Possible causes of pain on pressure at the xiphoid process include trauma, costochondritis, leukemia, and digestive system diseases. 1. Trauma: under the action of strong violence, soft tissue injury around the raphe or fracture of ribs or sternum can cause pain in this area. 2. Costochondritis: it is an inflammatory reaction that occurs in the rib cartilage. Under the stimulation of inflammation, chest pain can occur, and pressure and pain can also occur in the area of the raphe. 3. Leukemia: it is a kind of malignant tumor in the blood system, due to the excessive proliferation of leukemia cells in the bone marrow cavity, the pressure in the bone marrow cavity of the sternum rises after pressing the raphe, which can cause pain. 4. Digestive system diseases: As the lower part of the raphe is the part of human stomach, if there are chronic gastritis, gastric cancer, gastric ulcer and other diseases, pain can appear after pressing, mostly accompanied by digestive system symptoms, such as nausea and vomiting. There are many causes of pain on pressure at the xiphoid process, and it may also be related to intercostal neuritis, pleurisy, pneumonia and other diseases. If the symptoms continue to be unrelieved, it is recommended to consult a doctor in time to clarify the cause of the disease and carry out targeted treatment.