The human body is a complex system, and pain often signals that something isn’t working optimally. For instance, pain in the upper back when breathing can be alarming and deserves proper care. This combination of symptoms is relatively common.

This type of pain can happen around the upper chest and vary from sharp to mild aches. It can indicate an underlying condition, so looking for more symptoms can help identify the cause. Because some of the causes can be severe, it is important to seek medical advice when having upper back pain when breathing.

In this article, we will delve into the possible causes of upper back pain when breathing, its potential implications, and discuss why it is crucial to see a doctor.

What Can Cause Pain in the Upper Back When Breathing?

There are several causes of pain in the upper back when breathing:

  1. Pleurisy;
  2. Lung cancer ;
  3. Pneumothorax;
  4. Pneumonia;
  5. Asthma attack;
  6. Muscle strain;
  7. Fractured vertebra or rib;
  8. Anxiety disorder;
  9. Pulmonary embolism;
  10. Aortic dissection;
  11. Heart attack; and
  12. Gastroesophageal reflux disease.

The next section will briefly describe each of these conditions and the symptoms that frequently come with them.

1. Pleurisy

References: (1)

Pleurisy is the inflammation or infection of the tissue surrounding and covering the lungs, known as the pleura. Pleurisy can be caused by many conditions, including infections, inflammatory or autoimmune disorders (like rheumatoid arthritis or lupus), and cancer. It is most commonly produced by viral infections.

The common symptoms of pleurisy are:

  • Pain in the shoulder;
  • Fever;
  • Sharp pain on the side of the chest;
  • Cough;
  • Tiredness;
  • Fast heart rate;
  • Upper back pain; and
  • Difficulty breathing.

2. Lung Cancer

References: (2)

Lung cancer is most common in people who smoke, although it can occur in people that have never smoked, too. Usually without symptoms at first, it can develop symptoms when advanced, like:

  • Unintended weight loss;
  • Long-term tiredness;
  • Long-term cough;
  • Coughing up bloody mucus;
  • Difficulty breathing;
  • Difficulty swallowing;
  • Back pain when breathing.

3. Pneumothorax

Reference: (3)

A pneumothorax can happen after severe injuries to the chest, like those experienced in a car accident or those produced by stabs or bullets. However, in some people, it can occur spontaneously.
When the chest is damaged, air can enter the space around the lungs. The air can put pressure on the affected lung and collapse it. This can affect breathing and cardiac functions, which require immediate medical attention.

Some symptoms of a pneumothorax are:

  • Sharp chest pain on the affected side when breathing (pleuritic pain);
  • Shortness of breath;
  • Dizziness;
  • Feeling lightheaded;
  • Passing out.

4. Pneumonia

Reference: (4)

The lungs are in close contact with the back, so it makes sense that back pain can be related to breathing. Pneumonia is an infection in the lungs resulting from a viral, bacterial, or fungal infection. The infection produces inflammation in the lungs and pain when breathing.

Some common symptoms of pneumonia are:

  • Cough, usually with green-brown mucus and bad odor;
  • Fever;
  • Feeling sick;
  • Tiredness;
  • Trouble breathing;
  • Pleuritic pain;
  • Back pain.

Pneumonia is a serious infection and can be severe in older adults or people with other underlying conditions.

5. Asthma Attack

Reference: (5)

An asthma attack can produce difficulty breathing with pain in the upper back due to the tiredness of the back muscles. This occurs because of the effort the person makes to get the air into the lungs.

An asthma attack can produce anxiety, which can sometimes be similar to a panic attack.

An asthma attack can present with the following symptoms:

  • Chest pain;
  • Dry cough;
  • Wheezing sound when breathing;
  • Difficulty breathing;

6. Muscle Strain

Reference: (6)

Muscle strain is a common cause of upper back pain after strenuous physical activity or due to bad posture. It can be associated with pain when breathing because moving air in and out stretches the muscles surrounding the lungs (back and chest muscles).

Other causes of muscle strain are:

  • Muscle injuries;
  • Lifting something heavy.

7. Fractured Vertebra or Rib

Reference: (7, 8)

Several injuries, like those produced by car accidents, sports injuries, or falls from height, can produce spine or rib fractures. People with osteoporosis are at higher risk of fracturing a rib or vertebra with minor accidents since they have weaker bones.

A person that fractures a rib or vertebra in the upper part of the chest can have back pain that worsens when breathing or moving.

8. Anxiety Disorders

Reference: (9)

Sometimes anxiety disorders can manifest with upper back pain as a result of a panic attack, associated with other symptoms like:

  • Chest pain;
  • Difficulty breathing;
  • Sweating;
  • Shaking;
  • Dizziness;
  • Rapid heartbeat.

9. Pulmonary Embolism

Reference: (10)

A pulmonary embolism is an obstruction of a pulmonary blood vessel, particularly an artery. In some people, a blood clot can form somewhere in the body, frequently in the deep veins of the legs. It can then migrate and get trapped in a lung artery, resulting in a lack of blood supply to the lung tissue. This can produce the death of that section of the lung due to a lack of oxygen and nutrients.

The common symptoms of a pulmonary embolism are:

  • Sharp chest pain (pleuritic pain);
  • Upper back pain;
  • Irregular and/or rapid heartbeat;
  • Difficulty breathing;
  • Fast breathing;
  • Coughing up bloody phlegm.

10. Aortic Dissection

Reference: (11)

An aortic dissection is a life-threatening event where there is a tear in the aorta. The aorta is the largest artery in the body that supplies blood with oxygen from the heart to the rest of the body. The tear in the aorta causes blood to leak into the vessel wall, which requires emergency medical care.

When this happens, it causes:

  • Severe back pain when breathing;
  • Shortness of breath;
  • Severe chest pain;
  • Weakness;
  • Lightheadedness;
  • Sweating.

11. Heart Attack

Reference: (12)

A heart attack or myocardial infarction happens when one of the arteries that carries oxygenated blood to the heart gets clogged, which leads to severe damage to the heart muscle. The most common symptoms of a heart attack are heavy chest pain and shortness of breath. However, the pain can migrate to other parts of the body:

  • Back;
  • Left arm;
  • Jaw;
  • Neck.

12. Gastroesophageal Reflux Disease

Reference: (13)

Gastroesophageal reflux disease (GERD) happens when the stomach’s acid backs up into the esophagus, reaching the mouth. This causes upper back pain and sometimes difficulty breathing and coughing when the acid enters the airway.

Common symptoms of GERD are:

  • Heartburn;
  • Sour taste in the mouth;
  • Dry cough;
  • Upper back pain usually after eating.

What To Do In Case of Pain In the Upper Back When Breathing?

If you experience upper back pain while breathing, it’s crucial to recognize that many causes of these symptoms can be serious illnesses requiring immediate medical attention. Therefore, consulting a doctor is a must.

Conditions such as heart attack, aortic dissection, pulmonary embolism, and in certain cases, asthma attacks or pneumothorax, need urgent treatment, as these can result in severe consequences or even death.

By promptly addressing upper back pain when breathing, you can take proactive steps to safeguard your health and prevent potential complications.
It is vital to seek medical help promptly to ensure your well-being. Doctors can help you determine the type of pain, look for the underlying cause, and offer appropriate treatment.

Frequently Asked Questions About Pain in the Upper Back When Breathing

Should I see a doctor if I have pain in the upper back when breathing?

Yes, you should always consult your doctor if you experience back pain when breathing that doesn’t go away or comes with other symptoms.

Should I be concerned about upper back pain while breathing?

Yes, upper back pain when breathing could potentially indicate serious medical issues such as heart problems, pulmonary embolism, or other respiratory conditions. It’s important to consult a doctor if you experience this symptom.

What should I do if I experience sudden, sharp upper back pain while breathing?

If you experience sudden and severe upper back pain along with difficulty breathing, call emergency services or go to the nearest emergency room. It could indicate a life-threatening condition such as a heart attack or pulmonary embolism, among other causes.

Are there any non-life-threatening causes of upper back pain while breathing?

Yes, non-life-threatening causes, such as muscle strains or minor respiratory infections, can lead to upper back pain when breathing. However, a doctor’s evaluation is still recommended to rule out any severe issues.


Experiencing upper back pain when breathing can be a distressing and alarming sensation, often indicating underlying health issues that require immediate attention. This discomfort may result from a variety of causes, ranging from pleurisy, lung infections, and muscle strains to more serious conditions like lung cancer, aortic dissection, or heart attack.

Ultimately, anyone experiencing persistent or severe upper back pain when breathing should prioritize seeking medical attention to identify the underlying cause and receive appropriate care. A timely response to these symptoms can lead to effective management, improved quality of life, and better overall health outcomes.

See Also

What is Esophagectomy?

What is the Function of the Pancreas?

What is Chronic Pancreatitis?


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Virginia Rodriguez is a last-year medical student at the Catholic University of Cordoba, Argentina. Her undergraduate studies are complemented by a diploma in eating disorders and experience as a teaching assistant in a normal anatomy chair for 6 years at the same university. She is interested in developing her research skills and producing educational content.

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Franco Cuevas is a physician who graduated from the National University of Córdoba, Argentina. He practices general medicine in the Emergency Department at Sanatorio de la Cañada, Córdoba. His focus is on writing medical content to improve physicians' access to relevant medical information for daily practice. He has participated in some research projects and has a special joy in teaching and writing about medical concepts.

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