Back pain when breathing or pain that occurs with shortness of breath may be a sign of an injury or a more serious problem. If a person cannot breathe properly, they should seek medical advice.

Often, back pain and shortness of breath result from a muscle strain or carrying extra weight. However, sometimes a more serious condition can be the cause, and the person will require prompt medical attention.

Someone experiencing these symptoms with chest pain, sweating, nausea, dizziness, or loss of consciousness should contact their doctor immediately or seek emergency care. These symptoms can indicate a heart attack.

This article covers some potential causes of back pain and shortness of breath.

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There are many muscles in the back and between the ribs, and strains and sprains are common causes of back pain. Straining and injuring the muscles can cause pain, making it more difficult to take a deep breath.

Muscle strains may respond to:

A muscle strain typically goes away after a few days. If it lasts longer, a healthcare professional can prescribe stronger medications, such as a muscle relaxant, to help relieve the discomfort.

Pneumonia is an infection of the lungs that can result from a viral, bacterial, or fungal infection. Common symptoms include a cough, fever, and breathing problems, but a person may also experience back pain.

It can develop as a complication of flu or COVID-19. Symptoms can be severe in older adults and those with other underlying medical conditions.

For a bacterial infection, a doctor will prescribe antibiotics. For fungal infections, a person will need antifungal medications. People with severe symptoms may need to spend time in the hospital, where supportive care can help manage symptoms and prevent further complications.

Obesity and overweight mean the back muscles have to work harder to support the basic activities of daily life. Having extra fat around the chest or back can make it harder to take a breath or breathe deeply.

Losing weight can help reduce stress on the back. In addition, regularly exercising to work the muscles of the back can help to strengthen them and gradually reduce pain.

Chest pain and shortness of breath are the most common symptoms of a heart attack, but pain can also occur in the back, left arm, jaw, and neck. Anyone showing signs of a heart attack needs emergency medical care.

Anyone who suspects they may be having a heart attack should go to the nearest emergency room or call emergency services immediately.

Anyone who has or may have coronary artery disease or heart disease should mention these to their doctor when seeking treatment for back pain.

Factors that increase the risk of cardiovascular disease include:

The following symptoms can indicate a condition known as cauda equina syndrome, which affects the nerve roots at the end of the spinal cord. They transmit messages between the lower limbs and pelvic organs and provide feeling and movement in the legs and the bladder.

Cauda equina syndrome usually occurs when a severely herniated disk disrupts the function of these nerves.

It is a medical emergency and can lead to:

Gastroesophageal reflux disease (GERD) causes stomach acid to back up into the esophagus.

Common symptoms include chest pain, heartburn, or a sour taste in the mouth, but pain can also radiate to the back, often between the shoulder blades and usually after eating.

In addition, stomach acid can sometimes enter the airways, leading to shortness of breath or a cough.

For people with GERD, a doctor may recommend:

  • OTC or prescription medications
  • avoiding eating soon before sleeping or lying down
  • avoiding common trigger foods, such as spicy, fatty, or acidic foods, chocolate, coffee, and alcohol

The gallbladder is a small organ that sits in the abdomen. It stores bile, a substance the liver produces to help digest fats. Sometimes, small stones form in the gallbladder and block bile flow.

Without treatment, gallbladder disease and gallstones can cause severe abdominal pain that radiates to the back.

In most cases, treatment for gallstones involves surgery to remove the gallbladder.

A pulmonary embolism is a blood clot in the lung. The main symptoms are often shortness of breath and chest pain. Some people may also experience back pain.

Pulmonary embolism requires emergency medical treatment.

The aorta is a large blood vessel that exits the heart and helps distribute blood throughout the body. An aortic dissection occurs when there is a tear in the aorta, causing blood to leak into the vessel walls.

It is rare, but when it happens, it causes severe back pain, shortness of breath, chest pain, weakness, and sweating.

An aortic dissection is a life threatening event that requires immediate treatment. Depending on where the dissection is, emergency surgery may be necessary.

A fractured rib can cause breathlessness and chest pain radiating to the back. Breathing and coughing can make the pain worse.

A rib can fracture as the result of a trauma, such as a blow to the chest. In older people, ribs can fracture more easily as the bones become weaker with age.

Possible complications of a broken rib include pneumothorax, where the rib punctures the lung. Treatment includes rest and pain relief medication. A rib can take several weeks or months to heal, depending on the person’s age and other health factors.

Shortness of breath and back pain are not typical signs of lung cancer, although it can cause shortness of breath or chest pain. However, if cancer spreads to the bones, it can cause pain in other parts of the body, such as the back or hips.

A cancer specialist, or oncologist, provides treatment for cancer. Options include surgery, chemotherapy, and radiation therapy.

A person should contact a doctor if they experience back pain that:

  • is severe and does not improve with rest or OTC medications
  • occurs after a fall, blow to the back, or another injury
  • affects their ability to perform daily activities

A doctor can recommend further tests or treatment options to help relieve the pain.

Here are some answers to questions people often ask about back pain and shortness of breath.

How do I know if my back pain is lung-related?

Lung-related back pains typically occur in the upper back, near the shoulder blades. It may be a deep, stabbing pain.

When should you go to the ER for shortness of breath?

A person should seek emergency medical care if shortness of breath accompanies chest pain, nausea, fainting, a change in mental alertness, or a bluish tinge to their nails or lips. These may be signs of a heart attack or pulmonary embolism.

There are many potential causes of shortness of breath and back pain.

In many cases, treatment is possible at home with rest. However, it is important to check with a healthcare professional if a person has severe shortness of breath, chest pain, or if the symptoms do not go away after a few days.