Xiphoid Process Function & Anatomy | Sternum Tip Guide

Causes of Xiphoid Pain & Treatment | CPR Safety Tips

The xiphoid process is a small, bony structure located at the bottom of the breastbone (sternum). Shaped like the tip of a sword, it begins as cartilage at birth and slowly hardens with age. Unlike other parts of the sternum, it does not attach to any ribs. Despite its size, it supports chest muscles and plays a crucial role in breathing, posture, and various upper body movements.

Is it Bone or Cartilage?

The composition of the xiphoid process—whether it is cartilage or bone—depends largely on age, as it changes naturally over time. At birth, the xiphoid process is made of soft, flexible cartilage. As a person grows, this cartilage slowly hardens through a process called ossification. This typically occurs in middle age, although the exact timing can vary between individuals. In children and young adults, the xiphoid process remains cartilaginous.

In adulthood, the xiphoid process becomes a small but firm bony structure. Despite its small size, it serves important functions by supporting chest muscles and aiding in breathing. This transformation is a normal part of development and is usually not a cause for concern. However, if the sternum is injured or discomfort occurs, doctors may recommend imaging tests.

What is its Main Function?

As a significant part of your sternum, the xiphoid process protects organs in the chest, which include:

• Lungs
• Heart
• Oesophagus
• Diaphragm

The xiphoid process is also the main point of connection for ligaments in the chest and abdomen and some portion of your abdominal muscles. It binds together the muscles and ligaments to keep them in place.

Can it Cause Pain?

Yes, the xiphoid process can cause pain, especially if the area is injured or subjected to excessive pressure. The pain may feel dull or sharp and is sometimes mistaken for heart or digestive issues due to its location near the chest and upper abdomen.

In rare cases, a condition called xiphodynia can lead to tenderness and discomfort in the xiphoid process. While generally not serious, persistent or worsening pain should be evaluated by a healthcare professional.

Causes of Xiphoid Process Pain

The most common cause of xiphoid process pain is acute trauma to the chest. The surrounding structure does not protect or support the xiphoid process, causing it to be damaged. This damage can particularly take place during cardiopulmonary resuscitation (CPR) when an individual applies pressure to the lower sternum.

Some common causes of xiphoid process pain include:

• Lifting weights or any heavy object
• Straining the torso repeatedly

Other injuries an individual might face include:

• Damage between the connection of the cartilage-ligament and the sternum
• Fracture or microfracture
• Damage to the attachments of muscles to the xiphoid

Is it Involved in CPR?

Yes, the xiphoid process is a vital anatomical landmark used to guide proper hand placement during cardiopulmonary resuscitation (CPR). Chest compressions should be applied to the centre of the chest, specifically on the sternum, but just above the xiphoid process to avoid injury.

Applying pressure directly on the xiphoid process can cause it to fracture. The broken fragment can then be forced inward, potentially lacerating underlying internal organs such as the liver. This makes correct hand placement essential during CPR. With proper training, rescuers can ensure their compressions are placed slightly higher on the chest.

Although small, the xiphoid process must be protected during emergencies to prevent complications and improve the safety and effectiveness of life-saving efforts.

Treatment for Xiphoid Process Pain

Treatment for xiphoid process pain largely depends on the underlying cause and the severity of symptoms. If the pain is due to trauma, a healthcare provider may prescribe anti-inflammatory medications to ease discomfort. In milder cases, alternating between hot and cold therapy throughout the day may be recommended.

Additionally, doctors often advise reducing physical activity until the affected area begins to heal. If xiphoid pain is linked to acid reflux, making dietary changes can help alleviate symptoms. Eating smaller meals five to six times a day and avoiding trigger foods such as alcohol, chocolate, peppermint, and tomatoes can be beneficial.

Along with lifestyle changes, prescription medications may be used to lower stomach acid levels and support the healing of the oesophagus over time.

Can it be Removed?

Doctors may recommend surgical removal of the xiphoid process, known as a xiphoidectomy, particularly if it is fractured or causing significant pain and swelling. In some cases, abnormal growth of the xiphoid process can also lead to discomfort, making surgery a necessary option.

Although xiphoidectomy is considered safe and typically allows for quick recovery, it is usually a last resort. Doctors often try conservative treatments first, such as medications, rest, and physical therapy, before opting for surgery.

The xiphoid process is a small yet important part of the human body. Often overlooked, it plays a vital role in supporting chest muscles and protecting internal organs. However, it can cause discomfort or pain if injured, strained, or affected by a condition known as xiphodynia. Careful technique during CPR is important to avoid damaging this delicate structure.

Treatment for xiphoid-related pain depends on the underlying cause. While conservative methods are usually preferred, surgery may be considered if other options fail. Understanding the function and significance of the xiphoid process can aid in the better management of related health concerns.