Our bodies can certainly be mysterious—and aches and pains are some of the confusing signs they can send. But what does it mean when you have back pain with deep breaths? Dr. Erik Ekstrom, a back, neck and spine specialist at Summit Orthopedics, explains some possible reasons from an orthopedic perspective.
First, a caveat: Back pain with deep breaths is not always an orthopedic issue. It could be anything from a sign of a heart problem to a gastrointestinal issue to a symptom of anxiety.
“Deep breaths can shift internal organs like the kidneys and intestines, causing discomfort,” Dr. Ekstrom says. “They could also be signs of problems with the lungs.”
For those reasons, it is important to rule out nonorthopedic causes. In this blog, we’ll outline why your back may hurt when you breathe to help you figure out what to do next.
Should I Go to the ER If My Back Hurts When I Breathe?
Not all back pain when breathing requires a visit to the ER, but in some cases, it is a sign of a life-threatening medical emergency, such as a heart attack or a pulmonary embolism. In those cases, you should not drive yourself to the ER. Instead, call 911.
Back pain when breathing might be a sign of a heart attack if it occurs with any of these warning signs:
- Dizziness, sweating or nausea
- Pain that spreads into your jaw, neck or down either or both arms
- Shortness of breath
- Sudden chest pressure, tightness or a squeezing sensation
A pulmonary embolism happens when a blood clot breaks free and blocks an artery in your lungs. Call 911 if your back pain appears suddenly alongside:
- A rapid or racing heart rate
- Persistent coughing, with or without blood or pink, frothy phlegm
- Sharp chest pain that gets worse when you cough or move
- Sudden, severe difficulty catching your breath
Other Medical Conditions That Cause Back Pain With Deep Breaths
Certain lung conditions can also cause pain when you breathe. They don’t necessarily require a visit to the ER, but they do warrant a visit to your doctor.
- Pleurisy: This is inflammation of the lining around your lungs and chest cavity. When you inhale, the swollen lining tissue rubs together, causing sharp pain in your chest that may spread to your back or shoulders.
- Collapsed lung (pneumothorax): This occurs when air leaks from the lung and gets trapped in the chest cavity, placing pressure on the organ.
- Metastatic lung cancer: While lung tissue itself doesn’t have pain receptors, advanced lung cancer can spread to the spine, causing a persistent backache.
Possible Spine Issues That May Cause Back Pain With Deep Breaths
If other medical causes have been ruled out, it is time to consider the mechanics of the back itself.
“There is a range of spine-related conditions that could come into play with a symptom like this,” Dr. Ekstrom says.
Muscle Spasms
“Multiple structures support the back, including many muscles,” Dr. Ekstrom says. “Those muscles can spasm when they are stretching, as would be the case when you take a deep breath.”
The intercostals—muscles between the ribs used for breathing—are likely culprits, but muscle spasms can affect any muscle group, including the abdominal, spinal and pelvic floor muscles.
Muscle spasms may also occur if you have a muscle strain in your back or chest wall.
“Spasms in any one of those muscle groups could cause pain with a deep breath,” Dr. Ekstrom says.
Increased Intra-abdominal Pressure
Another possible cause is increased pressure.
“Deep breathing, coughing and bearing down should not cause pain, but if you have a spinal problem, the increased pressure could worsen it,” Dr. Ekstrom says.
For example, a herniated disc or nerve impingement could cause pain with deep breathing.
Curves in the Spine
Sometimes, the root cause is simply structural. Conditions like scoliosis (a sideways curve) or kyphosis (a forward rounding of the upper back) change the alignment of your spine. The conditions may reduce lung capacity, leading to difficulty breathing.
When to See a Spine Specialist for Pain With Deep Breaths
Ultimately, Dr. Ekstrom says, you shouldn’t experience back pain when breathing at all. Your body is designed to breathe smoothly and without discomfort.
“If you’re having a recurring issue with back pain when you take deep breaths, it may necessitate a higher-level review,” he says. “I’d encourage anyone having these symptoms to come in for an appointment, where we can take images of your spine and help you determine what is happening.”
In Conclusion
You should never ignore back pain that happens when you take a deep breath. It is not always a medical emergency, but it might be a sign of an underlying orthopedic or lung issue that requires a doctor’s help. Whether your pain stems from a simple muscle strain, increased pressure on a herniated disc or an internal medical condition, finding the root cause is the fastest path to relief.
Summit Orthopedics spine experts can help you manage back pain. Request an appointment or call us at (651) 968-5201 to schedule a consultation.
