A painful press on the sternal raphe may be due to prolonged external force on the sternal raphe area or localized traumatic tissue and muscle contusion, which may cause pain when the raphe is pressed. Fractures of the 4th-7th ribs, which are more prone to fracture, may also cause significant pain when the sternal raphe is pressed, and there may be abnormal movement. The diagnosis can be confirmed by taking an X-ray and observing the fracture line, which will require immobilization with a chest strap, or prompt surgical intervention in the case of multiple rib fractures. There may also be inflammation of the esophagus or stomach, mostly related to reflux esophagitis. Gastroscopy or barium meal can confirm the diagnosis. It may be related to leukemia, so you can go to the hematology department for bone marrow aspiration. It may also be costochondritis, which causes acute injury and chronic strain to the cartilage of the thoracic rib joints when people carry heavy loads and do heavy work. Viral infection caused by cold and flu, resulting in edema of the cartilage of the thoracic rib joint surfaces, can cause pain in the chest by pressing the sword bone, should go to the hospital in time to improve the relevant examination.