6 Reasons Your Back Hurts When You Breathe

Experiencing back pain when you breathe can be concerning and disruptive to your daily life. This pain—ranging from a dull ache to a sharp, stabbing sensation—may occur between your shoulder blades or in the middle or lower back.

While it can sometimes be caused by something as simple as muscle strain, back pain with breathing could also indicate a more serious underlying condition involving the lungs or heart.

Understanding the cause of your back pain and working with your healthcare provider to find a solution can help you receive the right treatment and recover more quickly.

Understanding the cause of back pain with breathing is important for finding the right treatment or management strategies.

Muscle Strain

You can strain a muscle in your back when the muscles supporting the spine become overstretched or torn. This is often due to heavy lifting, sudden movements, or poor posture—though up to a third of people with a strained back muscle don’t recall any specific cause.

A muscle strain can lead to sharp or aching pain in the back, which may get worse when you breathe or move. The pain might feel like it’s coming from a specific spot in your back and can be accompanied by muscle stiffness and limited movement.

Activities that strain the back muscles, such as manual labor, sports, poor posture, or lifting objects that are too heavy, can increase the risk.

Asthma

Asthma occurs when your airways get inflamed, making breathing difficult. It may also cause chest tightness and back pain. The pain can feel like a tight, squeezing sensation in your back, especially during an asthma attack. Other symptoms include wheezing, coughing, and shortness of breath.

Asthma attack triggers include allergens, exercise, cold air, and stress. Risk factors include a family history of asthma and exposure to irritants like tobacco smoke.

Anxiety

Anxiety is a feeling of intense worry. It can cause muscle tension and fast breathing, leading to back pain when breathing. The pain might feel like a dull ache or tightness along the spine. You may also feel pain concentrated in an area of the upper or lower back or the neck area.

Other symptoms of anxiety include a feeling of pressure or heaviness in the chest, restlessness, rapid heartbeat, and difficulty concentrating.

Scoliosis

Scoliosis occurs when the spine curves abnormally to the side. This can change how your chest and back move, contributing to pain when you breathe. Depending on the severity of the curve, the pain might be a dull ache or sharp discomfort.

Other symptoms of scoliosis include uneven shoulders or hips, backache, lower back pain, and trouble breathing.

Scoliosis can be caused by spine changes present at birth, neuromuscular conditions (conditions that affect the nerves, muscles, or the communication between them), or unknown reasons. Risk factors include family history and age.

Fractured Vertebra

A fractured vertebra (bone in the spine) can result from trauma (like a car accident), osteoporosis, or cancer spreading to the bones. It can cause severe back pain that worsens while breathing. The pain may be sharp and focused on the fracture site. Swelling and bruising may also occur.

Other symptoms of a fractured vertebra include reduced mobility and potential nerve damage if the injury affects the spinal cord. Risk factors include older age, low bone density, and participation in high-impact activities.

Heart Problems

A heart attack, or myocardial infarction, can cause pain or discomfort in the back or neck. This pain can get worse when you breathe. It might feel like a crushing or squeezing sensation.

Other symptoms, such as chest pain, shortness of breath, cold sweats, and nausea, are often happening, too. Risk factors for heart attack include hypertension (high blood pressure), high cholesterol, smoking, diabetes, and a family history of heart conditions.

Less Common Causes

Other causes of back pain while breathing may include:

• Gastrointestinal issues: Stomach ulcers can cause pain that spreads to the back, which could intensify with breathing. Pain can last anywhere from a few minutes to a few hours.
• Lung cancer: Lung cancer typically causes chest pain, especially with breathing. However, some cases suggest you may also feel this pain as back pain. Other symptoms of lung cancer include a chronic cough, weight loss, and fatigue.
• Pulmonary embolism: A pulmonary embolism occurs when a blood clot blocks an artery in the lungs, leading to sharp, stabbing chest pain. You can sometimes have back pain that worsens with deep breaths, coughing, or physical activity.

Back pain while breathing is not always a cause for concern, and rest and self-care may improve symptoms. However, it’s important to have a healthcare provider evaluate your back pain if it doesn’t go away or improve or if it interferes with your life.

Certain symptoms may suggest that back pain is a sign of a more serious condition. Seek immediate medical attention if you experience symptoms such as:

• Burning with urination or blood in urine
• Severe pain following an injury
• Numbness or tingling
• Unexplained weight loss
• Loss of bladder or bowel control
• Unexplained fever
• Severe abdominal pain

If you experience any of these symptoms, it’s crucial to seek medical attention right away to receive appropriate treatment and help prevent potential complications.

Diagnosing the cause of back pain with breathing involves a thorough evaluation by a healthcare provider, which typically includes several steps.

Medical History and Physical Exam

Your provider will likely ask about your medical history, including recent injuries, illnesses, or chronic conditions. They will also ask about the specifics of your pain, such as when it started, what it feels like, and what makes it better or worse.

Your healthcare provider may then perform a physical exam to assess your posture, range of motion, and areas of tenderness. They may ask you to perform certain movements to determine how the pain is affected.

Imaging Tests

Depending on the initial evaluation, the provider may order imaging tests to better understand the cause of the pain. Common imaging tests include X-rays, magnetic resonance imaging (MRI), and computed tomography (CT) scans.

Other Testing

Your provider may request additional testing depending on what they suspect is causing your pain. Potential tests may include:

• Blood tests: These can help check for signs of infection, inflammation, or other underlying conditions that could be causing the pain.
• Pulmonary function tests: If your provider suspects a lung condition, they may perform pulmonary function tests to assess your lung capacity and function.
• Electrocardiogram (ECG): If heart conditions could be the cause, your provider may request an ECG, which records your heart’s electrical activity, to check for heart-related causes of chest and back pain.

Accurate diagnosis of the underlying cause of back pain is essential for the most effective treatment approach. Consult a healthcare provider to determine the best treatment method based on your specific situation. They may recommend at-home treatments or other strategies.

Depending on the cause of your pain, treatments may include:

• Stretches and exercise
• Over-the-counter (OTC) pain relief medication
• Hot or cold therapy
• Proper posture
• Prescription muscle relaxants
• Relaxation techniques, counseling, or anti-anxiety medications
• Scoliosis bracing
• Anticoagulants or blood thinners for pulmonary embolism
• Surgery

Addressing underlying conditions such as gastrointestinal issues, lung cancer, or respiratory problems is also crucial and may involve medications, lifestyle changes, or specialized treatments tailored to the specific condition.

Experiencing back pain when you breathe can be alarming and disruptive to your daily life. The pain can range in intensity and may be caused by various underlying conditions, such as muscle strain, asthma, anxiety, scoliosis, or even heart problems.

Understanding the potential causes and addressing the pain can help you find relief. Persistent, severe, or recurring back pain with breathing is serious, and you should talk with a healthcare provider to determine the best course of action and help prevent potential complications.