Upper back pain can occur with breathing problems. Possible causes range from muscle strain to asthma, anxiety, and heart problems.

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If the cause is not obvious, a person may wish to seek medical advice. Pain when breathing can be a symptom of a serious health condition.

Pain in the upper back when breathing usually extends around the chest. A sharp pain could be a sign of pleurisy or a heart attack. A dull ache may be due to a fractured vertebra or muscle strain.

Looking out for other symptoms can sometimes help a person identify the cause of the pain. If upper back pain is causing ongoing difficulty breathing, it is important to seek medical advice, as there may be a serious cause.

Pain can make a person avoid taking deep breaths. Shallow breathing can result in insufficient oxygen getting into the body, which may damage a person’s health over time.

Keep reading to learn more about some of the possible causes of upper back pain when breathing.

Pleurisy affects the tissue covering the outside of the lungs, and this tissue swells because of an infection. This swelling can cause chest pain and difficulty breathing. A person may also feel pain in their shoulder.

The condition typically causes a sharp pain in the chest, which gets worse when a person breathes in. Other symptoms can include a cough, fever, tiredness, and a fast heart rate.

Pleurisy may improve without treatment, or resting and taking pain relievers may be sufficient. However, in some cases, a person may need treatment in the hospital to remove air or fluid from around the lungs. Medication can help reduce the swelling or get rid of an infection.

Causes of pleuritic back pain

Many conditions can lead to pleurisy. A common cause is viral or bacterial respiratory illnesses, such as pneumonia and bronchitis.

Chest infections can make breathing difficult, and muscle aches and pains can affect the whole body. Chest and back pain may be more painful when a person breathes in.

Other causes of pleurisy can include:


It is possible to treat a mild chest infection at home with rest, fluids, and pain relievers. However, people should seek medical advice for a more serious infection or for a child or older adult.

Chest infections caused by bacteria will likely require taking antibiotics. Endometriosis usually requires hormonal medications, but there may be other treatment options. In some cases, a person may need surgery.

A collapsed lung is a medical emergency. A doctor will usually insert a small tube between the ribs to release the air buildup and then insert a thoracostomy tube.

Treating lung cancer depends on the type and stage of the cancer but often requires chemotherapy or radiation.

Muscle strain is a common cause of upper back pain. It can cause pain when breathing, as moving air in and out of the lungs stretches the back muscles.

A person may strain the muscles in their upper back as a result of exercise, injury, or lifting something heavy.


A person can treat a muscle strain with rest, nonsteroidal anti-inflammatory drugs, and ice.

Applying a towel-wrapped ice pack to the upper back for up to 20 minutes regularly throughout the day should ease the pain and swelling.

The vertebrae are bones that make up the spine. A person may fracture a vertebra in a serious accident, such as a car crash or a fall from a height. It can also result from a sports injury.

Older adults who have osteoporosis have weaker bones. Due to this, they are at higher risk for fracturing a vertebra, even from a minor accident, such as a fall from standing.

If a person fractures a vertebra in the upper part of their spine, it can cause pain in the upper back when breathing. This pain often gets worse with movement.


The type of treatment will depend on the severity of the fracture, and a visit to a doctor is the only way to determine the severity of the injury. A back brace, physical therapy exercises, and a gradual return to normal movement can help a person heal.

Body aches can be more common in people who have anxiety and other mood disorders.

A person may feel upper back pain as a result of anxiety and panic attacks. Other possible symptoms include chest pain, difficulty breathing, sweating, shaking, dizziness, and a racing heart.


Treatment for anxiety disorders can involve therapy, anxiety medications, and relaxation techniques. Breathing exercises may help if a person feels as though they are about to have an anxiety or panic attack.

A person may need to try different treatments before they find something that works well for them.

The symptoms of an asthma attack can be similar to a panic attack, and the two conditions sometimes occur together. Therefore, upper back pain can sometimes occur with asthma-related breathing difficulties and chest pain.

In addition, in cough-variant asthma, a person may experience a persistent, dry cough which may strain or pull a person’s back muscles over time, causing back pain.

In people with chronic obstructive pulmonary disease (COPD), breathing difficulties and coughing can also cause strain on the chest and back.


Treatment for either COPD or asthma may involve preventative measures, such as limiting exposure to allergens that may trigger symptoms, getting an annual influenza vaccine, maintaining a healthy weight, and undergoing immunotherapy.

A person may also need to use a bronchodilator or corticosteroid inhaler.

Scoliosis is a condition that causes a sideways curve of the spine. Depending on the severity of the condition, a person may also experience back pain. The back pain may be spinal pain and is not always dependent on their breathing.

Other possible symptoms include slightly uneven shoulders or hips and the body leaning to one side.


For children and teenagers, a back brace or surgery can help stop a curve in the spine from developing any further. Exercises can help strengthen the back muscles and support the spine to reduce pain.

Problems with the heart can cause chest and back pain, as well as breathing difficulties. Heart problems can include a:

Heart attack

Although heart attacks can occur suddenly, most start slowly.

Heart attacks can also cause an arrhythmia, which describes a heartbeat that is irregular. Without a diagnosis, the problem can go on for a long time and cause complications. These can include chest pain and shortness of breath.

Females are more likely than males to experience back pain as a symptom of a heart attack.

Symptoms of a heart attack can include:

  • chest pain
  • feeling sick or dizzy
  • pain in the back, neck, or jaw
  • shortness of breath
  • pain in the arm or shoulder

Pulmonary embolism

A pulmonary embolism is another condition that can cause difficulty breathing and pain in the upper back.

The heart is responsible for pumping blood through the vessels throughout the body. When there is a blockage in an artery that feeds blood to the lungs, the lungs do not get an adequate blood supply. This results in parts of the lung dying due to a lack of oxygen.

A pulmonary embolism often begins with a blood clot that forms somewhere else, such as in deep vein thrombosis (DVT), and migrates to a spot that prevents the lungs from getting blood. The symptoms include:

  • a stabbing chest pain when breathing that may occur with upper back pain
  • an irregular heartbeat
  • difficulty breathing
  • fast breathing
  • coughing up bloody phlegm


Both a heart attack and a pulmonary embolism are medical emergencies. If a person is experiencing any symptoms, dial 911 immediately.

A person having a heart attack may require CPR until emergency services arrive. A trained person may perform this manually or use a defibrillator, if available. Once hospitalized, a person can receive a number of different treatments including a coronary artery bypass or angioplasty.

Treatment for an embolism will require hospitalization, where the person will receive oxygen through mechanical ventilation and receive blood-thinning medications to break up the clot.

If the upper back hurts when a person breathes, they may have strained a muscle. If this symptom occurs after an accident or injury, it is important to see a doctor, who can check for any damage to the spine.

Pleurisy and chest infections can both cause pain when breathing. A person may need medication to get rid of the infection.

Sharp pain and difficulty breathing could indicate a more serious medical problem, such as a heart attack. Therefore, people should seek urgent medical attention for sharp chest or back pain.

This section includes some additional answers to questions a person may have about upper back pain while breathing.

Can I prevent upper back pain?

Preventing upper back pain when breathing is challenging if the onset of symptoms is sudden and acute. Not every potential cause is preventable. However, maintaining a healthy lifestyle and good hygiene practices may reduce the likelihood of developing a cardiovascular condition or infectious disease. In addition, exercising and stretching can help a person avoid muscle strains.

When should I see a doctor?

Any time a person experiences sudden pain, difficulty breathing, or a sudden worsening of existing symptoms, they should call 911 or go to the emergency room immediately. If the experience is not acute, a person should visit their doctor when the symptoms begin to interfere with their daily life or if they do not know the cause. This will ensure a person is getting the right diagnosis and the best treatment.

Can COVID-19 cause upper back pain while breathing?

COVID-19 is a viral infection that may cause pleurisy, which can lead to breathing difficulties, chest pain, and pain in the upper back.