Everything you need to know about the xiphoid process
Even though it sounds like some complex medical procedure, the xiphoid process is nothing more than a bone (or bony cartilage depending on how old you are) right at the base of your sternum.
Ordinarily, your xiphoid will give you no cause for worry over the cause of your lifetime. Since it is not a stress carrying bone, nor exactly movable, it pretty much just sits in the middle of your chest doing nothing, or next to nothing.
But in some situations, you may have issues with your unobtrusive xiphoid process. How do you know the pain you feel is from your xiphoid? What can you do about it?
We’ve provided answers to all these questions and more within this article.
What is the xiphoid process and what does it do?
Also called the metasternum, the xiphoid cartilage or if you want a tongue twister, the xiphisternum, the xiphoid process is a small extension of bone just below your ribcage.
The name of the bone itself, xiphoid, derives from a Greek that basically means “straight sword”. That sort of explains the shape of the xiphoid as it looks like a very short sword, widest at the base and tapering off to a point heading off towards your stomach.
The xiphoid doesn’t start out as a bone though. It starts out as a structure made of cartilage at birth and then slowly hardens into the bone as you mature. It takes a long time to harden though and will not entirely become bone until your early 40’s.
So if you’re less than 21, that bump you notice just below your sternum is unlikely to be your xiphoid. You’ll need to look elsewhere.
What does the xiphoid do? Well, nothing really active. For one, it serves as a landmark that indicates where chest compressions may be administered during cardiopulmonary resuscitation (CPR). Just a caution here though: If you’re doing CPR, don’t lean on the xiphoid. If you do, it may break off and puncture the lungs. That’ll be serious.
The xiphoid also serves as an attachment point for organs and large muscles that make up the floor of the diaphragm. It also plays a part in the abdominal muscles that compress and flex the abdomen.
So, it doesn’t really do anything active and if you were suddenly to lose your xiphoid, you probably won’t miss it very much.
Pain and inflammation in the xiphoid process
Even though the xiphoid is generally unobtrusive, it can be a source of pain, especially when it is inflamed. This pain is usually called xiphodynia, the xiphoid syndrome or even xiphoidalgia.
The pain, which may be mild or far from mild, is generally felt in the lower part of the sternum, just above your abs. Now, when there's a pain in the xiphoid process, there are many reasons why it may be so. They include pain from:
An accident that causes chest trauma
CPR went wrong
Overeating (which may contribute to acid reflux)
Stress in the xiphoid due to weight lifting
If the lump you feel around your xiphoid is painless, then there may be a more natural explanation. The xiphoid is generally inverted. This means that for the majority of people, the xiphoid faces inward so there’s no lump on their chests.
However, about 5% of people have what is called a “protruding” xiphoid process. For these people, the xiphoid protrudes out of the chest, forming a lump that may look like a tumour. It’s totally harmless though and a perfectly natural phenomenon.
What is the treatment for damage to the xiphoid process?
Well, before thinking about treatment, you need to visit your doctor first and confirm that what you do have is xiphodynia. Generally, if you have felt this pain for more than one week, then you should see a doctor for assessment.
There may be some difficulty with the diagnosis due to the fact that the xiphoid could be mistaken for a lump or a hernia. Also, because of its proximity to several bone structures, it could be mistaken for a broken rib, especially where the pain is severe.
Magnetic resonance imaging (MRI) or a computerized tomography (CT) scan will take care of the diagnosis nicely though. These tests can An x-ray can reveal damage to the xiphoid. If the x-ray results are inconclusive, your doctor may recommend further testing.
The treatment for xiphodynia depends on its cause. Generally, and especially in the case of an accident, a doctor may prescribe anti-inflammatory drugs to reduce the pain. If it is caused by weight lifting, the doctor may also recommend that you avoid intense exercise or activities that put a strain on your xiphoid.
Pain caused by acid reflux would ordinarily include recommendations to avoid foods that could trigger a reflux such as chocolates, peppermint and tomatoes.
Surgery may be considered as a last resort in the event of severe damage to the xiphoid such as its breaking. If left that way, it may be very dangerous as there’s a risk that it will puncture the lungs.
How do you hide the bump on your sternum?
As mentioned earlier, if what you have is a painless bump, you may have no cause to worry. The bump, in this case, is most probably caused by a protruding xiphoid process, an entirely natural phenomenon.
There’s no danger to you here. But some people are very self-conscious about what they fear may be perceived as a defect. So it’s normal for you to ask how you can hide the bump on your sternum.
You may have heard (or may think) that doing some more exercise around your pecs and abs will hide the bump or make it less noticeable. Nothing can be further from the truth.
When you exercise your pecs, only the muscles to either side of the sternum develop and get filled out. The area along your sternum will maintain its depression so what you have after exercising that area may be a more prominent bump.
The best thing to do is leave it alone. The bump is entirely natural and hardly anyone will notice it. Unless, of course, if you keep directing their attention to it by being overly self-conscious.
If you are intentional about getting rid of the bump, you can approach your doctor to explore the possibility of getting a surgery. You should think this over carefully though.
As you have seen from this article, there are many reasons why you could be experiencing the pain below your sternum. But you need to take it slow and consult your doctor before taking any other steps.