Pain When Breathing
Chest or side pain that occurs or worsens with breathing
Quick Facts
- Type: Respiratory and chest symptom
- Common causes: Muscle strain, infection, pleurisy, lung conditions
- Key warning: Pain with breathlessness or palpitations
- Emergency: Sudden sharp pain with shortness of breath
Overview
Pain when breathing is chest, back, or side pain that appears or worsens as you breathe in or out, or when you cough, sneeze, or laugh. The pain may feel sharp and stabbing, like a catch in the chest, or dull and aching. Doctors often call sharp pain that worsens with breathing pleuritic pain, because it frequently involves the pleura, the thin lining around the lungs.
The causes range from harmless, such as a strained chest muscle, to serious and life-threatening, such as a blood clot in the lungs. Because some causes are emergencies, it is important to know the warning signs. Pain when breathing that comes on suddenly with shortness of breath, a fast heartbeat, or fainting needs immediate medical attention. The chest contains the lungs, heart, large blood vessels, the food pipe, and the muscles and ribs of the chest wall, so painful breathing can arise from any of these structures. The character of the pain, where it is located, what makes it better or worse, and how quickly it began all help point toward the cause and how urgent it is.
Common Causes
Pain when breathing can arise from the chest wall, lungs, or surrounding structures:
- Muscle or rib strain: Overuse, coughing, or injury to the chest wall muscles or ribs.
- Pleurisy: Inflammation of the lung lining causes sharp pain with breathing; see pleurisy.
- Respiratory infections: Pneumonia and other infections can inflame the lungs and chest.
- Pulmonary embolism: A blood clot in the lung is a serious cause; see pulmonary embolism.
- Pneumothorax: A collapsed lung causes sudden sharp pain and breathlessness.
- Asthma or other lung conditions: Can cause chest tightness and discomfort; see asthma.
Associated Symptoms
The symptoms accompanying painful breathing help indicate how serious it is:
- Shortness of breath or breathlessness
- Cough, which may bring up mucus or blood
- Fever and chills (suggesting infection)
- A fast or irregular heartbeat
- Pain spreading to the back, shoulder, or arm
- Lightheadedness, dizziness, or fainting
- Swelling or pain in one leg (which raises concern for a clot)
Sudden severe pain with breathlessness, a fast heartbeat, or leg swelling can indicate a pulmonary embolism and is an emergency.
Diagnosis & Evaluation
A doctor evaluates pain when breathing based on its features and risk factors:
- History and examination: Listening to the lungs and heart and checking the chest wall.
- Chest X-ray: To look for pneumonia, a collapsed lung, or fluid.
- Blood tests: To check for infection or clotting markers.
- CT scan: A CT pulmonary angiogram if a blood clot is suspected.
- ECG and oxygen levels: To assess the heart and breathing.
The evaluation is guided by how quickly the pain started and whether breathlessness or other red flags are present.
Treatment & Management
Treatment depends entirely on the cause:
- Muscle or rib strain: Rest, ice or heat, and over-the-counter pain relievers usually help.
- Pleurisy: Treating the underlying cause and using anti-inflammatory medication; see pleurisy.
- Infections: Antibiotics for bacterial pneumonia and supportive care for viral infections.
- Pulmonary embolism: Urgent treatment with blood thinners in a medical setting.
- Collapsed lung: May require a procedure to remove trapped air.
- Asthma: Inhalers and other medications to control symptoms.
Because some causes are emergencies, prompt evaluation is important when the pain is sudden or severe.
Self-Care & Prevention
- Stay up to date with recommended vaccinations, including flu and pneumonia vaccines
- Avoid smoking, which harms the lungs and blood vessels
- Move regularly and stay hydrated during long trips to reduce clot risk
- Warm up properly and avoid overexertion of the chest muscles
- Seek prompt care for respiratory infections that worsen
When to See a Doctor
Call emergency services immediately if pain when breathing comes on suddenly or is severe and is accompanied by:
- Shortness of breath or difficulty breathing
- A fast or irregular heartbeat
- Coughing up blood
- Lightheadedness, fainting, or bluish lips
- Swelling or pain in one leg
See a doctor promptly for painful breathing with fever, a persistent cough, or pain that does not improve, as it may signal an infection or other condition needing treatment.
Frequently Asked Questions
What causes pain when breathing?
Causes range from minor, like a strained chest muscle or rib, to serious, like pleurisy, pneumonia, a collapsed lung, or a blood clot in the lungs. Sudden severe pain with shortness of breath needs emergency care.
When is painful breathing an emergency?
Call emergency services if pain when breathing comes on suddenly or is severe with shortness of breath, a fast heartbeat, coughing up blood, fainting, bluish lips, or leg swelling. These can signal a pulmonary embolism or collapsed lung.
Can a pulled muscle cause pain when breathing?
Yes. A strained chest wall muscle or rib, often from coughing, exercise, or injury, commonly causes pain that worsens with breathing or movement. This type of pain usually improves with rest, but a doctor should rule out more serious causes if you are unsure.
Is pleurisy serious?
Pleurisy, inflammation of the lining around the lungs, causes sharp pain with breathing and is often due to an infection or other condition. It is treatable, but the underlying cause needs to be identified, so it should be evaluated by a doctor.
Should I worry about chest pain when breathing with a cold?
Mild discomfort from coughing is common with a cold. However, see a doctor if you develop fever, a worsening cough, or breathlessness, which can indicate pneumonia. Seek emergency care for sudden severe pain with shortness of breath.
References
- Mayo Clinic. Pleurisy and pulmonary embolism — Symptoms and causes.
- MedlinePlus, U.S. National Library of Medicine. Breathing difficulty and chest pain.
- American Lung Association. Pneumonia and lung health.
- Centers for Disease Control and Prevention (CDC). Venous Thromboembolism (Blood Clots).