Why My Back Hurts When I Breathe? 8 Causes & What to Do

Medical review: Dr. Clarisse Bezerra
Family Doctor
October 2022

Back pain with breathing is generally related to a lung problem or due to a problem with the lung tissue lining, also known as the pleura. The most common causes of lung problems that lead to back pain are cold and flu viruses. However, pain can also emerge with more serious lung issues, like pneumonia or a pulmonary embolism. 

This type of pain may also be a sign of a problem in other tissues, like the muscles or heart. However, in those situations, other symptoms will likely appear. 

Nonetheless, if you do feel back when breathing, especially if the pain is intense or lasts for over 3 days, you should seek medical attention. The doctor will likely order testing, like a chest x-ray, to identify what is causing the pain and to start appropriate treatment. 

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Causes of back pain when breathing 

Your back can hurt when you breathe for many reasons, including: 

1. Cold and flu

The cold and flu are commonly-occurring health conditions that are caused by a viral infection. These illnesses are associated with symptoms like a runny nose, coughing, fatigue and even fever. Although back pain is less common, it is possible to occur with a viral infection. This pain may be related to the accumulation of mucus in the respiratory airways, or it may be related to muscle fatigue from persistent coughing. 

What to do: The cold and flu viruses are naturally eliminated by the immune system after a few days. It is important to support your body and strengthen your immune system by resting and ensuring adequate fluid intake. Check out these natural cold and flu remedies that you can try at home to speed-up your recovery. 

2. Muscle strain

A strained muscle is another common, benign cause of back when breathing. A strain is characterized by small tears in the muscle fibers that cause pain for 2 to 3 days. This can occur with overexertion of the back muscles from heavy activity, bad posture, exercising or persistently coughing during a cold or flu. 

What to do: The best way to treat a muscle strain is with rest, so that the torn muscle fibers can heal. For pain relief, you can apply a cold compress on affected areas 3 to 4 times per day for the first 48 hours.

3. Costochondritis

Costochondritis consists of inflammation of the cartilage that connects the sternum to the ribs. This condition generally caused intense chest pain that can radiate to the back. It is especially felt when taking a deep breath. In addition to pain, costochondritis can also cause shortness of breath and pain when pressing down on the sternum. 

What to do: Normally, costochondritis-related pain can be relieved with warm compressed on the sternum, as well as rest and avoiding strenuous activity. If pain is very intense and interferes with your activities of daily living, you should see a doctor to assess the need for medications like analgesics and anti-inflammatories. 

4. Pneumonia

Although back pain with breathing is often related to a cold or flu, pain that progressively worsens may be a sign of a more serious infection, like pneumonia. 

In these cases, in addition to pain, you may experience symptoms like coughing, a runny nose and other, more severe symptoms, like difficulty breathing, fever over 38ºC (or 100.4ºF) and green phlegm or bloody phlegm. Learn more about the symptoms of pneumonia and what can cause it. 

What to do: If you suspect if you have pneumonia, you should see a doctor for diagnosis and treatment, which may involve antibiotic use. Pneumonia is very easily spread, especially viral pneumonia, therefore you should wear mask when leaving the house. You can also use these home remedies for pneumonia to complement the medical treatment prescribed by your doctor. 

5. Pulmonary embolism 

Although this is a rare condition, a pulmonary embolism can also cause intense pain when breathing. This condition occurs when a blood vessel in the lungs becomes blocked with a clot. This impedes blood flor and oxygen to certain parts of the lung, causing pain and other symptoms, like shortness of breath, coughing with blood, and blue-tinged skin. 

An embolism can occur in anybody, but it is more frequently seen in people with a history of clots, coagulation probelms, obesity and a sedentary lifestyle. 

What to do: This is a life-threatening condition that requires immediate medical attention. If you suspect you have a pulmonary embolism, proceed to the closest emergency room or call an ambulance. Treatment usually involves the use of medications, like heparin, to destroy the clot. 

6. Pleurisy

Pleurisy, or pleuritis, is another lung condition that can cause intense back pain with breathing. It is characterized by an accumulation of fluid between the two layers (or pleurae) that line the lungs. When this occurs, the pleura can become swollen and cause pain that worsens with coughing or deep breaths. Other symptoms include frequent coughing, shortness of breath and persistent low grade fever. 

Although it is not a serious condition, pleurisy can be a sign of another respiratory condition that has not been diagnosed or is not being treated correctly. 

What to do: Any suspicions of pleuritis should be assessed by a doctor in a hospital setting. Treatment usually involves the use of anti-inflammatories to relieve swelling, however the doctor should identify what is causing the inflammation in the first place.

7. Pericarditis

Back pain when breathing is almost always related to a lung problem, however it can also occur with cardiac issues like pericarditis. Pericarditis is an inflammation of the membrane that lines the heart, the pericardium. In addition to intense chest pain, it can also cause intense pain that radiates to the back that is especially felt with deep breathing. 

Pericarditis is more commonly seen in patients with an infection or inflammation in another area of the body, like pneumonia, tuberculosis, rheumatoid arthritis or even a dental cavity. 

What to do: Treatment for pericarditis is relatively straight-forward when this condition is identified in its early stages. If you suspect you have a heart problem, you should see a doctor immediately for assessment, diagnosis and treatment. 

8. Heart attack

Although the most common symptom of a heart attack is intense, tightening chest pain, there are also times when chest pain can cause mild back pain with breathing. Other symptoms that may emerge include tingling in one of the arms (usually the left side), nausea, general malaise and difficulty breathing. 

Heart attacks are particularly prevalent in people with specific risk factors, like an unhealthy diet, smoking, stressful lifestyles, high blood pressure, diabetes or high cholesterol.

Learn more about the heart attack symptoms you shouldn’t ignore. 

What to do: If you suspect you are having a heart attack, proceed immediately to the nearest hospital or call an ambulance. The earlier it is diagnosed, the greater the chance of treating the problem and preventing further complications. 

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Edited by Tua Saude editing team in October 2022. Medical review completed by Dr. Clarisse Bezerra - Family Doctor in October 2022.

References

  • BARBOSA, Ana Carolina. et al.. Diagnóstico diferencial da dor torácica: ênfase em causas não coronarianas. Rev Med Minas Gerais 2010; 20(2 Supl 1): S24-S29.
  • NIH. Heart Attack. Available on: <https://www.nhlbi.nih.gov/health-topics/heart-attack>. Access in 23 Jan 2020
Show more references
  • NIH. Pleural Disorders. Available on: <https://www.nhlbi.nih.gov/health-topics/pleural-disorders>. Access in 23 Jan 2020
  • NIH. Pneumonia. Available on: <https://www.nhlbi.nih.gov/health-topics/pneumonia>. Access in 23 Jan 2020
  • Longo, DL et al.. Harrison’s Principles of Internal Medicine. 19.ed. New York: McGraw-Hill, 2015.
Medical review:
Dr. Clarisse Bezerra
Family Doctor
Dr. Bezerra possesses a medical degree and specializes in family medicine. She is licensed to practice under CRM-CE licence #16976.