Why Does My Back Hurt When I Breathe?

Causes Could Include Injury or a Medical Condition

There are several different causes of back pain, many of which can worsen with breathing. Back pain can be due to an injury to the bones or muscles in your back, or result from a medical condition affecting internal organs such as the heart or lungs.

This article looks at the possible causes for back pain when breathing, as well as symptoms and treatment options for each.

Learn More: 13 Causes of Upper Back Pain

Strained Muscle

Pulling a muscle in your upper back or shoulder blade area can occur with heavy lifting or strenuous movement involving your upper body. This can result in pain and tenderness that can worsen with deep breathing as the ribcage expands and places pressure on the pulled muscle.

Back pain with breathing may also result from an intercostal muscle strain, although this type of injury to the muscles between the ribs more often causes chest pain. Strained muscles tend to heal on their own over time, although physical therapy may be recommended to help facilitate recovery.

Pulmonary Embolism

A pulmonary embolism is a type of blood clot that travels into an artery that supplies blood to the lungs, blocking the flow of blood. Common symptoms include pain in the middle of the back and/or chest that occurs with breathing, shortness of breath, and coughing up blood.

Treatment typically involves anticoagulant medication to break down the blood clot and cardiac support to restore functioning of the heart and lungs. Surgery may also be needed to remove the clot.

Scoliosis

Scoliosis is a disorder that causes an abnormal curvature of the spine. Scoliosis most often produces an S-shaped curve, affecting the thoracic spine and lumbar spine of the upper and lower back. Because the ribs attach to the thoracic spine, scoliosis can also cause abnormal twisting and compression of the rib cage. This can decrease the area of the chest cavity where the lungs sit, and can make it harder for the lungs to fully expand when breathing.

Symptoms of scoliosis include back pain with inhalation or exhalation and difficulty breathing, depending on the extent of the scoliosis. For mild to moderate scoliosis, wearing a back brace, getting physical therapy, and stretching and breathing exercises can help reduce discomfort. For more severe cases of scoliosis, surgery may be needed to realign the spine.

Obesity

Having obesity can cause breathing problems from excess weight around the neck, chest, and abdomen that can compress the airways or make breathing harder. In some cases, it can be painful to take deep breaths.

Weight loss through a combination of diet and exercise is recommended to lose weight for individuals with obesity. Other treatments like medication may be recommended by your healthcare provider if excess weight is linked to a hormonal condition.

Bruised or Broken Rib

A bruised or broken rib can occur with falls or traumatic injuries. Symptoms involve pain in the chest and/or back depending on what part of your ribs was affected. Pain worsens with deep breathing, coughing, sneezing, and activities that increase intra-abdominal pressure.

Broken ribs typically heal on their own, but pain medication and physical therapy to restore your movement can help aid in your recovery.

Pleurisy

Pleurisy results from inflammation of the pleura, the thin membrane surrounding the lungs and the chest cavity. Symptoms of pleurisy include shortness of breath, cough, and chest pain. Pain can also radiate to the shoulder or mid-back region.

Treatment involves managing any underlying cause, taking antibiotics, and draining fluid through thoracentesis. Surgery may also be considered to insert a drainage tube or remove a portion of the inflamed pleura.

Herniated Disc

A herniated disc occurs when the inner jelly-like substance of an intervertebral disc breaks through its tougher outer ring. This disc material pushes out of the spinal column and can compress nearby nerve roots, causing pain in the spine and symptoms like shooting pain, numbness, tingling, or weakness that can travel into the arms or legs.

Herniated discs are more likely to affect the lower back, but they can also occur in the thoracic spine of the upper back, causing pain between the shoulder blades. Increased pressure from breathing can worsen symptoms. Treatment for a herniated disc involves physical therapy and possible surgery if symptoms are chronic and/or severe.

Pneumonia

Pneumonia is an infection that causes fluid to accumulate in the  lungs. Chest, back, or abdominal pain with breathing or coughing are typical symptoms. Treatment involves antibacterial or antiviral medication to treat the cause of the infection. Severe cases of pneumonia may require hospitalization.

Lung Cancer

Early stages of lung cancer often do not cause symptoms, but later stages as the cancer progresses can result in chest pain with breathing along with other symptoms like shortness of breath and chronic coughing. This pain can also spread to the upper back, especially if the cancer spreads to other parts of the body.

Treatment for lung cancer typically involves a combination of chemotherapy, radiation, and surgery to remove cancerous tumors.

Read Next: Is Upper Back Pain a Sign of Lung Cancer?

Heart Attack

A heart attack occurs when blood flow to the heart’s muscles becomes blocked, starving the heart of oxygen and damaging it. While chest pain is most commonly associated with a heart attack, pain can also radiate down the arms, to the jaw, or the mid-back, which may worsen with breathing.

After a heart attack, a cardiologist will monitor your heart and may prescribe treatment such as cardiac medications or cardiac rehabilitation to improve the functioning of your heart. If your heart attack was due to blockage in an artery, you may undergo a procedure in which a stent is surgically implanted to widen an artery. Another standard treatment after a heart attack is a cardiac bypass, in which a grafted artery is used to bypass the blocked artery to allow blood to reach the heart better.

Fractured Vertebra

Falls and traumatic injuries can cause fractures of the vertebrae of the spine. People with osteoporosis are more prone to vertebral fractures, even without significant injury, due to decreased bone strength. Symptoms include back pain that can increase with intra-abdominal pressure, such as coughing or sneezing, or movements like bending, lifting, and twisting.

For mild fractures, rest and physical therapy can promote healing, while more significant fractures need surgery to stabilize the spine.

When to Seek Emergency Care

Back pain is common, but sometimes it can result from serious conditions. You should see a healthcare provider if you experience back pain that worsens or does not improve after a few weeks. If you experience other concerning symptoms along with your back pain, you should see your healthcare provider immediately.

These include:

• Severe pain

• Numbness or tingling

• Chest pain and difficulty breathing

• Weakness and difficulty walking

• Unexplained weight loss

• Fever

Summary

Back pain that worsens with breathing can result from a variety of different conditions. Some are due to conditions or injuries to your muscles or bones, such as scoliosis, herniated discs, strained muscles, broken ribs, or fractured vertebrae.

Other times, pain can result from conditions that affect your internal organs, including lung cancer, pleurisy, pneumonia, pulmonary embolism, or heart attack. Treatment will vary depending on the underlying cause of your back pain. If your back pain does not improve after a few weeks and you continue to have pain with breathing, schedule a visit with your healthcare provider.

Read the original article on Verywell Health.