Experiencing pain in your side when you cough is a common sensation that can understandably cause concern. This discomfort often arises from the intense physical exertion of coughing, straining various body parts. The pain can range from a dull ache to a sharp, stabbing feeling, and its origin can be direct mechanical strain or a more serious underlying medical issue.
Musculoskeletal Causes of Side Pain
Coughing places stress on the torso’s muscles and skeletal structures, often leading to musculoskeletal pain. The intercostal muscles, located between the ribs, are particularly susceptible to strain or even tearing from repeated, vigorous coughing. Similarly, the abdominal muscles can become pulled or strained due to the intense contractions required during a cough. These muscle injuries cause localized pain that worsens with movement or further coughing.
In some instances, severe or prolonged coughing can result in stress fractures or bruising of the ribs. This is more prevalent in older individuals, those with osteoporosis, or people with other conditions that weaken bone density. The repetitive pressure on the rib cage during coughing can lead to microscopic breaks or contusions. A condition known as costochondritis involves inflammation of the cartilage that connects the ribs to the breastbone. When inflamed, this cartilage causes pain that worsens with coughing, typically presenting as tenderness and sharp discomfort in the chest wall.
Other Medical Conditions Causing Side Pain
Beyond muscle and bone strain, several medical conditions can cause or worsen side pain during coughing. Pleurisy, an inflammation of the pleura—the two thin layers of tissue that surround the lungs and line the chest cavity—is a notable cause. When inflamed, these layers rub against each other with each breath or cough, producing a sharp, stabbing pain. This condition can stem from various infections or autoimmune disorders.
Respiratory infections like pneumonia or bronchitis often lead to inflammation within the lungs and airways, contributing to pain that worsens with coughing. Pneumonia, an infection that inflames the air sacs in the lungs, can cause a persistent cough with chest or side pain. Bronchitis, an inflammation of the bronchial tubes, also results in a cough that can irritate the chest and cause discomfort. Even severe colds can inflame the respiratory passages enough to cause pain with coughing.
Gastroesophageal Reflux Disease (GERD), a condition where stomach acid frequently flows back into the esophagus, can also indirectly contribute to cough-related side pain. The chronic irritation from reflux can trigger a persistent cough, and the associated muscle strain from coughing may then lead to side discomfort. Less commonly, conditions such as a hernia in the abdominal wall can present with pain that is aggravated by coughing, as the increased intra-abdominal pressure pushes on the affected area. Kidney issues, such as kidney stones or infections, might also cause flank pain that worsens with the jarring motion of a cough, though this is less common.
When to Seek Medical Attention
It is important to know when side pain with coughing warrants medical evaluation. You should seek medical attention if the pain is severe, does not improve with rest or over-the-counter remedies, or progressively worsens over time. Additional symptoms alongside the pain also indicate a need for a doctor’s visit. These include a high fever, chills, shortness of breath, or difficulty breathing, which could suggest a more serious underlying infection.
Wheezing, coughing up blood, or discolored phlegm (green, yellow, or rust-colored) are concerning signs that require prompt medical assessment. Pay attention to the characteristics of the pain; sharp, stabbing pain that significantly limits your movement, pain that radiates to other parts of your body, or pain accompanied by noticeable swelling or tenderness should be evaluated. Individuals with pre-existing health conditions, such as chronic lung disease, heart conditions, or a compromised immune system, should consult a healthcare provider if they experience new or worsening side pain with coughing.
Managing Cough-Related Side Pain
For mild to moderate side pain from coughing, several self-care measures can help, assuming no serious underlying conditions are present. Resting and reducing strenuous physical activity allows strained muscles and tissues to heal. Over-the-counter pain relievers, such as NSAIDs (ibuprofen or naproxen) or acetaminophen, can manage pain and reduce inflammation. Applying a hot or cold compress to the affected side can also provide localized relief.
Staying well-hydrated by drinking plenty of fluids like water and clear broths helps thin mucus, making coughs more productive and less forceful. Over-the-counter cough suppressants might reduce coughing frequency and intensity, minimizing side strain. However, consult a healthcare professional before using cough suppressants, especially if your cough is productive (producing phlegm) or persists for an extended period.