Burning behind the breastbone

introduction

A burning sensation in the sternum is a rather rare phenomenon. Often the burning sensation arises behind the breastbone. It is burning pain, burning on its own is not that common.
The burning sensation can lie directly behind the breastbone, but it is not uncommon for this unpleasant sensation to affect the entire chest. It is often accompanied by other symptoms such as pressure on the chest or tightness.
These complaints can often not be clearly distinguished from one another, so that a general malaise behind the breastbone can be interpreted as a burning sensation.

The possible causes

The causes of a burning sensation in or behind the breastbone are very diverse. Immediately behind the breastbone, i.e. in the chest, there are several organs that may be the source of the complaints.

The classic burning sensation just behind the breastbone is usually triggered by reflux. Stomach acid rises up into the esophagus and attacks the mucous membrane there.
But heart problems can also make themselves felt as a burning sensation behind the breastbone. All types of heart failure (heart failure) through cardiovascular diseases to acute heart attacks are conceivable as the cause. The lungs can also cause a burning sensation. This can be triggered by irritation of the airways, for example by particularly cold breathing air.

For more information, read on: Reflux.

The tension as the cause

Tension usually refers to excessive tension in the muscles that cannot be released on its own. There are actually no muscles behind the breastbone that can trigger these complaints. However, there are many muscles in the chest area that can be tense and cause a burning sensation behind the breastbone.

Such tension can occur in the so-called intercostal muscles, i.e. the small breathing muscles between the individual ribs. Most often, however, a burning sensation behind the breastbone is triggered when there is tension in the diaphragm. Irritation of the nerves that control the diaphragm can lead to dysregulation of muscle activity. This happens, for example, with hiccups, in which the diaphragm twitches uncontrollably. Somewhat more serious functional disorders can lead to cramping or prolonged tension of the diaphragm. Not only does this result in burning pain, but breathing can also be impeded, so that shortness of breath occurs especially during exercise.

Also read the article: Diseases of the diaphragm.

The esophagus as the cause

The esophagus is part of the digestive system and runs from the lower end of the larynx to the entrance to the stomach. The job of the esophagus is to move food from the mouth to the stomach. The esophagus and the windpipe run directly behind the breastbone. Shortly before it flows into the stomach, the esophagus passes through the diaphragm. The esophagus is closed at the bottom by the narrowing in the diaphragm and a sphincter muscle (esophageal sphincter). This is to prevent the gruel from the stomach from rising back up the esophagus.

In the stomach, the chyme is mixed with the extremely acidic stomach acid. The stomach itself is protected from the acid by an additional layer of mucus. If this chyme enters the esophagus again due to a dysfunction of the sphincter, its unprotected mucous membrane is attacked by the strong acid. Typical heartburn occurs, which is noticeable as a burning sensation just behind the breastbone.
Risk factors for heartburn are a malfunction of the sphincter and a widening of the passage through the esophagus as well as an increase in pressure in the abdomen. This can be caused, for example, by being overweight, but also by pregnancy and leads to the stomach being narrowed and pushed upwards. This promotes reflux, i.e. the reflux of the chyme from the stomach into the esophagus.

Find out more about the topic here: Heartburn.

Mental causes

The primary psychological cause of a burning sensation behind the sternum is stress. This can promote reflux, which leads to heartburn and thus to a burning sensation behind the breastbone.

However, the stress can also affect the heart function and lead to a burning sensation in the chest or behind the sternum. Even with pronounced fears, the heart can begin to race and create a burning sensation behind the breastbone. Fears and panic attacks also affect breathing, so that affected people often breathe very quickly and shallowly. This ineffective breathing can mess up the lungs and muscles, causing burning pain.

Reduce stress? Find out more about this here.

Stress as a cause

Stress is a very common trigger for chest pressure or burning behind the breastbone. Typically, stress can cause reflux, causing burning pain in the esophagus (heartburn).
In addition, breathing flattens out under stress. This cramps the diaphragm and can cause a burning sensation behind the breastbone. The lungs can also be irritated by constant stress breathing.

Long-term stress also has a negative effect on the heart function and the coronary arteries. There is more calcium deposits in the vessels, this worsens the blood flow to the heart muscles. As a result, the heart is no longer adequately supplied with nutrients and burning or stabbing heart pain can occur.

Read more about the topic here: Consequences of stress.

Back pain as a cause

Back complaints are usually not only noticeable directly on the spine and back. The symptoms often radiate to other parts of the body. Since the rib cage and thus also the sternum have a direct bony connection to the back, the symptoms of the back can quickly affect the sternum as well.

Muscular tension in the back also affects the muscles in the chest and occasionally causes a burning sensation behind the sternum. Damage to the nerves in the spinal cord can also affect the chest. This manifests itself as a burning or electrifying pain.

You can read more about this topic here: Symptoms of back pain.

The accompanying symptoms

The burning sensation in / behind the breastbone has many accompanying symptoms, depending on the cause.

If the esophagus is the cause of the symptoms, heartburn typically occurs. In the long run, the mucous membrane of the esophagus is damaged, so that the burning sensation occurs more frequently and more intensely. Bleeding in the esophagus can also occur if the mucous membrane is severely damaged. This leads to bright red vomiting of blood or black stools (tarry stools).

If the burning sensation in the sternum is triggered by the heart, the reason is often a long-standing cardiovascular disease. In connection with this, calcifications are increasingly appearing in the coronary arteries and also in other vessels. This can lead to insufficient blood flow in various parts of the body. The heart itself loses its pumping function, which is particularly noticeable during physical or psychological stress. You are less resilient, you get out of breath more quickly, and pressure or tightness in your chest can occur when you are exerted.

If the burning sensation behind the breastbone is triggered by the lungs, irritated airways are often the cause of the symptoms. This often also leads to a dry cough. If the lung tissue is permanently irritated and thus severely damaged, a reddish (bloody) sputum can develop when coughing.

A feeling of pressure as a symptom

The feeling of pressure on the chest is usually caused by a restriction of the heart. The cause is arteriosclerosis, i.e. calcium deposits in the coronary arteries. As a result, the heart muscle is no longer adequately supplied with oxygen and other nutrients.
This undersupply can cause severe pain in the heart and thus in the entire chest. The burning or stabbing pain occurs together with a feeling of pressure, especially when the heart is exerted, when it needs more nutrients.

Find out all about the topic here: Arteriosclerosis.

The diagnosis

A burning sensation behind the breastbone is more of a symptom than a diagnosis. This symptom is usually asked for by the doctor during the examination. Accompanying complaints and the triggers of the complaints (for example always after eating or during exercise) can provide important diagnostic information.

Depending on the assumption made from the anamnesis, a targeted physical examination of the affected organ should be carried out. Then you can do an ultrasound or an EKG on the heart, for example. An X-ray can be done for the lungs. A lung function test and an examination of the blood gases can also provide clues as to the underlying disease.
In the case of heartburn, there is usually no further diagnosis, but an acid-inhibiting therapy is started. If the symptoms persist, an endoscopic examination of the esophagus can be performed.

Find out more about the topic here: Pulmonary function test.

The treatment

Therapy for burning behind the breastbone is highly dependent on the cause.

If heartburn is the cause, the symptoms are usually treated with a proton pump inhibitor. This causes the stomach to produce less acid, which reduces the damage to the esophagus. In addition, if people are overweight, they should try to reduce their weight. Several small meals instead of a few large meals can also improve the symptoms.

If there is irritation of the respiratory tract, which causes the burning sensation, the irritating substance should first be removed. In an acute emergency, an oxygen supply can alleviate the symptoms. In the case of more severe lung diseases, detailed lung diagnostics and therapy are necessary.
If the heart is the trigger of the complaints, therapy for blood lipids and arteriosclerosis should be started. In addition, various medications can improve the heart function again in the case of cardiac arrhythmias and cardiac insufficiency.

For more information, read on: Lipid metabolism disorder.

The duration

The duration of the symptoms depends on the cause and the therapy options. Heartburn may go away after a few days with proton pump inhibitors.
Heart and lung diseases, on the other hand, often require lifelong therapy. The symptoms can reappear as the disease progresses.