Reading Time: 13 min read 
Published: 11/01/2024 
Last Updated: 13/03/2024 
Back pain at any time can be frustrating, but when you get upper back pain when breathing and moving, it can quickly take its toll on your quality of life. You might find it becomes more difficult to get up and move around, which can actually make the problem worse.
Lots of different health conditions can cause upper back pain when breathing and moving. Sometimes these will clear up by themselves in a few days, while others need urgent medical treatment.
In this article, we explore all the major possible causes of upper back pain when breathing, how you can diagnose your back pain, and which treatments are available for each condition.
What can cause upper back pain when breathing and moving?
Back pain is a very common complaint. It’s estimated that up to 34.8% of people have upper back pain that lasts around one year [1]. For many people, symptoms can clear up more quickly than this — but you’ll often need to find the right treatment.
Here are 13 major causes of upper back pain that can interfere with your daily activities.
1. Muscle strain
Injury and muscle overuse are among the most common causes of back pain. Even the gentle rising and falling of your chest when you breathe can stretch your back muscles, so injuring a muscle in your back can cause pain when you breathe or move.
Symptoms of muscle strain
- Sudden upper back pain when lifting, exercising, or otherwise exerting yourself.
- Reduced range of motion in your back and upper torso.
- Muscular spasm.
- Pain when walking or moving.
Treatments for muscle strain
- Rest — Give your body a chance to recover by stopping exercise for at least a few days.
- Ice — Applying a cold compress to the upper back can reduce any inflammation causing additional pain.
- NSAIDs — Non-steroidal anti-inflammatory drugs like ibuprofen can also reduce inflammation and help with pain management.
- Gentle reintroduction to exercise — After resting for as long as needed, restart your exercise programme gently, especially if it involves weight training. Seek support from a private physiotherapist if you’re unsure about getting back into training after a back injury.
2. Chronic cough or chest infection
A persistent or severe cough can strain your back and core muscles, leading to painful sensations when you breathe. Some research also shows that violent coughing can lead to nerve root irritation in your back, which may manifest as sciatica or other types of lower back pain [2].
Symptoms of a chest infection
The most common symptom is ongoing severe coughing (even after you’ve recovered from a chest infection). Other chest infection symptoms can include chest tightness when breathing, coughing up phlegm or mucus, and fever.
Chronic cough and chest infection treatments
Controlling your coughing is the best way to reduce coughing-related back pain. If you have a chest infection, you’re normally advised to:
- Rest and drink plenty of water.
- Keep your head propped up while you sleep.
- Manage your fever and any aches or pains with over-the-counter painkillers.
If there’s another reason for your persistent or painful coughing, speak to a doctor about diagnosing and treating your underlying condition.
3. Asthma
Asthma is a lung condition that can make breathing more difficult. Studies show that having asthma can put you at greater risk of developing both upper and lower back pain [3]. This may be linked with the effect of asthma on coughing, posture, and airflow through your airways.
Symptoms of asthma
- Wheezing and chest tightness (this can happen at any time, but may have specific triggers like allergies or cold weather).
- Coughing.
- Breathlessness.
- Asthma attacks (being too breathless to speak, rapid heartbeat, confusion, drowsiness, blue lips or fingers).
Treatments for asthma
Asthma attacks can be life-threatening, so if you suspect you have asthma (or are having an asthma attack) you must seek urgent treatment.
Most people with asthma can control it using inhalers and, in more severe cases, tablets like leukotriene receptor antagonists or steroids.
4. Chronic obstructive pulmonary disease (COPD)
COPD is a group of conditions including emphysema and chronic bronchitis that affect your lungs and breathing. Like asthma, COPD can cause general back pain (both lower and upper), as well as back pain when breathing and moving [4-5].
COPD is more common in long-term smokers. Studies suggest women, those with poor mental health, and people who experience frequent headaches or migraines may be at greater risk of developing back pain alongside COPD [5].
Symptoms of COPD
COPD symptoms may start off mildly and get worse over time. Common symptoms include:
- Shortness of breath.
- Persistent chesty cough.
- Chest infections.
- Wheezing.
Treatments for COPD
Seeking treatment early can help you better manage symptoms of COPD. If you’re a smoker, stopping smoking is the best way to pause and reduce symptoms.
Other treatments include inhalers and tablets to control wheezing and make breathing easier. Antibiotics can treat bacterial chest infections. In severe cases, oxygen therapy or surgery may be recommended.
5. Anxiety and panic attacks
Mental health conditions are often linked with more severe or persistent back pain [6]. Panic attacks (which are often triggered by episodes of intense anxiety) can cause you to breathe more quickly (hyperventilate), which might intensify your back pain.
Symptoms of anxiety and panic attacks
- Chest pain.
- Breathing problems and hyperventilating.
- Rapid heartbeat and/or heart palpitations.
- Feeling dizzy.
- Difficulty controlling your thoughts.
Treatments for anxiety
Short-term relief from panic attacks includes self-reassurance (or reassurance from those around you), and taking slow, deep breaths. Regulating your breathing can reduce the pain intensity in your back, and help you feel less anxious.
Longer-term anxiety treatments include therapy, meditation, stress reduction techniques, and anti-anxiety medication.
6. Pleurisy
Pleurisy is inflammation in the lining of your lungs, which causes sharp chest pain (and, less often, back pain) when you breathe in, move, sneeze, or cough.
Pleurisy isn’t always serious, but it can be if it’s a symptom of a more dangerous underlying problem like pneumonia. Symptoms are similar to those of a heart attack, so if you’re unsure which you have, seek urgent medical treatment.
Pleurisy symptoms
- Sharp pain in the chest.
- Chest pain that stops if you hold your breath for a few seconds.
- Pain that spreads to the shoulders and back.
- Shallow breathing.
Pleurisy treatments
Pleurisy often gets better by itself without treatment. But if your symptoms persist, check in with a doctor, as there may be an underlying infection you need to treat.
7. Bone fracture
Fracturing a bone in your spine or ribs can cause a lot of pain when breathing, especially if the bone is impacting your lung(s). Fractures are usually caused by trauma, injury, osteoporosis, infection, or other bone diseases [7].
Symptoms of a bone fracture
- Sudden onset of pain (often after a specific trigger or incident like a car crash).
- Neck pain.
- Muscle spasms.
- Back stiffness.
- Numbness or shooting pains in the legs and hips (if the fracture is pressing on your sciatic nerve).
- Limb paralysis (in severe cases).
Treating bone fractures
Some bone fractures can be treated conservatively (i.e. with painkillers, light activity, and physiotherapy).
In more severe cases, you may need to wear a brace to help the bones reset and heal. Some people also need injections and/or surgery to manage the pain and heal their fractures.
8. Scoliosis
Scoliosis is a back and spine condition that causes the spine to curve to one side. It can affect people of any age, but studies suggest it has a prevalence of 1-2% among teenagers, rising to more than 50% in those over 60 [8].
Adults with scoliosis often experience back pain, including when breathing and moving. Scoliosis is one of the causes of lower back pain in females and can also be felt at rest, especially if your spine is very curved or twisted. People with curvature of 80° or more might also find their breathing is more restricted.
Symptoms of scoliosis
- Spine that curves to one side.
- Leaning to one side involuntarily.
- One shoulder dips more than the other.
- Ribs are more visible on one side of the body.
Scoliosis treatments
- Physiotherapy.
- Back brace (more common in children, who may need to wear it until they stop growing).
- Painkillers.
- Steroid injections for back pain management.
- Surgery (in rare cases).
9. Heart problems
Serious health problems like heart attack and pulmonary embolism (a blood clot that prevents blood flow to the lungs) can cause back pain when breathing. However, you’re likely to feel other more painful symptoms if you’re experiencing a heart problem or blood clot.
Heart attack symptoms
- Acute, severe chest pain (this may feel like tightness, pressure, or a squeezing motion across your chest).
- Pain that spreads from the chest to the arm(s), jaw, neck, back, and stomach.
- Feeling dizzy.
- Shortness of breath and wheezing.
- Feeling panicked.
Pulmonary embolism symptoms
- Sudden shortness of breath.
- Difficulty breathing.
- Chest pain that gets worse when you breathe in.
- Coughing up blood.
Treatments for heart problems
Both heart attacks and pulmonary embolisms are medical emergencies. Seek immediate treatment if you think you might have either of these conditions.
If you go into cardiac arrest (i.e. your heart stops), someone may be able to perform cardiopulmonary resuscitation (CPR) on you to keep your heart working until emergency services arrive.
10. Obesity
Being obese (i.e. having a body mass index of 30 or more) can put you at higher risk of back pain [9-10]. One study found that 52% of obese patients experienced upper back pain, while 63% had lower back pain [10].
Carrying too much weight around your back, neck, and stomach can also lead to breathing problems, including breathlessness, sleep apnoea, and discomfort in your back when breathing.
Symptoms of obesity
Having a body mass index (BMI) of 30 or more is the most common clinical way to establish obesity. Calculate your BMI using the NHS’s BMI calculator [11].
You might also feel an impact on your day-to-day mobility, such as:
- Shortness of breath.
- Sweating excessively.
- Difficulty doing exercise and other physical activities.
- Back pain.
- Pain in your feet and ankles.
Treating obesity
Losing weight through a combination of diet and exercise is the first-line treatment for obesity. In more severe cases, medication (such as weight loss injections Wegovy or Mounjaro) and/or weight loss surgery may be recommended.
11. Lung cancer
Lung cancer is a rare cause of back pain when you breathe, but it’s important to be aware of the symptoms so you can seek treatment at the earliest possible time. Back pain may indicate that the cancer has spread to your spine [12-13].
Lung cancer symptoms
- Persistent cough.
- Breathlessness.
- Unexplained or unintentional weight loss.
- Persistent chest infections.
- Coughing up blood.
- Swelling in your face.
Treatments for lung cancer
Lung cancer is normally treated using a combination of medication, radiotherapy, chemotherapy, and surgery. The earlier you’re treated, the higher your chances of recovery. So make an appointment as soon as you can if you suspect you might have lung cancer.
12. Pneumonia
Pneumonia is a bacterial, viral, or fungal infection of the lungs. It causes the air sacs in your lungs to become inflamed and fill with fluid, which can restrict your breathing. Studies have shown pneumonia can lead to back pain alongside breathing difficulties [14].
Pneumonia symptoms
Pneumonia can be mild to moderate to life-threatening. Keep an eye on your symptoms so you know if you need more urgent care.
Symptoms include:
- A productive cough.
- Breathlessness, even at rest.
- Chest, stomach, or back pain that gets worse when breathing and/or coughing.
- Fever, sweating, and chills.
Pneumonia treatments
Treatment depends on the cause of your pneumonia. Antifungal medications and antibiotics may help if the cause is fungal or bacterial respectively. Viral pneumonia can clear up on its own with plenty of rest, fluids, and home care.
You might need hospital treatment if your symptoms are severe.
13. Collapsed lung
Lung collapse (also known as pneumothorax) happens when air leaks out of your lung into your chest cavity. It can happen as a result of trauma to the chest or back, as well as underlying conditions like COPD or leakage from a blister on the lung.
Symptoms of a collapsed lung
Back or chest pain when breathing is one of the most significant symptoms of a collapsed or punctured lung. You might also find your pain gets worse when coughing or sneezing.
Coughing is common with a collapsed lung. But unlike pneumonia, pleurisy, and other conditions, your cough is likely to be dry and non-productive.
Treatments for a collapsed lung
Not all collapsed lungs need active treatment. Small air leaks may heal by themselves within a couple of weeks. More serious cases might need surgery to repair the lung.
Signs you may need urgent treatment for back pain when breathing
If you have any of the following symptoms alongside back pain when breathing, it’s a good idea to seek urgent treatment. That’s because these could indicate a lack of oxygen or a heart problem that needs immediate attention:
- Sharp stabbing chest pains.
- Difficulty breathing.
- Feeling so breathless at rest that you can’t speak.
- Coughing up blood.
- Blue lips and/or fingers.
Diagnosing back pain when breathing and moving
While some upper back pain conditions have an obvious underlying cause, many require diagnostics and imaging services to discover what’s making it painful to breathe.
Common diagnostics for back pain include:
- X-rays.
- MRI scans.
- CAT scans.
You’ll also be asked about your medical history and lifestyle habits (such as whether you’re a smoker, ex-smoker, or non-smoker) and when your symptoms started.
How can I tell if my back pain is lung-related?
Muscular back pain is usually dull or achy in nature, whereas lung-related back pain is more likely to be sharp and acute. However, the only way to tell for sure is to get a diagnosis.
Urgent treatment for lung-related problems is often available on the NHS. But if your back pain is deemed non-urgent — even if it hurts to breathe — you might be waiting a while for treatment. That’s why many people turn to private pain management units like Harley Street Specialist Hospital for faster treatment.
Is back pain a symptom of a lung tumour?
In most cases, no. However, it can be, especially if you have other symptoms like unexplained weight loss and facial swelling. Imaging tests can help rule out more serious causes of back pain.
Can a pulled muscle in the back make it hard to breathe?
Yes. Breathing uses lots of muscles in your chest, abdomen, and back. Pulling one of these can make even the slight motion of breathing more difficult.
However, other symptoms can indicate a more serious underlying cause. If your breathlessness gets worse, seek immediate medical help.
Treating back pain at Harley Street Specialist Hospital
Discovering the cause of your back pain when breathing and/or moving is essential to finding the right back and spine treatment.
To establish the cause, book an appointment at Harley Street Specialist Hospital. Our extensive pool of doctors, physiotherapists, and pain management consultants can help you diagnose and treat your condition, reduce your upper back pain when breathing, and get you back to feeling healthier and fitter.
