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The collarbone, or clavicle, is a long, thin bone that connects the arm to the body. It is located at the base of the neck, connecting the breastbone (sternum) to the shoulder blade. The collarbone is prone to injuries due to its thin structure and proximity to the skin, with fractures commonly occurring from falls or direct impacts. Weak shoulder muscles can also lead to collarbone pain and issues such as thoracic outlet syndrome, where the collarbone slips and puts pressure on the nerves and blood vessels underneath. Strengthening the muscles around the collarbone through physical therapy or exercises is often recommended for treatment and prevention of such issues.
| Characteristics | Values |
|---|---|
| Number of muscles in the neck | 30 |
| Functions of neck muscles | Support and stabilise head, neck and upper spine; enable head movement; assist with chewing, swallowing and breathing; enable facial expressions |
| Clavicle (collarbone) | Long, slightly curved bone that connects the arm to the body; prone to injuries like fractures, dislocated shoulder and separated shoulder |
| Clavicle fractures | Caused by falling horizontally on the shoulder or with an outstretched hand, or by a direct hit to the collarbone |
| Thoracic outlet syndrome | Caused by weak shoulder muscles that allow the clavicle to slip down and forward, putting pressure on the nerves and blood vessels in the thoracic outlet |
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What You'll Learn
Clavicle fractures
The clavicle, or collarbone, is a long, slightly curved bone that connects the arm to the body. It is one of the most commonly fractured bones, accounting for about 5% of all adult fractures. Clavicle fractures are most often caused by a fall onto the shoulder or an outstretched arm, or a direct hit to the collarbone. This can happen during a fall or an accident, like a car collision.
It is important to seek medical attention if you suspect a clavicle fracture. While waiting to reach a physician or emergency facility, immobilize the arm and shoulder by holding the arm close to the body or using a sling. Applying ice for 20-30 minutes at a time can also help, but be careful not to freeze the skin.
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Thoracic outlet syndrome
There are three types of TOS: neurogenic, venous, and arterial. Neurogenic TOS is the most common type, accounting for about 95% of all cases. It occurs when there is pressure on the brachial plexus, a network of intertwined nerves that travel across the upper chest. This type of TOS is often caused by repetitive stress injuries (often from sports) and sudden trauma to the neck, such as whiplash. Venous TOS is more common in men and typically occurs in individuals in their 20s or 30s. It involves the compression of the subclavian vein, which can lead to upper body thrombosis. Arterial TOS is the rarest form, representing only about 1% of cases. However, it is the most common cause of acute blood clots in the arm among people under 40.
The symptoms of TOS include pain, tingling, and numbness in the arms and hands. These symptoms may worsen when the arms are lifted overhead or held up for extended periods. Other symptoms include swelling or heaviness, skin colour changes, skin that feels cool to the touch, and slow-healing sores on the fingers. The specific symptoms can vary depending on the type of TOS.
Treatment for TOS typically does not involve surgery. Physical therapy and exercises can help strengthen the muscles around the shoulder, improving their ability to support the collarbone. Postural exercises can also help improve posture, reducing pressure on the nerves and blood vessels. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be used to manage pain and reduce swelling. If overweight, a doctor may recommend a weight loss program to reduce stress on the shoulder muscles that support the collarbone. In some cases, surgery may be offered if non-surgical treatments do not provide relief.
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Joint injuries
The collarbone, or clavicle, is a long, thin bone that connects the arm to the body. It is one of the most commonly fractured bones due to its proximity to the skin and its role in shoulder and arm movement. Clavicle fractures can occur when falling on an outstretched hand, falling directly on the shoulder, or from a direct hit to the collarbone.
In addition to fractures, the collarbone is susceptible to joint injuries, such as dislocations and separations. A dislocation occurs when the collarbone moves either anteriorly (forward) or posteriorly (backward) from its normal position. While both types of dislocations are serious, a posterior dislocation is particularly concerning as it can lead to life-threatening issues with breathing, choking, or blood flow.
Another joint injury associated with the collarbone is acromioclavicular (AC) joint separation, commonly seen in young athletes. This injury occurs when the collarbone separates from the scapula, causing ligament damage. Minor AC joint separations often heal with immobilization in a sling, while more severe cases may require surgery followed by rehabilitation and muscle strengthening.
The sternoclavicular (SC) joint, formed by the collarbone and the sternum, can also be injured. SC joint injuries typically arise from motor vehicle accidents or contact sports. Most SC joint injuries are minor and do not require surgery. However, in rare cases, a strong blow to the shoulder can cause the SC joint to dislocate completely, resulting in either an anterior or posterior dislocation.
Thoracic outlet syndrome (TOS) is another condition related to the collarbone. TOS involves the compression of nerves, veins, and arteries in the thoracic outlet—the space between the collarbone and the first rib. This compression can be caused by weak shoulder muscles, overhead activities, or traumatic injuries like whiplash. Treatment for TOS typically includes physical therapy, postural exercises, and nonsteroidal anti-inflammatory drugs (NSAIDs).
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Osteoarthritis
The sternoclavicular joint is one of the four joints that make up the shoulder, and it is located at the base of the neck. While problems with this joint are not common, they can result from injury or other disorders. High-energy injuries, such as motor vehicle collisions or contact sports, are common causes of injury to the sternoclavicular joint. Most injuries to this joint are relatively minor and do not require surgery. However, in rare cases, a hard blow to the shoulder can damage the vital organs and tissues nearby, such as the main blood vessels, trachea, and oesophagus, requiring immediate medical attention.
The acromioclavicular joint, on the other hand, is commonly affected by arthritis, fractures, and separations. Joint separation occurs when the ligaments that hold the bones together are torn, resulting in pain, swelling, and limited movement. Treatment options for joint separation are similar to those for osteoarthritis, including medication, immobilization, steroid injections, and physical therapy. Surgery may be considered for severe cases or when other treatments have not been successful.
It is important to note that collarbone pain can have various causes, including fractures, infections, bone infections, cancer, and underlying illnesses. Mild collarbone pain may be related to a muscle strain or minor injury and can often be treated at home using the RICE method (Rest, Ice, Compression, and Elevation). However, sudden or severe collarbone pain, especially after a fall or trauma, requires emergency medical care. Chronic or ongoing pain should also be evaluated by a healthcare provider.
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Clavicle anatomy
The clavicle, or collarbone, is a long, slender, S-shaped bone that connects the shoulder blade to the sternum (breastbone). There are two clavicles, one on each side of the body, and they are the only long bones that lie horizontally. The clavicle is part of the skeletal system and plays an important role in everyday functional movement, serving as the connection between the axial skeleton and the pectoral girdle. It also acts as a brace for the shoulder, allowing weight to be transferred from the upper limbs to the axial skeleton.
The clavicle is a palpable bone, and in people with less fat in this region, it can be seen under the skin. It has three main functions: attaching the upper limb to the trunk as part of the shoulder girdle, protecting the underlying neurovascular structures supplying the upper limb, and transmitting force from the upper limb to the axial skeleton. The shaft of the clavicle acts as a point of origin and attachment for several muscles, including the deltoid, trapezius, subclavius, pectoralis major, sternocleidomastoid, and sternohyoid. The clavicle also provides attachment points for two ligaments: the conoid tubercle and the trapezoid line.
The clavicle is particularly susceptible to fractures, which can occur when a person falls horizontally on the shoulder or with an outstretched hand, or from a direct hit to the collarbone. Falls are a top cause of clavicle injuries, and the bone's thin structure and proximity to the skin make it one of the most commonly fractured bones. Clavicle fractures can be managed conservatively, such as with sling immobilisation, or operatively, such as with open reduction and internal fixation.
The shape of the clavicle varies more than most other long bones, and it is typically longer and larger in males compared to females. In some cases, the clavicle may be pierced by a branch of the supraclavicular nerve. The clavicle also plays a role in the development of the embryo, as it is the first bone to begin the process of ossification during the fifth and sixth weeks of gestation.
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Frequently asked questions
The collarbone, or clavicle, is a long, thin bone that connects the breastbone (sternum) to the shoulder.
Collarbone pain can be caused by a fracture, arthritis, a bone infection, or another condition related to the position of your clavicle. Sleeping in certain positions can also cause collarbone pain if a person has a tender or arthritic sternoclavicular joint or acromioclavicular (AC) joint.
Mild collarbone pain can be treated with a modified version of the RICE method: Rest, Ice, Compression, and Elevation. For more severe cases, physical therapy is a common treatment, and surgery may be required if non-surgical treatments do not work.
Thoracic outlet syndrome occurs when the collarbone slips down and forward, putting pressure on the nerves and blood vessels that lie underneath it. This can be caused by weak shoulder muscles or being overweight, which stresses the shoulder muscles that support the collarbone.
