What can cause back pain while breathing?

Back pain while breathing is usually nothing to worry about. However, sometimes, it can be a sign of something more serious.

What can cause back pain while breathing?
Viktor Simunović, Dr.med.
Dr.med. Viktor Simunović
08 Mar 2024.

Experiencing back pain while breathing can be a disturbing symptom, often leading to questions and concerns about the underlying cause. Could it result from a simple muscle strain or indicative of a more severe condition, such as heart disease or a lung disorder?

While several potential explanations exist, the precise cause can vary significantly from person to person, depending on many factors.


Kyphosis, a spinal disorder characterized by an excessive outward curve of the spine, can also contribute to back pain during breathing. This abnormal curvature puts undue stress on the muscles and ligaments of the back, potentially leading to muscle strain. The constant strain can make everyday activities, such as breathing, painful due to the persistent pressure on the chest wall.


Scoliosis is a spine condition characterized by an abnormal, sideways curvature of the spine. It can trigger back pain because the curvature can stress your muscles and cause them to spasm.

Breathing can exacerbate this pain as the movement of the rib cage can put additional strain on the spine and surrounding muscles. Physical therapy is often recommended for managing scoliosis-related pain. This involves exercises to strengthen the muscles and improve posture, which can alleviate back pain.

Heart attack

Surprisingly, a heart attack can also cause back pain during respiration, as intense discomfort in the chest can radiate to other parts of the body. During a myocardial infarction, commonly known as a heart attack, the chest pain typically experienced can also cause pain in the back. This pain may intensify during breathing, making it harder for individuals to distinguish it from other potential causes of back pain. The referred pain is due to shared nerve pathways between the heart and the back.

The physiological stress of a heart attack combined with the strain of breathing may compound the back pain. Early recognition of these symptoms is vital for immediate medical intervention, potentially saving lives.


Obesity strains the back muscles excessively, leading to upper and lower back pain. The added weight can also cause postural changes that can hurt the back, particularly while breathing.

The back is a complex structure of bones, joints, ligaments, and muscles. When obesity provokes an imbalance in this system, it can lead to intense back pain while breathing. The causes of back pain are multifaceted, and obesity, with its myriad of compounding issues, is a significant contributor.

Lung problems

A significant proportion of individuals experience back pain while breathing due to lung-related issues, which can range from mild conditions such as bronchitis to more severe diseases like lung cancer.

These lung problems can induce pain during deep breaths due to the pressure exerted on the spinal cord. A persistent cough, often associated with these conditions, can exacerbate back pain by straining the muscles and ligaments around the spine.

Pulmonary embolism

Occasionally, back pain while breathing can indicate a more severe condition, such as a pulmonary embolism, characterized by a blockage in one of the pulmonary arteries in the lungs. This blockage, typically a blood clot, restricts blood flow, exacerbating the pain during inhalation due to the increased pressure.

Symptoms often include sudden, sharp chest or back pain, shortness of breath, and a rapid heart rate. The pain usually worsens with deep breathing, coughing, eating, or bending. Though it can mimic other conditions, a sudden onset of these symptoms necessitates immediate medical attention. One's lifestyle, genetics, prolonged immobility, and certain medical conditions like heart disease or cancer can increase the risk of developing a pulmonary embolism.


In addition to pulmonary embolism, pneumonia, an infection that inflames the air sacs in one or both lungs, can lead to back pain while breathing. The inflammation of air sacs due to pneumonia often results in fluid or pus build-up, which can cause discomfort or pain during breathing. The pain usually intensifies with deep breathing or coughing. The location of the pain varies depending on which part of the lung is infected. If the lower part of the lung is affected, it can cause referred pain to the back.

Intercostal neuralgia

Another potential cause of back pain when breathing is intercostal neuralgia, a condition characterized by damage or inflammation to the intercostal nerves that run between the ribs.

This condition can cause sharp, sporadic pain or a constant, dull ache that intensifies during deep inhalation or exhalation. The pain is typically felt in the upper back or at the side of the chest, mimicking heart problems, which can lead to misdiagnoses.

Intercostal neuralgia is often caused by an injury, surgery, or infection that affects the chest area. However, it can also be due to a nerve entrapment syndrome or a degenerative process like aging.

Soft tissue injuries

Soft tissue injuries, encompassing damage to muscles, ligaments, and tendons, significantly contribute to back pain experienced during respiration. These injuries, often the result of physical trauma or overuse, can lead to inflammation and swelling that exacerbates discomfort when breathing.

The intercostal muscles, significant to the breathing process, are susceptible to such injuries. When these muscles are strained or torn, the consequent pain can be amplified during respiration. Additionally, ligament or tendon injuries in the back can compromise the spine's stability, increasing pressure on the intervertebral discs. This can trigger pain signals during the expansion and contraction of the lungs.


In addition to soft tissue injuries, pleurisy - an inflammation of the pleura (the protective layers of tissue surrounding the lungs) - can also cause severe pain in the back during respiration.

This condition often results from viral or bacterial infections, autoimmune diseases, or certain medications. As the inflamed layers of pleura rub against each other during breathing, sharp, stabbing pain can be felt in the chest and back. This discomfort typically worsens during deep inhalations, coughing, or sneezing.

Pleurisy's distinct symptomatology aids in its identification, thereby facilitating prompt medical intervention.

Muscle strain

Muscle strain, particularly in the back, can significantly contribute to discomfort and pain when breathing, often resulting from overuse, improper use, or trauma. The muscles involved in the breathing process, including the intercostal muscles between the ribs and muscles in the lower back, can become strained and induce pain. Common triggers include heavy lifting, poor posture, or sudden movements, which may overextend or tear the muscle fibers.

This strain can create an inflammatory response, causing pain and stiffness. Due to the constant movement of these muscles, this pain and stiffness increase during the breathing process.

Anxiety disorders

Surprisingly, a considerable number of individuals experiencing back pain while breathing may be struggling with anxiety disorders, a psychological condition that can manifest itself through various physical symptoms. When anxiety levels rise, the body responds with a fight-or-flight response, leading to physical tension. This increased tension can cause the muscles in the back to tighten, resulting in discomfort or even pain when breathing.

Asthma and COPD

Your back pain while breathing could be caused by respiratory conditions such as asthma or Chronic Obstructive Pulmonary Disease (COPD). Both of these conditions can lead to discomfort in the chest and back due to the strain they place on the diaphragm and other breathing muscles.

Asthma, characterized by inflammation and narrowing of the airways, can cause a feeling of tightness in the chest, which may extend to the back.

COPD, a progressive lung disease that makes it hard to breathe, can cause similar symptoms. In severe cases, the struggle to breathe can lead to muscle fatigue and discomfort.

Fractured vertebra

Suffering a fractured vertebra can significantly contribute to back pain while breathing, posing a severe health challenge that necessitates immediate medical attention. This condition occurs when an excessive force or pressure is exerted on the spine, causing one or more vertebrae to break or collapse. The ensuing pain is often exacerbated during inhalation due to the interconnected nature of our skeletal system.

The fracture can disrupt the spine's normal alignment, resulting in nerve compression that manifests as sharp, radiating pain. Even slight body movements or deep breathing can induce discomfort with a fractured vertebra.

Bruised or broken rib

Another potential cause of back pain while breathing is a bruised or broken rib, an injury typically resulting from a direct blow or impact to the chest. This damage can be painful, and the discomfort is often amplified during inhalation due to the movement of the rib cage.

It is important to understand that such injuries not only cause localized pain but can also radiate towards the back. This rib-related back pain is typically sharp and may increase with coughing, sneezing, or upper body activity.

Herniated disc

In addition to rib-related injuries, a herniated disc is a common spinal condition that can manifest as back pain during breathing. This condition arises when the softer inner part of the spinal disc protrudes through a crack in the more rigid exterior casing. This bulging disc can then press on the nerves surrounding the spine, causing discomfort and pain, which may intensify during inhalation due to the motion of the upper body.

Depending on the affected nerve, the pain may radiate to other parts of the body, like arms or legs. The development of this condition can be attributed to factors such as aging, which naturally degenerates the spine, or to physical trauma caused by improper lifting or sudden movements.

When to see a doctor?

Immediate medical attention becomes crucial when this pain is accompanied by difficulty breathing, chest discomfort, sharp pain, or other alarming symptoms like fever, unexplained weight loss, and numbness or weakness in the legs.

Persons experiencing these symptoms should not hesitate to call for help. Timely intervention can prevent potentially severe outcomes and provide valuable peace of mind.

Treatment options

Addressing back pain during breathing involves a holistic approach encompassing various treatment methods tailored to the underlying cause and the individual's overall health.

Standard therapies include physical exercises, medication, and, in severe cases, surgery. Physical exercises, often recommended by physiotherapists, can help strengthen back muscles and improve posture. Medications like non-steroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants could be prescribed for temporary pain relief. In case of conditions like a herniated disc or spinal stenosis causing the pain, surgery may be considered.

Other complementary treatments, such as acupuncture or chiropractic care, can also be beneficial. Any treatment must be pursued under the guidance of a healthcare professional to ensure safety and effectiveness.

Watch for warning signs

To sum up, back pain while breathing can result from various conditions, from musculoskeletal issues such as scoliosis and herniated discs to systemic diseases like obesity and heart attacks. Respiratory conditions such as asthma and COPD also play a pivotal role. Understanding the underlying cause is vital for effective treatment, which calls for prompt medical attention, especially if the pain is severe or accompanied by other alarming symptoms.

If you are unsure whether the pain is from something serious, please book a consultation with our medical expert and remove any doubt.

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