What causes xiphoid (zyphoid) process pain?

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Last updated: April 28, 2025View editorial policy

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From the Research

Zyphoid process pain should be managed with a multi-faceted approach, prioritizing conservative treatment and considering surgical options like xiphoidectomy in severe cases, as supported by the most recent study 1.

Initial Management

For immediate relief, over-the-counter pain medications like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) can help reduce inflammation and discomfort.

  • Apply ice for 15-20 minutes several times daily during acute pain, then switch to heat therapy after 48 hours.
  • Rest and avoid activities that worsen the pain, particularly heavy lifting or movements that put pressure on the chest.
  • Gentle stretching exercises for the chest and back muscles can help relieve tension around the area.

Diagnosis and Treatment Considerations

Xiphoid process pain often results from inflammation (xiphoiditis), trauma, or strain to the surrounding muscles and ligaments, as noted in 2.

  • The cartilaginous nature of this structure makes it susceptible to irritation, particularly after physical exertion, repetitive movements, or direct pressure.
  • Risk factors for developing secondary xiphoidalgia include GERD, gall-bladder disease, angina pectoris, and coronary-artery disease, as mentioned in 2.
  • If the pain persists beyond 1-2 weeks, worsens significantly, or is accompanied by difficulty breathing or other concerning symptoms, medical evaluation is necessary.

Surgical Intervention

In severe cases where conservative management fails, xiphoidectomy has been shown to be a safe and effective option, with nearly all patients experiencing improvement of complaints, as demonstrated in 1.

  • Xiphoidectomy is a viable treatment option for patients with xiphodynia who do not respond to conservative management, with a high success rate and minimal complications, as supported by 1.

References

Research

Operative results after xiphoidectomy in patients with xiphodynia.

Asian cardiovascular & thoracic annals, 2021

Research

Treatment and Management of Xiphoidalgia.

Orthopedic reviews, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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