Let us make one thing clear. Xiphoid Process is not a process or a procedure! The term “Xiphoid” is derived from the Greek word “xiphos.” It means “a straight sword.” On the other hand, “Eidos” means “like.” It is because of the sword-like appearance of the extension that it has earned its name.
Sometimes severe pain is experienced in this particular region. It is felt the most when you are taking deep breaths or bending down.
It can be for some reasons, and the symptom for each also differs.
This article will guide you all through the Xiphoid Process.
The xiphoid process is at the level of your 9th thoracic vertebra and the T6 dermatome. In simple terms, it is a small cartilaginous extension of the lower part of your sternum.
The Xiphisternal joint is an immobile point between the two portions of the sternum.The development of this structure is slow and gradual. This extension can be seen and felt distinctively in infants.
During this stage, the Xiphoid Process is mostly a lump located underneath the sternal notch. It eventually becomes ossified and fuses with the sternum as the infant grows up.
The cartilage-like structure then becomes bony and hard between 15 to 29 years of age.This pattern of a cartilage-like structure becoming ossified with time is quite common in your human body.
In any case, you must always keep one thing in your head. You must positively see a doctor if you are experiencing pain in this region for more than two or three days.Even if your child tells you about any such pain in the lower thoracic region, you must pay attention to it and get it diagnosed. The pain can turn worse if you neglect it!
Significance Of Xiphoid Process
The xiphoid process may be small in size, but it is a pointer to various surgical procedures and anatomical structures. The xiphoid process is cartilage-like until it ossifies at around 40 years.
There are several muscles attached to a xiphoid process. They help you to stabilize the ribs on the lower end.The structure also acts as the node of attachment of the diaphragm muscles. It helps the diaphragm make a good floor for the ribcage and helps you to perform the respiratory functions.
The xiphoid process also acts a pointer to other anatomical structures like:
- The superior margin of your liver.
- The lower margin of your heart.
- The central tendon of your diaphragm.
- The lower limit of your anterior thoracic cage.
Apart from these positional advantages, the xiphoid process also serves one other surgical function. It helps doctors to properly position needles during Pericardiocentesis.
Now, what is Pericardiocentesis?
Pericardiocentesis is a surgical process by which any fluid accumulated in the sac surrounding the heart (pericardium) is drained out.
The collection of fluid from the pericardium is called pericardial effusion.
Chest trauma, heart disease, and infections add to its causes. The building up of this fluid in the pericardium is life-threatening.
Pericardiocentesis is a process which starts with the insertion of a large needle into the pericardium. The accumulated fluid is then aspirated to relief the pressure.
The xiphoid process helps dictate the proper positioning of the needle.
Anatomically speaking, the needle is inserted alongside the xiphoid process. It is then steered upwards and then leftwards towards your heart. There might be an instance where the needle is inserted incorrectly at a different angle or position.
The xiphoid process helps the needle from causing any potential damage to the lungs.
Xiphoid Process Pain
We just saw how significant the xiphoid process is to us. Sometimes you can also experience pain in this structure, and it can be for some reasons. It is not advisable to always associate any chest pain with pain in the xiphoid process.
Just to be sure, let us first have a look at the symptoms:
Symptoms Of Xiphoid Process Pain
Pain and tenderness over the area of the xiphoid process is a typical symptom when there is any swelling. The pain is even more when you cough or laugh. Look for these symptoms if you think you are affected:
- Normal breathing associated with piercing pain.
- Slight tenderness on your back.
- Activities related to lifting, bending or twisting may become challenging because of the pain and tenderness.
- If it is affecting your daily routine. You might find it difficult to do some daily works.
- The slight pressure exerted over xiphoid process resulting in severe pain.
What Causes Pain In The Xiphoid Process
Now that you can point out and be sure that the pain you are having is because of any problem in the xiphoid structure, it is essential for you to know the reasons.
Some of the causes are sole because of any physical injury. But there can also be other internal factors acting up.
Let us now have a look at the causes in details:
1. Physical Injury
Even though the bone is very small, in the event of a fracture it can get separated from the sternum. It might also be pushed down to the diaphragm or the heart.
This is the reason why you need to be examined by medical experts if you have any chest injury.
This can include any force exerted because of any collision with an object. Or, the blow from the steering wheel in case of a car accident. Or when the region is hurt by any moving object, especially during sporting activities.
Fractures and injuries might also occur when inexperienced persons try to administer CPR.
Cardio-Pulmonary Resuscitation or CPR is an emergency course of action performed to make the brain function manually. It is treated as a temporary solution before more steps can be taken to bring back proper circulation of blood.
CPR alone is never enough to revive the heart to pump blood. CPR’s main function is to bring back the partial run of oxygenated blood to the heart and brain.
This helps us to avoid tissue damage until medical help arrives.
The ribcage is composed of the ribs and the sternum. It is designed to help in the prevention of any injury to organs.
But, the ribcage has its limits. If pressure is applied is forceful, the rib cage or the sternum might fracture and damage organs.
Fracture of the xiphoid process is a very common outcome of the application of CPR. This essentially happens due to wrong placement of the hand.
The hands should not be placed lower than it is advised. The xiphoid process can be easily fractured because of its cartilage-like nature.
A distinctive “pop” sound can be heard if the xiphoid process fractures. This results in dislocation, and it might also puncture your liver. In some cases, it leads to internal hemorrhage.
2. Xiphoid Syndrome
When you feel pain and tenderness in the lower portion of the sternum, it is known as Xiphodynia- a xiphoid syndrome. There are some opinions opposing this condition as some researchers have concluded it is rare while the others object it by saying that it is often overlooked.
The chief characteristics of the xiphoid syndrome are:
Intense and sharp pain is experienced when the xiphoid process is pressed. Sometimes the pain can also spread in the adjoining area.
You experience a piercing pain when you are bending over or twisting.
The area in and around the xiphoid process is extremely tender to touch.
One of the reasons why it is commonly overlooked is the presence of another severe medical condition, such as:
- Heart disease
- Bone disease
- Gallbladder stones
In some severe cases, the pain might radiate to your back, neck, and shoulders. Sometimes it becomes so concentrated that you might feel nauseated.
Also, care must be taken for the proper diagnosis as sometimes these symptoms take off as certain other thoracic disorders or abdominal problems.
3. GERD – Gastroesophageal Reflux Disease
GERD usually happens when your stomach acid starts flowing in the opposite direction, entering the food pipe (esophagus).
During normal digestion, your cardiac sphincter or the Lower Esophageal Sphincter (LES) opens up to allow food to pass into the stomach.It then closes to stop food and other acidic juices in the stomach, to flow back into your esophagus.
When your Lower Esophageal Sphincter becomes weak or relaxes improperly, your stomach’s contents flow up back into your esophagus.
The question is what does your stomach acid have to do anything with xiphoid process pain? The location plays an important role in this case.
The esophagus is situated behind the trachea, which runs right behind your sternum.The proximity of these two structures is accountable for the manifestation of in this region.
The characteristic feature of GERD is acid indigestion. It is also commonly known as heartburn. You might experience a burning chest pain that originates from your breastbone and spreads to the neck and across your throat.
This pain may continue for several minutes or two hours straight. It becomes worse after a heavy meal. It might also be forced to a lying position or bending over frequently.
4. Fluctuation of Body Weight
We have already seen that the xiphoid process ossifies with age. As the child grows, it becomes less visible.
In some adults, and especially in those who have reduced weight, the xiphoid process can be felt. In people who are obese, the visceral fat exerts a fair amount of pressure on the internal organs and the ribcage.
Because of this, they expand. As a result, the xiphoid process is pushed out because of its cartilaginous nature. It looks like an object protruding out from your sternum.When these obese people lose weight, the protruding xiphoid process can be felt again. Most of the people think that the protrusion is some cancer or a tumor, and panic. Other ignore it and hopes that it will disappear.
Most doctors believe that this protruding xiphoid process is not any cause for fear. But to be on the safe side, you must consult your doctor.
Any other lump on your sternal body can be caused due to trauma or an accident or by a fracture in the xiphoid process that didn’t heal appropriately and is protruding out.
Treatment For Xiphoid Process Pain
The intensity of the pain in a xiphoid process can be somewhere between mild discomfort to severe pain. There is no certain and definite treatment for the xiphoid syndrome. The treatment mostly depends on the underlying causes and the amount of pain.
The patients with xiphoid syndrome should avoid eating heavy meals and lifting of heavy objects. The xiphoid process is fundamentally a self-limiting disease.
So first, the patient must be comforted and made aware of his situation.The main options for managing xiphoid syndrome are given below:
1. The first form of treatment for the xiphoid syndrome is painkillers or analgesics and Non-Steroidal Anti-Inflammatory Drug (NSAIDs). These drugs will help you relieve the pain and reduce the inflammation. If you subscribe to these drugs, they will help you feel comfortable.
2. If the pain is severe in its intensity, then it will not be relieved with the help of painkillers. In this situation, an opioid analgesic may be advised by the doctor to help you control the pain.
3. Application of heat can also be used to help ease the pain and discomfort caused because of the xiphoid syndrome. Application of cold can also help you reduce the discomfort.
4. If the pain is not lessened by the drugs, then local anesthetic, such as Lidocaine and corticosteroids can be injected into the xiphoid process. This will help you to alleviate the pain. Corticosteroids will also help reduce inflammation, additionally. These injections are curative, but the risk of complication is always there.
This is the reason why the doctors often hesitate to prescribe them to you. The complications like pneumothorax, infection, and peritoneal perforation are always there.
5. If xiphoidalgia is due to GERD, diet modification is a vital part of the treatment. The underlying cause must be addressed and then treated for proper management of the pain caused by the xiphoid syndrome.
6. If treatments fail to help or in the case of fractured, then the xiphoid process can be removed. The xiphoid process doesn’t serve any major function, but it just helps anchor some important muscles. Xiphoidectomy is the surgical process used to remove the xiphoid process.
It is indeed a complex procedure, and it can only be done by doctors. It is not compulsory to always remove the entire structure.Sometimes the removal of the extension is sufficient to treat xiphoidalgia.
Xiphoidectomy is the last resort as effective management of xiphoidalgia.
Xiphoidalgia can also be caused by many other medical conditions.For proper treatment of xiphoid syndrome, the underlying causes must be addressed and treated by professionals.
Home Remedies To Get Rid Of Xiphoid Process Pain
Garlic is a herb rich in various kinds of vitamins and minerals like calcium, iron, phosphorus, thiamin, niacin, riboflavin, and vitamin C. Additionally, it contains traces of sulfur, iodine, and chlorine.
Raw garlic is beneficial for your heart, as it helps you have a healthy blood circulation. You could drink hot water with 5-6 drops of garlic juice to reduce chest pain while breathing. To solve the problem of GERD, you can directly eat 3 to 4 cloves of garlic.
2. Omega 3 Fatty Acids
Not all fats are harmful to your body. Omega-3 fatty is essentially beneficial for your body. These fats can prevent CHD, that is, coronary heart disease.
Lower your chances of having a CHD; lower are the chances of you having pain in your Xiphoid Process.
For the efficient amount of Omega 3 Fatty Acid, you could try eating food products like:
- Soybean chunks and canola oil
- Fishes, such as mackerel, herring, lake trout, sardines, tuna, and salmons.
- Supplements of fish oil and cod liver oil.
Physiotherapy also proves helpful in reducing pain. Xiphoid syndrome happens to be a musculoskeletal disorder. Thus it is essential also to take note of the muscles that attack the xiphoid process.
The therapy must be concentrated in the chest muscle area. Physiotherapy helps soothe the tenderness and pain in the muscles. In the long run, gentle exercises are proven to help improve flexibility.
4. Garlic Oil
Physiotherapy is proved to be an excellent solution to ease out pain due to the sterna area. You can heat some natural, non-scented body oil along with a few drops of garlic juice. You can also crush garlic cloves and directly put it in the oil.
After heating, it is essential to cool down the oil to impart all the extracts in the garlic clove. You can now apply this oil to your thoracic region and massage the area where you experience pain.
5. Elastic Belts
Elastic belts are an amazing way to reduce all the discomfort and pain caused due to a xiphoid syndrome. This belt provides an optimum pressure to the sternum and helps you alleviate the pain.
Care must be taken to see that the belt does not cause any problems in breathing. It is wise not to wear the belt when you are sleeping.
Your xiphoid process will not cause any discomfort during the early stages of life. Then it’s just a protrusion of a soft lump. As and when it matures, care must be taken to not exert any enormous amounts of pressure in that area.
Xiphoid process pain is a harmless medical condition that usually is not fatal If you experience pain in that specific area, you must get it checked right away to prevent it from spreading.
This pain might also cause slight nausea, shoulder and back pain.
You must consult the doctor right away if you have any doubts regarding it. It is always better to be safe than sorry!