Upper back pain when breathing is a common symptom that can range from benign to serious. Understanding its characteristics and potential origins helps in addressing discomfort and determining if medical attention is needed.
Common Reasons for Pain
Upper back pain with breathing can stem from musculoskeletal issues or respiratory conditions. The chest and back move significantly during breathing, making them susceptible to pain from various causes.
Musculoskeletal problems frequently cause upper back pain with breathing. Muscle strains, especially of the intercostal muscles, can cause sharp pain that worsens with deep breaths, coughing, or twisting. Poor posture, like prolonged slouching, contributes to muscle tension and discomfort, exacerbated by breathing. Rib subluxation, where a rib partially dislocates, causes sharp, localized pain intensified by deep breathing, twisting, or coughing. Spinal issues in the thoracic region, such as disc herniations or arthritis, can also cause pain that worsens with breathing.
Respiratory conditions are another cause, as lung or airway inflammation or infection can directly affect breathing pain. Pleurisy, inflammation of the lung lining (pleura), causes sharp chest pain that spreads to the back and worsens with deep breaths or coughing. Lung infections like pneumonia can cause upper back pain, especially if inflammation affects the pleura or from coughing-induced muscle strain. Bronchitis, an inflammation of the bronchial tubes, also leads to upper back pain from persistent coughing and muscle strain. Asthma, characterized by narrowed airways, can cause back pain due to increased breathing effort and muscle strain.
Less common but serious causes include:
Shingles, a viral infection, can cause sharp, burning nerve pain in the back or side, sometimes worsening with movement or breathing.
Anxiety and stress can lead to muscle tension in the back and chest, causing pain aggravated by deep breathing.
Some cardiac issues, though typically associated with chest and left-sided arm pain, can present as referred pain in the upper back, especially in women.
Costochondritis, inflammation of the cartilage connecting ribs to the breastbone, causes chest pain that radiates to the back and worsens with deep breathing or coughing.
When to Seek Professional Medical Advice
While many cases of upper back pain with breathing are not severe, certain “red flag” symptoms warrant prompt medical attention for timely diagnosis and treatment.
Seek immediate medical assessment for sudden, severe, or worsening pain, especially if it appears without a clear cause. Pain accompanied by shortness of breath, chest tightness, dizziness, lightheadedness, or fainting indicates a possible emergency, such as a heart attack or a blood clot in the lungs.
Other concerning symptoms include fever, chills, or a persistent cough, especially if it produces colored phlegm, which can signal respiratory infections like pneumonia or bronchitis. Numbness, tingling, or weakness in the limbs alongside back pain suggests potential nerve involvement or spinal issues.
Seek medical advice if pain does not improve or worsens despite home care, or if it follows trauma or injury. Individuals with heart or lung conditions should be vigilant, as new or worsening back pain with breathing could indicate a complication.
Strategies for Home Relief
For mild upper back pain with breathing, and without “red flag” symptoms, several home strategies can help manage discomfort by reducing strain and alleviating pain.
Resting the affected area and modifying aggravating activities prevents further irritation. Over-the-counter pain relievers like NSAIDs (ibuprofen, acetaminophen) can reduce pain and inflammation. Topical pain relief creams or gels may also provide localized relief.
Applying hot or cold packs to the upper back can alleviate pain and muscle tension. Cold therapy (ice pack) reduces swelling and soreness, especially in the first 48 hours. After this, heat (heating pad, warm compress) relaxes muscles and improves circulation. Gentle stretching, if pain allows, and maintaining good posture also reduce strain on back muscles.
Controlled breathing techniques can minimize pain. Taking shallow, controlled breaths or holding a pillow against the painful area while coughing or breathing deeply may reduce discomfort. Avoid prolonged shallow breathing, as it can lead to other issues. If symptoms worsen or persist despite these measures, or if new symptoms develop, consult a healthcare professional.