The pain in the back when breathing


Breathing pain is very disturbing. Since breathing in is done actively through muscle work, while breathing out is mainly done by relaxing the respiratory muscles, breathing pain occurs more intensely when breathing in. Coughing, sneezing, or laughing make the pain worse.

Breath-dependent pain can also occur in the back or radiate to the back. The cause is often harmless. Tension and blockages are common causes.

The reasons

The causes of breath-dependent back pain are very different. Often the cause is not dangerous. There is tension, blockages or intercostal neuralgia (a form of nerve pain). This pain is also dependent on movement. The pain becomes worse as you inhale, sneeze, and laugh. In some cases, a fracture of a vertebral body can also make itself felt in this way. In old age, vertebral body fractures can occur even without major force.

Another harmless cause is overuse of the chest due to infectious diseases, which are accompanied by a lot of coughing. Pleurisy - an inflammation of the connective tissues that surround the lungs - can also lead to breathing-dependent pain in the back.

Find out all about the topic here: Painful breathing.

The rib block

A rib block is the restriction of the mobility of a rib joint. The limited mobility can cause pain when sneezing, laughing, etc.

Although blockages are not bad, those affected severely limit their quality of life. Rib blockages are caused by bad posture. As a rule, the blockage unblocks itself again.

How can you resolve a rib block? Read more about this here.

The intercostal neuralgia

Intercostal neuralgia is also colloquially referred to as a pinched nerve. The pain increases with deep breaths. Furthermore, they are dependent on movement. The pain in intercostal neuralgia comes from nerves. Therefore, unlike muscle pain, they feel burning, stabbing, or tingling. The pain is usually one-sided.

Intercostal neuralgia can be accompanied by abnormal sensations and can be caused by various diseases. Shingles is a common trigger.

Find out more about the topic here: Intercostal neuralgia.

The heart attack

During a heart attack, the heart muscles are insufficiently supplied with oxygen. Classically, a heart attack results in pain in the chest region that pulls into the left arm. In women, the pain is often localized in the upper abdomen. The pain can also radiate from the arm to the back.

A heart attack often causes shortness of breath, but the pain itself is not necessarily influenced by breathing. If a heart attack is suspected, a doctor should be consulted immediately.

Heart Attack Symptoms? Find out more here.

The pulmonary embolism

Pulmonary embolism is a very serious condition. A pulmonary artery is blocked. In addition to shortness of breath, breathing-dependent pain occurs. However, these do not necessarily have to be located in the back. If the main branches of the blood supply are blocked, cardiac arrest can occur. Those affected then have to be resuscitated and taken to hospital as quickly as possible.

More information on the subject Pulmonary embolism you'll find here.

Other accompanying symptoms

The accompanying symptoms are important to differentiate between the many possible different causes.

In the case of the underlying infectious disease, patients suffer not only from breathing difficulties, but also from general exhaustion, fever, limb pain, headache and cough. With breath-related pain caused by problems in the ribs, deep breathing, coughing, and sneezing make the pain worse.

With muscular problems, blockages, vertebral body fractures or intercostal neuralgia, few accompanying symptoms occur. As a rule, the mobility of the spine is limited due to the pain. With a pulmonary embolism, shortness of breath, cough, fever and, under certain circumstances, a blue discoloration of the lips occur. A heart attack is usually accompanied by shortness of breath in addition to the pain. Furthermore, there is fear of death, sweating and restlessness

The heartburn

Heartburn typically causes a burning sensation behind the breastbone. In severe cases, the pain can also radiate further - to the back. The back pain in heartburn is not breath-dependent, but occurs in conjunction with the other classic symptoms of heartburn. The symptoms mainly persist after eating.

Read more on this topic at: The heartburn.

The diagnosis

A doctor does a physical examination in which, on the one hand, the lungs are auscultated in order to check breathing. Furthermore, the spine is examined for mobility and pain in order to detect possible misalignments, blockages or fractures. In many cases, a detailed description of the symptoms to the doctor and a physical examination are sufficient to identify the cause of the pain in the back when breathing.

If a serious illness such as a pulmonary embolism or a heart attack is suspected, further tests such as a blood test or an EKG must be carried out. If the suspicion cannot be ruled out, a hospital must be visited for further clarification and treatment.

The treatment

The therapy depends on the cause of the back pain.

Intercostal neuralgia can be relieved by applying heat. You should also rest in a relaxed position. If this is not enough, manual therapy can also be used. Manual therapy can also be used for a rib block. In addition, you should keep moving in case of a blockage - but of course don't overdo it. In order to prevent blockages, bad posture and painful tension, you should ensure sufficient exercise and correct posture in everyday life.

If you have a heart attack or pulmonary embolism, go to a hospital immediately. If you have a pulmonary embolism, you will be given oxygen, pain relievers, and a blood-thinning drug. A severe pulmonary embolism can lead to cardiac arrest and resuscitation must be performed.

You might also be interested in these topics:

  • The therapy of a heart attack
  • The therapy of a pulmonary embolism


Overall, the prognosis is pretty good. The duration and prognosis of the pain depend on the cause.

In the case of tension, blockages and intercostal neuralgia, the symptoms usually pass over a period of a few days. In the case of pain due to pleurisy or overuse from coughing during an infection, it takes time for the infection to subside. During this time you should take it easy.

A heart attack or pulmonary embolism are serious illnesses that require immediate treatment, as they can otherwise be fatal. Depending on the extent and response to therapy, the prognosis can be very good.