Experiencing pain when coughing is common. While often a temporary symptom, the body’s natural reflex of coughing can sometimes strain tissues, leading to discomfort.
Common Causes of Cough-Related Pain
Pain experienced during coughing can stem from various sources, including musculoskeletal issues, respiratory infections, and gastrointestinal conditions.
Musculoskeletal causes often involve the structures of the chest wall. Forceful coughing can strain the small muscles located between the ribs, known as the intercostal muscles, leading to sharp, localized pain that intensifies with movement or deep breaths. In some instances, severe coughing can even result in stress fractures of the ribs, particularly if bones are weakened. This type of pain is typically intense, sharp, and directly over the affected rib. Another musculoskeletal condition, costochondritis, involves inflammation of the cartilage connecting the ribs to the breastbone. Coughing aggravates this inflammation, causing sharp chest pain.
Respiratory infections cause cough-related pain due to inflammation and irritation in the airways and lungs. Bronchitis, characterized by inflammation of the bronchial tubes, often leads to a burning or aching sensation in the chest during coughing as the inflamed lining is irritated. Pneumonia, an infection affecting the lung’s air sacs, causes painful coughing due to inflammation and fluid accumulation, often manifesting as a deep ache or sharp pain, especially with deep breaths. Pleurisy, an inflammation of the pleura (the membranes surrounding the lungs and lining the chest cavity), causes sharp, stabbing chest pain that worsens with breathing and coughing as the inflamed layers rub against each other.
Gastrointestinal issues can contribute to cough-related pain. Gastroesophageal Reflux Disease (GERD) occurs when stomach acid flows back into the esophagus, irritating it and sometimes triggering a chronic cough. This irritation, combined with the act of coughing, can lead to a burning pain in the chest, particularly after eating or when lying down.
Less commonly, other inflammatory conditions can cause cough-related chest pain. Pericarditis, an inflammation of the sac surrounding the heart, can cause chest pain that may worsen with deep breaths or coughing due to the proximity of the inflamed pericardium to the chest wall.
When to Consult a Doctor
While pain when coughing can often be managed at home, medical evaluation is necessary if the pain is persistent, worsens over time, or is severe and debilitating, interfering with daily activities or sleep.
Prompt medical attention is warranted for symptoms including shortness of breath, even at rest, alongside cough-related pain. A persistent fever accompanying the pain suggests an underlying infection. Coughing up blood or discolored phlegm, such as green, yellow, or rusty sputum, is another concerning sign. Significant chest pain that occurs even without coughing, or pain that began after a significant injury, should also prompt a medical visit.
How Doctors Diagnose the Cause
Healthcare professionals identify the underlying cause of cough-related pain through a structured diagnostic process. This process typically begins with the patient’s medical history. The doctor will inquire about the onset, duration, and specific characteristics of the pain, as well as any accompanying symptoms like fever, shortness of breath, or recent illnesses. Information about past medical conditions, existing health issues, and current medications also provides valuable context.
A physical examination follows. This often includes listening to lung sounds with a stethoscope to detect any abnormal sounds such as crackles, wheezes, or diminished breath sounds, which can indicate respiratory issues. The doctor may also gently palpate, or feel, the chest wall to pinpoint areas of tenderness, which can suggest musculoskeletal involvement. Vital signs, including temperature, heart rate, and blood pressure, are also checked.
Depending on the initial findings from the history and physical examination, further diagnostic tests may be ordered to confirm a diagnosis or rule out serious conditions. A chest X-ray is a common imaging test that can reveal signs of pneumonia, fluid around the lungs (pleural effusion), or rib fractures. Blood tests may be performed to check for markers of infection or inflammation within the body. In certain situations, more advanced imaging, such as a CT scan, might be used to provide more detailed views of the chest structures. If heart-related issues are suspected, an electrocardiogram (EKG) may be performed to assess heart function.
Managing and Relieving Pain
Managing pain associated with coughing involves symptomatic relief and supportive care. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help reduce discomfort and inflammation. When appropriate for the type of cough, cough suppressants may lessen the frequency and intensity of coughing, thereby decreasing the strain on the chest.
Adequate rest. Staying well-hydrated by drinking plenty of water, clear broths, or warm teas helps thin mucus, making it easier to clear from the airways and potentially reducing the effort and pain of coughing. Using a cool-mist humidifier in the room, particularly during sleep, adds moisture to the air. Inhaling humidified air can soothe irritated airways and loosen congestion, which may alleviate cough-related pain. Warm showers or steam inhalation can offer similar benefits by providing moist air.
Avoiding irritants prevents further respiratory aggravation. This includes steering clear of cigarette smoke, strong perfumes, chemical fumes, and excessive dust. Minimizing exposure to personal allergens, if applicable, can also reduce cough triggers.
Employing proper coughing techniques can help minimize strain on the chest. Supporting the chest with a pillow or clasped hands while coughing can distribute pressure more evenly and protect sore areas. Leaning forward slightly when coughing can also help reduce the direct impact on the chest wall. Effective long-term management relies on addressing the underlying cause of the pain.