Occasional stabbing pain in the sternum may be caused by the following reasons: 1. It may be neuropathic pain in the chest, most commonly intercostal neuralgia, which is the sequelae of neuralgia due to herpes zoster invasion of the intercostal nerve, or intercostal neuralgia of unknown origin. 2. The pain may be aggravated by coughing, deep breathing or forceful lifting. 3, it may be a heart problem, if the stabbing pain is combined with chest tightness, palpitations or dizziness, weakness of the limbs, etc., it is highly suspected to be an acute heart disease and must be checked by electrocardiogram and cardiac function enzyme profile for clear diagnosis.