Swollen Xiphoid Process: Causes, Symptoms And How To Treat It?

Any non- medical person may not be familiar with the xiphoid process. To make it simple, xiphoid process is the end part of sternum, the breastbone. It is a tiny bone, triangular in shape attached with the body of the sternum. Sternum lies in the middle of chest. The ribs are attached to it to form the ribcage.

During childhood, xiphoid process is a flexible cartilage tissue, but it forms into a bone as the child becomes adult. Due to its flexibility during childhood, it protects the growing organs underlying it, such as the portion of heart, esophagus etc.

Xiphoid process lies at the level of 9th thoracic vertebra.

Though uncommon, xiphoid process can get swollen due to direct injury to the chest. The condition is also known as xyphoidynia. The characteristic symptoms are pain and tenderness on touch or while lifting heavy object or bending.

Swollen xiphoid process may take time to heal. It may be few weeks or months. Anti- inflammatory medications, heat, and change in lifestyle and work may help to enhance the healing process.

Causes Of Swollen Xiphoid Process

  • Xiphoid process is a tiny bone of sternum. A direct injury to chest and particularly a blow on the xiphoid process can cause swelling of xiphoid process. As a result the xiphoid process becomes tender and painful. The condition is often called xiphodynia.
  • Besides direct collision on sternum and xiphoid bone, lifting heavy weight, sudden twisting etc can strain the bone and it may become inflamed. Excessive coughing as in emphysema and whooping cough can also cause swelling of xiphoid bone.
  • Sometimes the pain and tenderness in xiphoid area may be due to problems related to heart, gallbladder and bone diseases. Therefore it is necessary to distinguish between symptoms of pain and tenderness in the xiphoid area due to other diseases and that of swollen xiphoid process.
  • Xiphoid process can get inflamed and swollen due to overenthusiastic pressure put on xiphoid process during cardiac massage in case of heart failure.

Swollen Xiphoid Process Symptoms

Pain and tenderness over xiphoid process are typical symptoms of swollen xiphoidynia. Often the pain is severe while you cough or laugh. It is in the last part of sternum, the area in medical parlance is called epigastrium.

  • If the condition is severe even normal breathing may be associated with pain.
  • There may be tenderness in the back.
  • Lifting, bending and twisting may become difficult due to pain and tenderness.
  • It can affect the daily routine of a person. He may find it difficult to do his daily work.
  • Slight pressure over xiphoid process can give rise to severe pain.

Certain other conditions should be ruled out which cause similar pain in epigastric area, the commonest is reflux esophagitis. Inflammation of gall bladder can cause pain in xiphoid area. The other important ailment is angina which can mimic similar pain in chest and xiphoid process.

If you sustain severe chest injury, the xiphoid process may break and form a bump, which can be felt when you palpate the chest.

How To Treat Swollen Xiphoid Process?

Pain and tenderness in xiphoid process should not be neglected. You should consult your physician as soon as possible. Usually after a detailed medical history, examination and certain tests such as X-ray and MRI, the physician can diagnose the condition related to swollen xiphoid process.

  • Anti inflammatory medication and analgesics usually alleviate pain and swelling.
  • Fomentation with warm water is extremely beneficial in relieving pain and tenderness. Heat increases circulation in the affected area which helps to reduce swelling and pain. You should alternate it with ice fomentation.
  • Wear a rib belt around the thorax. It restricts the movement and allows the xiphoid process to heal quickly.
  • Avoid lifting heavy objects or doing strenuous work which may cause irritation to ribs and xiphoid process.

The swelling and symptoms of damage to xiphoid process may take few weeks to heal.

22 comments


  1. Wanda

    Five years ago my husband developed a horrid pain in his lower sternum area. They removed his gall bladder, but it didn’t ease the pain at all. After nine months and two doctors when nothing happened, an experienced doctor said he had studied all of the tests and reports of other doctors and come to the conclusion that my husband had somehow injured his xiphoid process.

    He was eventually sent to UCLA where they inserted a pain pump which took away about 80% of the pain. He is now having horrid pain in his back and is bent over. Saw a neurosurgeon yesterday who said it is not the spine. He said the pain is causing the curvature.

    The back pain begins just opposite the xyphoid process. Is there any possibility it could be connected to the pain of the xyphoid process?

  2. Betsy

    Wanda, my Xiphoid Process was damaged in a car accident and the doctors kept referring me to other doctors because none of them understood what was happening to me. Finally one doctor ordered a CT scan but that did not show any fracture so the doctor offered to get me to a pain management doctor.
    I told him the pain was unbearable and that indicated something had to be seriously wrong and pain management wasn’t going to resolve the issue but it would just mask it. I had read about a doctor in Fort Worth, TX who was a Thoracic specialist who had some expertise with damaged Xiphoid so I insisted that he call in a referral.
    Within two weeks I had surgery to have my Xiphoid removed and he found it had inverted so the pain would have never gone away on its own. Dr Albert Yurvati saved my life from pure misery. Keep looking for answers as it is not normal to be in that kind of extreme pain.

  3. Chris

    I have had pain in my sternum since April. It started as burning sensation and then super sharp pain that then spreads to my ribs left and right of sternum. I have had MRI, CT scan and throat bone scan done but nothing major.
    Just consulted a doctor who told me about taking out xiphoid. It is destroying my life and family it makes me mad. I am on Percocet for pain but it only helps some of the time. Just wanted to ask you if this sounds like it is xiphoid.

  4. Jim

    Hi Betsy. Can you give me the name of the surgeon who did this operation for you? I live in N.E. Texas and I am seeking serious help in my issue with the xp. Is the doctor specialist or the surgeon? This issue has plagued me for last 25 years and reared it’s ugly head in a episode this August. My active life has ended since then and nothing gives me relief for very long.
    I think Intercostal Neuritis goes hand in hand with this, as my research has led.

  5. Melanie

    I am not sure exactly what’s wrong with me. All I know is that I have a pain in between my rib cage and it is not a constant hurt. It hurts when there is pressure by pushing both cages together. For instance, when I wake up in the morning and I lift myself up without hands and just using my abdominal muscles, there is extreme pain and I have to lie down. If I am laughing too hard, coughing, or lying on my sides while sleeping, all this causes pain.
    I am only 19 years old and wouldn’t even know where to begin. I was hoping that it was an infection or the area was just inflamed like I read on other sites but I’m a little worried.
    It has been getting progressively worse and I have only had it now for about a week. I don’t remember ever receiving a direct injury to this area as I don’t play in any sports and I am just not generally an active kind of person.

  6. Karen

    Melanie, I see that nobody had commented on your post so far. I have the same problems that you are having. I have not consulted any doctor as of yet. Have you been checked to see what it is?

  7. RPT

    I have swelling over xiphisternum area but there is no pain or associated symptoms. It is almost 8 month after I started lifting weights in the gym. What should I do for this?

  8. Linda

    In December of 2013 I had an out patient procedure to remove a neuro-stimulater from my upper left chest, near my collar bone, that was installed in 2005 for severe facial nerve pain, from a severed supratroclear nerve. When I recovered from anesthesia I was in the worst pain of my life.

    I spent the next year and a half completely down and under oxycodone to survive pain. Initially no one identified the source of my pain. I now know that my xiphoid process was somehow damaged during the surgery.

    The situation has improved but the quality of my life has diminished. If I do too much physical activity I return to a terrible 8-10 pain level. Would like some feedback as to weather surgery would benefit me?

  9. Tova

    I too have the sharp shooting pains in my sternum xiphoid area. Has anyone got issues with the cervical or thoracic spine?
    Is it heart related, has anyone gotten an answer on this?

  10. Nitza

    My XP got hurt a year ago but looking further back I think it all started with my myomectomy surgery. I had 3 surgeries in a period of 2 years or less. My last was removal of gall bladder thinking that it would solve the problem. Now it is still hurting when I do too much work. Lifting hands or objects that are heavy is impossible.

    My doctor is ruling out pancreas mass due to pain in the back but he is almost positive that it is my XP. He mentioned that it will take time and effort from my part not to do any heavy lifting. I have read that this can take years to heal.

    In my case I work with luggage at the airport but cannot do this anymore. Even just standing for long periods hurts. Can anybody suggest some remedy?

  11. Dave

    After having my gallbladder removed, it was no surprise that I had pain and labored breathing. However, exactly one month after the laparoscopic surgery I started to get this very strange chest pain. One day it wrapped around my chest and 2 days later, I went to the ER with severe pain in the middle lower area of my rib cage. It was severe and I thought I was having a heart attack. I have been to a GI doctor and neither Xiphoid process or Costachondritus was mentioned. I think it is one of the two and I guess it doesn’t matter, because there’s no cure and will hopefully go away soon- But extremely painful.

  12. Tom

    I have recently begun having pain in my xiphoid process. I just had an MRI, which showed moderate to severe narrowing of C5, C6 bilateral foramina (pinched nerves). I am wondering if this could be associated with my chest pains?

  13. Erin

    I have been having this pain for 2 years now. First I thought it was heart related but have had several tests and all were normal. I have been given prednisone 3 different times as 3 different doctors said it was costachondritis. Prednisone did not work.
    The pain is 24 hours a day everyday and is ruining my life. I can’t even wear a bra and when I do the pain is extreme. I have all the symptoms you have mentioned. There is pain when lying on sides, using my abdominal muscles; pain is straight through to the spine. I have had CT scan of chest and all they saw was some spots on my lungs which they say are “probably benign” but nothing else is wrong they say.
    I have researched and asked the doctors about the xiphoid process and they just dismiss my questions. I can’t exercise anymore which makes me feel more miserable. I don’t know what to do, the pain gets so bad sometimes I think I am having a heart attack and go to the ER where they do all the tests and when it is normal, they look at me like I am insane. It’s very hard living like this.

  14. MDP

    I have read about symptoms of the xiphoid process and I still have no idea what to do. I do suffer from heart problems but not because it’s diseased. I had a dissection a few years ago, Right Coronary Artery 90% dissection. I was exercising and my coronary artery tore away from my heart. Things were going really well. I was on some strict rules but I felt great.

    Now here I am with this Xiphoid Process swollen and painful and also making me sick to my stomach. I have a very hard time eating. Everything I put in my mouth feels like it is going to come back up. I am sure that heart failure is involved but why all of a sudden is my XP sticking out and 3 times bigger than it was.

    I cannot touch it and I feel like it is going to pop out of my chest. Deep breathing is difficult which is heart related. I just don’t understand everything was going so well and now I feel more ill than I did after my dissection.

  15. Barb

    I too have suffered pain in the exact location right at the center of my chest just at the end of the sternum. I have gone to see a GI specialist who put me through a battery of tests (nuclear stomach emptying), tested for Celiac disease and finally a hydrogen breath test. I failed the hydrogen breath test which indicates that I have bad bacteria in my small intestine.
    He asked me to show him where my pain was and when he pressed down on the area, I went through the roof. He said that is definitely my xyphoid.

    He wants me to be treated for two weeks with a heavy antibiotic that will hopefully heal the pain and pressure I have in my chest area. He said if it doesn’t improve, I will need to go for an upper endoscopy and ultrasound of gall bladder.

    I have hope that the antibiotics will offer some relief. I have suffered with this pain off and on probably for the last thirty years but lately it has gotten progressively worse with no known cause. It seems as though from what I am hearing, that diet can be related. Hope this information helps someone out there.

  16. Barry

    So relieved to know that I am not alone in this. 6 years ago after severe gastritis I lifted something moderately heavy and felt a pop mid sternum. I have since been in excruciating pain. I have been hospitalized several times, seen many doctors and no one has ever mentioned XP. I was finally diagnosed with abdominal wall pain in Jan. 2016. Yesterday I stumbled on XP. I am appalled that no doctor ever mentioned this to me, they have no clue about XP. This condition has ruined my life and I am almost bed ridden for 6 years, can barley walk and even a daily shower is a struggle.

    The pain is unbearable and I have developed horrendous IBS. Constantly in the bathroom aggravates the pain. Everyday living is a nightmare. Have now made appointment with cardio thoracic surgeon but so far nothing shows on scans. My life has become miserable, eating is difficult and I have list 30 lbs from 110. I feel this condition could kill me. I pray for relief from this truly terrible pain which no one really understands.

  17. Lindt

    So glad that I finally found the information about xiphoid process. I now know that I have an ailing xiphoid process, lately after a few minutes it has started causes me nausea and weakness for some time. Does it get completely cured?

  18. Lori

    All these stories are very moving for me. I have been struggling with pain, discomfort and many symptoms like churning, burning feeling and some times a pulsating feeling. I feel pushing from the inside out, often feel like a socks under my right rib since 2011 every day. I had a colonoscopy for no reason other than family history and Since then I have been battling this problem.

    I have had several CAT scans, MRI, Ultrasound, Hyda scan for the gallbladder and medical treatment from muscle relaxers and so forth. Few years later I was sent to a surgeon for a laparoscopic view but he wanted to re-do the Hyda scan first, that was showing gallbladder function was only 7% so it was removed. This did not fix the problem. All test were showing nothing.

    Finally I just went to MD as the discomfort was so bad and stomach felt so distended. He said all tests were good he felt nothing. He thinks it is Costochondritis, which is rib inflammation, which had been mentioned before but no real diagnosis. This doctor was trying to show me the range and he pressed on the Xhp and I saw stars. So treatment in the meantime is ibuprofen with Zantac for stomach. I have had no injury to my sternum I can’t even understand how. I am still looking for more answers, hope this helps.

    To Tova, yes I have thoracic outlet syndrome as well.

  19. Mike

    My XP has been swollen for several years now and it is still growing. I do not have any accompanied symptoms from it like pain or anything. I just see it protrude when I stretch or just feel on it but again no pain or anything associated with it.

  20. David

    I have major back and neck issues and along with this part of my sternum is swollen. I have degenerative discs and joints, arthritis of the spine, and fibromyalgia. I am not sure if this has any correlation? I will appreciate if anybody can help me in this matter.

  21. Angie

    I have been suffering from this condition for about five years now. Right now the pain is worse than ever. I cannot do exercise and when I do housework I suffer with pain later. Doctors have told me I have this but said they don’t recommend surgery.

  22. Ron

    I am soon going to be 54 years old, heavy smoker and frequent drinker. In the past year I have noticed a hard lump at the bottom of my sternum that is slowly getting larger. I have suffered heavy blows to the chest both from auto accidents and fighting as a younger adult. I am starting to experience a constant dull ache from it, also getting rather painful to touch. I don’t want to run to the doctor for something he will say not to worry about, but I also don’t want to wait so long that it becomes something very serious.

    The lump is hard, like cartilage, and doesn’t move around. If I have damaged the XP and there is some growth due to injury should I be worried about the discomfort or the fact that it is getting bigger and what is the chance that it is actually serious like cancer or something?

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