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7 Reasons Why You Have Back Pain When You Breathe, According To Doctors
Back pain is common — nearly 40 percent of adults reported having back pain in 2019 — and it's often caused by everyday issues like poor posture or strained muscles.
But if you have back pain that's triggered each time you take a breath, this may be a sign of something more serious like pneumonia or a blood clot.
Here are seven reasons you may have back pain while breathing and when you should see a doctor.
1. Strained muscleStrained muscles occur when your muscles are stretched too much, causing tears in the muscle fibers or tendons.
"There are small muscles between the ribs, front and back, that help expand and contract your chest as a normal part of breathing," says Dr. Kate Rowland, a family medicine doctor and professor at Rush University.
These muscles can get pulled or strained through activities like heavy lifting or prolonged coughing. When this happens, "the muscle strain can get re-aggravated with each breath you take," Rowland says.
Some other signs that you may have a strained muscle are:
To treat a strain, you'll need to rest your muscles for at least a day. If you have swelling, you can ice the area for 10 to 15 minutes every few hours.
Also, "people often say it feels better with an anti-inflammatory drug like ibuprofen or naproxen," Rowland says.
2. PleurisyPleurisy is a condition that occurs when the tissue between your lungs and your chest wall becomes inflamed.
When you take a breath, your lungs press the swollen tissue against your chest, which can trigger pain.
This pain often starts in your chest but can spread throughout your back, shoulders, and abdomen.
There are many possible causes of pleurisy, including:
If you think you have pleurisy, see your doctor as soon as possible so they can determine the underlying cause and plan your treatment.
3. PneumoniaPneumonia is an infection in your lungs that's generally caused by bacteria or a virus like the flu.
A pneumonia infection irritates the lining of your lungs, which can trigger pleurisy and cause back pain when you breathe.
"The pain of pneumonia can be sharp or a dull ache, especially when taking a deep breath," says Dr. Megan Boysen Osborn, a professor of emergency medicine at the University of California, Irvine.
The pain also tends to get worse if you're coughing a lot, says Dr. Jessica Oswald, an emergency medicine and pain specialist.
Some of the other symptoms of pneumonia include:
If you think you may have pneumonia, see your doctor as soon as possible. If the infection is caused by bacteria, you'll need to take antibiotics, while a viral infection usually goes away on it's own.
4. Lung cancerLung cancer is relatively rare, but it's much more common if you smoke — around 90 percent of lung cancer cases are linked to cigarette smoking.
"Most small and focal lung cancers are painless, but the lesions can erode into ribs, nerves and lining of the chest wall," Oswald says.
This erosion can cause sharp pain that gets worse with breathing or coughing.
The pain often appears in your chest, but if the lesions are on the back of the chest wall, you might have back pain as well, Oswald says.
Some other signs of lung cancer include:
Your doctor can diagnose lung cancer by taking scans or samples of your tissue. Depending on how advanced the cancer is, your doctor may treat it with surgery, chemotherapy, radiation, or other cancer treatments.
5. Pulmonary embolismA pulmonary embolism is a type of blood clot that occurs in one of the blood vessels of your lung.
A pulmonary embolism can cause chest or back pain, depending on where it appears in your lung.
"The pain can be felt anywhere in the back or chest, as high as the clavicles/neck and as low as the bottom of the rib cage," Osborn says.
Besides pain, other symptoms of pulmonary embolism include:
You're at greater risk of developing a pulmonary embolism if you:
Your doctor can diagnose a pulmonary embolism by looking at scans of your chest. They can then decide how to treat you — some common treatments include blood-thinning medications, using a catheter to break up the clot, or surgery for severe cases.
6. Certain heart conditionsThe two main heart conditions that can cause back pain with breathing are pericarditis and myocarditis, says Osborn.
The are many possible causes of myocarditis, including:
Along with chest and back pain, some of the different symptoms of myocarditis are:
Pericarditis causes some of the same symptoms as myocarditis as well as:
Pericarditis may also be caused by an infection or inflammatory disorder, as well as:
If you develop the symptoms of either condition, you should get medical help as soon as possible. Severe forms of myocarditis can damage your heart or may even be fatal.
Your doctor will determine what type of treatment you need, which may include corticosteroids, blood thinning medications, or various surgeries.
7. Broken or bruised ribBroken or bruised ribs generally happen after you've had an injury or accident. "So usually people know when they have that kind of thing happen, and the pain starts right away," Rowland says.
"Broken ribs are usually very painful and hurt like crazy with every breath because the fracture moves a little with each one," Rowland says. If the break is on the back of your rib, you'll feel this pain in your back.
But even if you're in pain, "it is important for patients to take deep breaths to avoid getting pneumonia after a broken rib," Osborn says.
Along with pain, some common symptoms of broken or bruised ribs are:
Broken or bruised ribs generally heal on their own, but you should still see your doctor to confirm that you have a break and make sure there aren't any complications like a punctured lung.
Insider's takeawayThere are many different reasons you might feel back pain when you breathe. "Anything that causes irritation to the chest wall can cause pain while breathing; this could be a serious cause or a not serious cause," Osborn says.
It's important to see your doctor if you have any back pain that:
Health Beat: Understanding Pleurisy
Viral infections are still going around and experts warn they can lead to a painful lung condition.
The condition is called "pleurisy." It's an inflammation of the lining of the lungs and is common after viruses like flu, Covid, and RSV.
"Pleurisy can happen on the heels of a viral infection," said Dr. Alan Hyslop, pulmonologist at Indiana University Health.
When inflamed, the tissue layers rub against each other, causing sharp pains.
"When you take a deep breath or upon coughing. And it can also happen even in certain positions too, like bending over," Dr. Hyslop said.
Health experts say that sudden, intense pain can be alarming.
"It is scary in the moment. Anybody who has had that type of pain can relate that it does feel like, you know, something really terrible's happening," explained Hyslop.
Pleurisy is usually mild and, with time and rest, will eventually heal on its own, but you should always get it checked out.
"You want to rule out or exclude other causes that are life threatening," Dr. Hyslop cautioned.
The condition can affect anyone, even children.
"Certainly a lot of kids are getting viral illnesses, so I'm sure they're experiencing that. Obviously, they are not as apt to describe their pain probably as well," added Hyslop.
Along with the sharp pain, other symptoms of pleurisy include fever, shortness of breath, coughing and issues swallowing.
So again, be sure to get checked out if you feel any kind of chest pain.
NHS Issues Urgent Warning If You Have Pain When You 'cough, Sneeze Or Move'
If you have pain when coughing, sneezing or even if you move, the NHS is warning people to seek help. This could be because you have something called pleurisy.
But what is this? "Pleurisy is inflammation around the lungs, which causes sharp chest pain. It's easy to treat and usually gets better in a few days, but can sometimes be a sign of something more serious, like pneumonia", the NHS explains.
What is pleurisy?In a further and detailed explanation by WedMB, they explain that the chest pain affects part of your body called the pleura - and you have two in total with one for each lung.
They write: "Each pleura consists of two thin, sheet-like layers of tissue. The inner layer covers your lung. The other layer lines the inside of your chest wall. They fit snugly within your chest. There's a small amount of fluid in the space between the two layers (the pleural space). This helps the pleurae glide smoothly as you breathe.
"These layers keep your bare lungs from rubbing against the wall of your chest cavity every time you breathe in. When the pleurae are swollen and inflamed, they rub against each other in a painful way each time your lungs expand. When you inhale deeply, cough, sneeze, or laugh, you'll probably feel a sharp, stabbing pain in the area that's affected."
What are the symptoms of pleurisy?The primary symptom of pleurisy is a sharp chest pain that occurs when you inhale. The pain can intensify with coughing, sneezing, or movement and it may radiate to your shoulders and back.
Go to your GP or call 111 if:These symptoms may indicate a more serious condition, such as a heart attack or a blood clot in the lungs (pulmonary embolism).
If you visit your GP, at the appointment a GP will examine you and listen to your chest. If they suspect something is wrong, they cam refer you to a specialist.
You may need to have tests, such as:
Pleurisy typically improves on its own within a few days without the need for treatment from a GP. However, if a bacterial infection like pneumonia is the cause, antibiotics may be required.
You can ease the chest pain by:
Hospital treatment may be necessary if your symptoms are severe or stem from a more serious condition, such as a pulmonary embolism or tuberculosis.
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