The xiphoid process is a small extension of bone just below the sternum. Straining and heavy lifting can damage the xiphoid process, leading to pain in the lower ribcage, breastbone, and muscles around the abdomen and diaphragm.

The name xiphoid derives from the Greek word for “straight sword,” as the structure has a sharp tip resembling a sword. Its other names include the metasternum, xiphisternum, and xiphoid cartilage.

Here are some fast facts about the xiphoid process:

  • Pain in the xiphoid process manifests 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.

In this article, we discuss symptoms, causes, and treatment options for xiphoid process pain.

A man weightlifting and a red star indicating where his xiphoid process is locatedShare on Pinterest
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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 forms 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, it can cause some discomfort in later life for many reasons.

Discomfort can range from mild to severe. A person may feel pain and experience swelling in muscle groups connected to the xiphoid process around the abdomen and chest, such as:

  • upper abdominals
  • chest
  • throat
  • arms

Pain, tenderness, and swelling can come and go, making its cause 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. However, people can often mistake it for a more serious medical condition, such as a tumor or hernia.

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:

  • lifting heavy objects or weights
  • repeatedly straining the torso

Other forms of injury a person may incur include:

  • fracture or microfracture
  • damage to the cartilage-ligament connections to the sternum
  • damage to the muscle attachments to the xiphoid

People with pain in their lower sternum should speak with a doctor immediately to rule out a heart attack.

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 a chest X-ray, MRI, or CT scan.

With the help of these images, it is possible to assess any damage to the structure and the extent of any inflammation.

Treatment for xiphoid process pain depends on its cause.

A doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain.

They may also recommend that a person experiencing pain avoids exercise or activities that strain the area, such as lifting, until the injury heals.

A strain or inflammation of the xiphoid process does not typically result in permanent damage. However, if the xiphoid process breaks or fractures, it is possible for bone fragments to cause damage to surrounding vital organs.

For example, in rare cases, it is possible for a bone fragment to puncture the lungs, which can be life threatening. This is usually due to high energy blunt trauma.


In such cases, surgical interventions may be a necessary precaution against internal damage.

A surgeon can remove the xiphoid process using an electrosurgical dissection of the lower sternum. This is typically referred to as a xiphoidectomy. The procedure is considered safe, with a low risk of complications.

The area can feel tender for several weeks postsurgery until the wound has healed.

Below are some commonly asked questions about the xiphoid process.

What happens if a person presses the xiphoid process?

The xiphoid process consists of very soft bone. Therefore, it is essential not to apply too much pressure to this region, as it may lead to a fracture.

Is it normal to feel a lump in the xiphoid process?

It is not usual to feel a lump in the xiphoid process. If a person can feel a lump or swelling has developed around the xiphoid process region, it usually indicates the area has become inflamed.

Can the xiphoid process be removed?

It is possible for a surgeon to remove the xiphoid process in a surgical procedure known as a xiphoidectomy. In the rare case that the xiphoid process breaks or fractures, this procedure prevents the possibility of bone fragments causing damage to surrounding vital organs.

Why does the bottom of my sternum hurt when I press it?

Pain when pressing the bottom of the sternum may point to a sternum fracture, a hernia, or xiphoid process inflammation.

Learn more here about the causes of pain in the sternum.

The xiphoid process is a small, triangular part of the sternum that starts out as cartilage and hardens as a person ages. Its main function is to act as an area for muscular attachment.

Xiphoid process pain may produce discomfort and swelling. However, it is rarely a cause for concern. However, if an individual 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 surgical removal of the xiphoid process to prevent more serious internal damage.