 1 week should see a doctor for assessment.
Diagnosing xiphoid process pain can be challenging given the transient nature of symptoms and its proximity to several major organs and bone structures. For example, it can be initially mistaken for a broken rib.
The presence of inflammation forming a lump can also be mistaken for a tumor or a hernia.
Given the difficulty in confirming xiphoid process pain, doctors may recommend an X-ray, magnetic resonance imaging (MRI), or computerized tomography (CT) scan.
With the help of these images, it is possible to assess any damage to the structure and the extent of any inflammation.
A doctor may recommend avoiding high-intensity exercises that strain the xiphoid process.
Treatment for xiphoid process pain depends on its cause.
A doctor may prescribe anti-inflammatory drugs to reduce pain.
They may also recommend that a person experiencing pain from xiphoid process avoids high-intensity exercise or activities that put a strain on the area.
Damage to the xiphoid process itself is not severe.
However, if the xiphoid process breaks or fractures, it is possible for bone fragments to cause damage surrounding vital organs.
For example, it is possible for a bone fragment to puncture the lungs, which can be life-threatening.
In such cases, surgical interventions may be a necessary precaution against internal damage.
The xiphoid process can be removed using an electrosurgical dissection of the lower sternum. The procedure is considered safe, with a low risk of complications. The area can feel tender for several weeks post-surgery until the wound has healed.
Xiphoid process pain may produce discomfort, but is rarely a cause for concern. However, if anyone experiences a tight pain in the lower sternum for more than a week, they should seek medical attention.
Xiphoid process pain can be triggered by many different causes and is most commonly a result of acute chest trauma.
Inflammation of the region can cause a lump to develop that may be mistaken for a more serious condition, such as a tumor or a hernia.
Some fractures or breaks may require the xiphoid process to be surgically removed to prevent more serious internal damage.