Having back pain and trouble breathing can be particularly concerning, especially if you’re unsure about the cause. Here are some potential reasons why back pain and shortness of breath may occur together, as well as when to see a doctor. Show
Intercostal muscle strainIf one or more of the intercostal muscles are strained, breathing may become more difficult as the pain can worsen while the rib cage expands and contracts. Read: Upper Back Pain from Intercostal Muscle Strain The intercostal muscles run between adjacent ribs and play an important role in expanding and contracting the rib cage when breathing. If one or more of these muscles are strained along the back, the symptoms can range from a mild tenderness or stiffness to intense, sharp back pain. Breathing may also become more difficult as the pain can worsen while the rib cage expands and contracts. See Intercostal Muscle Strain Symptoms and Diagnosis An intercostal muscle can be strained in various ways, such as:
See Causes of Intercostal Muscle Strain An intercostal muscle strain typically starts to feel better within a few days and fully heals within 6 to 8 weeks. To help manage the initial pain, which may be severe, some people find relief from ice, heat packs, or over-the-counter pain medications. It is also advised to modify or reduce activities for a few days to protect the strained muscles from further injury. If the pain is severe, prescription medication may be required after evaluation by a physician. See Treating Intercostal Muscle Strain Severe kyphosisWhen the thoracic spine is curved at least 50 degrees, it is commonly referred to as kyphosis. If the condition progresses, it may cause trouble with breathing, walking, and other basic functions. Read: Thoracic Kyphosis: Forward Curvature of the Upper Back A healthy thoracic spine (upper back) is slightly curved forward, which is called a kyphotic curve or kyphosis. However, if the thoracic spine is curved at least 50 degrees, it is considered hyperkyphosis, also commonly referred to as kyphosis. If a patient is still growing, kyphosis is commonly treated with a brace in an effort to prevent it from progressing to the point of causing troubles with breathing, walking, and other basic functions. Special exercises to improve posture may also be advised to help prevent kyphosis from worsening. If kyphosis has progressed to the point of causing breathing troubles, surgery may be needed. See Kyphosis Causes and Treatment Other potential causesSome other causes of back pain with breathing troubles include:
Other potential causes of back pain and breathing problems that can be quite serious include infection and/or blood clots. When to see a doctorAny unexplained shortness of breath or breathing problems need to be evaluated by a medical professional. Additionally, seek medical attention if back pain does not go away on its own within a couple weeks or if other troubling signs are present, such as pain that radiates to the chest, or any tingling, numbness, or weakness that persists. Learn more:Upper Back Pain Symptoms All About Upper Back Pain It’s normal for people to experience occasional pain in their back. It could be due to muscle strain from throwing out your back or from an injury that may resolve on its own, but sometimes it can represent a serious underlying problem. For instance, if you have pain in your upper back or around the shoulder blades, that may indicate an underlying lung condition. Sometimes lung pain can also manifest as chest pain or back pain. Where Are The Lungs Located on The Back?The lungs are located in the chest cavity between the heart and the spine. They are a delicate yet vital organ of the respiratory system and are vulnerable to a range of illnesses. The pair of spongy organs are lined by a thin membrane called the pleura, which helps protect and cushion the lungs. They are housed inside the ribcage for protection, with the top of the lungs located just above the collarbones. The following symptoms are warning signs that you may have a lung condition, infection, or disease.
Potential CausesLung problems are relatively common and can be caused by simple infections or allergies. But sometimes lung problems can be caused by more serious illnesses like tumors or bleeding. If you have lung pain that extends to the back, this may be due to pleurisy, pneumonia, or other serious medical conditions. If left untreated, some of these issues can lead to severe breathing problems, so it’s critical to identify the underlying cause of your symptoms. InjuryAn injury to the lining of the lung can cause pain in the chest, and in some cases, in the back. For example, an injury to the lungs like a gunshot, knife wound, or fracture, can cause a lung to collapse. Although the more common symptoms of a collapsed lung include sharp chest pain and shortness of breath, severe cases may also cause back pain. To diagnose a collapsed lung or other lung injury, your physician may order a chest x-ray or CT scan. InfectionThere are a number of viral infections and bacterial infections that can cause lung issues. Two common health complications that often occur because of lung or chest infection are bronchitis and pneumonia. In severe cases, these infections can cause back pain. Acute bronchitis is inflammation of the breathing tubes and can be caused by a viral infection, like from a cold or flu virus. It can also be caused by a bacterial infection, in which case your doctor or health care provider would likely prescribe antibiotics for treatment. PneumoniaPneumonia is an infection of one or both of the lungs that causes air sacs to fill up with fluid or pus. It’s a complication that arises from bacterial, viral, or fungal infections—though bacterial infections are the most common cause. There are several types of bacteria that can cause pneumonia, and it’s possible for a bacterial infection to develop after getting certain viral infections, like the common cold. Certain groups of people may be susceptible to developing pneumonia, like infants under the age of two, adults over the age of 65, people who are immunocompromised, and smokers. Symptoms of pneumonia include:
In severe cases, chest pain can radiate towards the shoulders and the back. While some mild cases of pneumonia can clear up on their own, anyone who is experiencing moderate to severe symptoms should seek medical care as soon as possible. ScoliosisScoliosis is a condition that creates an abnormal curvature of the spinal column. Most people with scoliosis begin experiencing symptoms during adolescence. It’s a progressive condition that tends to worsen as you age. While mild cases may be asymptomatic, more severe cases can cause persistent and worsening back pain. In cases of severe scoliosis, the angle of the spine can create chest pain and even negatively impact lung function. If the spine’s curvature is angled in a way where it presses against the ribcage, that can create uncomfortable pressure against the heart and the lungs. Symptoms of scoliosis include:
If you suspect you have scoliosis, getting a proper diagnosis is important. Left untreated, it’s likely that the condition will worsen and lead to greater health complications, such as respiratory failure, later in life. Although there isn’t a cure for scoliosis, there are treatments that may help prevent the condition from worsening. Pulmonary embolismWhen a blood clot occurs in the body, a piece of that clot can break off and travel to another area of the body. That traveling clot is called an embolus. The pulmonary embolus can then lodge itself into a blood vessel and cut off blood supply to an organ, like the lungs. When a blood vessel that is attached to the lungs is blocked by an embolus, that is called a pulmonary embolism. The most common symptom of a pulmonary embolism is shortness of breath, but it can also cause pain throughout the chest, upper back, and lower back. Pulmonary hyperinflationPulmonary hyperinflation occurs when air gets trapped in the lungs and cannot empty efficiently, causing them to overinflate. This may happen because of airway blockages or poor working air sacs in the lungs. Pulmonary hyperinflation is common in respiratory conditions like chronic obstructive pulmonary disease (COPD) and emphysema, and can cause upper back and lower back pain. Common symptoms of pulmonary hyperinflation include:
PleurisyPleurisy is a condition characterized by inflammation of the pleura, a membrane that lines the lungs within the chest cavity. A few causes of pleurisy include lung infection, pulmonary embolism (blood clot), connective tissue disorders, and lung cancer, with the one of the most common causes of pleurisy being pneumonia. Depending on its cause, pleurisy may create complications like fluid buildup in the space between the lungs and chest wall, called a pleural effusion. A person may also experience difficulty breathing. Common symptoms of pleurisy to look out for are:
Pleurisy usually causes sharp chest pain, which can sometimes spread to the shoulders and to the back. To treat pleurisy, your doctor will need to run diagnostic tests—like chest x-rays, CT and MRI scans, ultrasounds, and blood tests—to understand the underlying cause. Depending on the cause, treatments can include antibiotics for bacterial infections, anti-inflammatory drugs for connective tissue disorders like rheumatoid arthritis, or anticoagulants for blood clots. AtelectasisAtelectasis is when the lung’s air sacs are unable to fill up with air. This could be due to an airway blockage or an injury that causes the lung to collapse. In minor cases where only a small area of the lung is affected, you may not experience any symptoms. But if a larger area of the lung is affected, atelectasis can cause fever, shallow breathing, wheezing, or coughing. In severe cases, you may even experience sharp chest pain that radiates to the shoulders or the back. Lung CancerIf you struggle with back pain, lung cancer may be one of the last things that you suspect as the underlying cause. This was the case for a 68-year-old former smoker that struggled with back pain, only to eventually be diagnosed with non-small cell lung cancer. MRIs confirmed that a lung tumor was pressing against the spine, causing spinal cord compression. This resulted in severe back pain, numbness in the legs, and difficulty walking. Because of cases like these, the American College of Physicians guidelines for diagnosis and treatment of low back pain have changed, recommending more involved investigations into the cause of back pain when certain high-risk factors are involved. These factors include a history of osteoporosis, history of cancer, weight loss, older age, fevers, neurological conditions, and pain that doesn’t improve after one month. Back pain can happen with lung cancer for a number of reasons. According to this study, cancer spread (metastasis) from the lungs to the bones occurs in approximately 30-40% of cases. Another study reported that leptomeningeal metastasis (when cancer cells spread to the thin layers of tissue that cover the cervical and spinal cord) is present in 1-5% of patients with tumors. This is a late-stage complication that can cause severe back pain and weakness if the spinal cord is affected. Back pain can be a symptom of lung cancer, but it isn’t necessarily a common sign. Since the disease can manifest in many different ways, signs of lung cancer will vary from person to person. Common symptoms of lung cancer include:
Cancer diagnosis can be difficult because the symptoms of lung cancer can occur with many other illnesses too. If you are experiencing these symptoms, it’s a good idea to talk to your doctor—especially if symptoms persist or worsen. Heart AttackA heart attack happens when blood flow to the heart is blocked. Without blood, the heart’s muscle tissue loses oxygen and begins dying. This is a serious condition that can be fatal and requires immediate medical attention. The sooner a person gets to the emergency room, the better their chance of survival. If you experience these heart attack warning signs, don’t wait to get medical help:
Feeling Lung Pain on One Side?Sometimes you may feel lung pain on only one side of your body. If you are feeling lung pain on your right side, the underlying cause could be:
If you’re feeling pain on just the left side of your body, you could be experiencing one of the conditions that commonly affects the right lung. However, it’s important to note that heart conditions, like heart attack and stroke, are more likely to cause pain on the left side of your body. This is due to the heart’s location, which lies slightly to the left and behind your breastbone. When to See a DoctorSince back pain is so common, it can be easy to ignore the pain and any mild accompanying symptoms. However, it’s always a good idea to talk to your doctor about any pain you are experiencing. Sometimes symptoms that don’t “seem all that bad” could be warning signs of a serious condition. If you’re experiencing the following symptoms, you should seek medical attention as soon as possible, as you may have a medical emergency:
How K Health Can HelpDid you know you can access online urgent care with K Health? Check your symptoms, explore conditions and treatments, and if needed, text with a healthcare provider in minutes. K Health’s AI-powered app is HIPAA compliant and is based on 20 years of clinical data. Frequently Asked QuestionsCan lung pain be felt in the back? Yes, sometimes chest pain from lung conditions can radiate to the shoulders, neck, and back. Where is the lung pain felt in the back? Due to the location of the lungs, most lung conditions cause pain in the upper-to-middle regions of the back. It's not unheard of for some lung conditions to cause lower back pain, but it is much less common. Can you feel a lung infection in your back? Yes. Severe infections can cause the pain to travel to other regions of the body, including the back. Does COVID-19 give you back pain? Research shows that body aches and pain are a common symptom of COVID-19, particularly in the early stages of contracting the virus. When it comes to back pain, it seems that the lower lumbar region is more commonly affected. K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
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