Middle Back Pain When Breathing: Causes & How to Get Relief

Key takeaways:

• Many conditions can cause middle back pain that worsens when you breathe, including musculoskeletal and organ-related problems.
• Treatment for middle back pain while breathing depends on the underlying cause.
• Understanding the signs of a potentially serious condition and when to seek medical care for your middle back pain when breathing is important.

The middle back encompasses the lower eight vertebrae of the thoracic spine, ribs, muscles, and ligaments that attach them. Middle back pain can result from musculoskeletal problems in any of those joints, bones, or muscles. It can also be caused by conditions in internal organs like the heart, lungs, gallbladder, pancreas, spleen, or kidneys.

If you have middle back pain while breathing, it is important to recognize signs of a serious underlying condition. Most causes are not serious. This article will explain the many causes of middle back pain and their symptoms. We’ll also explore some home remedies that may help relieve your symptoms.

How back pain while breathing works

Back pain while breathing can result from lung expansion irritating the nerves and muscles of the spine and upper back. Back pain while breathing can also be referred from internal organs that share nerve pathways or are nearby.

Pain that specifically affects the middle back can be caused by musculoskeletal conditions or referred pain from nearby organs. Those organs include the heart, lungs, gallbladder, pancreas, spleen, and kidneys.

Symptoms associated with back pain while breathing

There are a variety of symptoms reported by people who experience back pain while breathing. These largely depend on the cause.

Increased pain with deep breathing

Most causes of middle back pain while breathing cause increased pain with deep breaths. Pain referred from the gallbladder can cause middle back pain (sharp or dull) while breathing.

Referred pain from gallbladder inflammation is caused by the movement of the diaphragm while breathing, which puts pressure on the gallbladder. Associated symptoms include nausea, vomiting, fever, chills, and jaundice (yellowing of skin and eyes).

Shortness of breath

Middle back pain associated with breathing can also result in shortness of breath, particularly when caused by conditions related to the heart or lungs.

These conditions include:

• Pneumonia
• Pulmonary embolism (blood clot in the lungs)
• Asthma
• Pneumothorax (collapsed lung)
• Heart attacks
• Pleurisy (inflammation of the membrane covering the lungs and inside of the chest cavity)

Cough

Certain lung conditions that cause middle back pain while breathing can also cause a cough. These include cough-variant asthma, pneumonia, and pulmonary embolism.

• Bacterial pneumonia typically causes a productive cough with yellow or green sputum, fever, and chills. The location of pain while breathing depends upon the location of the infected area of the lungs.
• Pulmonary embolism can be accompanied by a cough with frothy white or pink, blood-tinged sputum, shortness of breath, and a feeling of anxiety, restlessness, or impending doom.

Neck, jaw, and shoulder pain

Middle back pain while breathing caused by a musculoskeletal condition can radiate to the neck and shoulder, as many muscles extend from one part of the back to another. It can also result from lung or heart conditions.

Back pain while breathing can be caused by a myocardial infarction (heart attack). Associated symptoms are sweating, nausea, shortness of breath, chest pain, neck pain, jaw pain, or shoulder pain.

Dull, crushing, or pressure-like pain

Dull pain while breathing can be caused by musculoskeletal conditions, including poor posture or muscle strain. It can also occur with a heart attack.

A heart attack that results in back pain usually occurs with other symptoms like chest pain, nausea, and sweating. Women and those assigned female at birth (AFAB) may be more likely to feel the dull, crushing pain of a heart attack in the back.

Pain from pancreatitis radiates to the back from the upper abdomen and worsens with breathing. Patients usually describe it as a dull, steady pain that is aggravated by lying flat, drinking alcohol, or eating. Leaning forward may relieve the pain.

Numbness, tingling, or incontinence

If the cause of middle back pain while breathing is due to conditions that put pressure on the spinal nerves, it can result in numbness, tingling, weakness, or incontinence. Neurologic signs like this are a signal to seek medical care immediately.

Considerations based on the location of back pain while breathing

The location of back pain while breathing can provide clues to the underlying cause.

Middle left back pain while breathing

Most episodes of middle back pain are due to muscle strain or injury. They can sometimes be a sign of a more serious condition in an internal organ or a chronic condition affecting the spine. Chronic conditions often require specialized medications or surgery to prevent long-term complications.

Middle right back pain while breathing

In addition to musculoskeletal causes of back pain, middle right back pain can occur due to conditions affecting the gallbladder, pancreas, the right kidney, or the right lobe of the lung.

Middle back pain while breathing during pregnancy

Middle back pain while breathing during pregnancy can be caused by a shift in the center of gravity and postural changes in the baby's weight. During pregnancy, ligaments relax due to hormonal changes. Abdominal muscles are stretched and offer less support for the back and torso.

How to get relief from back pain from breathing at home

If you have back pain from breathing, treating the underlying cause is essential. If a musculoskeletal problem causes your back pain from breathing, the simple measures below may be helpful.

Anti-inflammatory medications

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can temporarily relieve pain and inflammation. Ibuprofen, diclofenac, and naproxen sodium and three common NSAIDs.

Ice

Ice packs can help relieve acute back pain. Sprays like IcyHot and Biofreeze also constrict blood vessels and keep inflammatory cells and chemicals released by the immune system from the area of injury.

Heat

Applying a warm compress or heating pad to the painful area of your back after applying heat can provide some temporary relief.

Massage

Massage often helps relax tense muscles or release muscle spasms in the back and neck.

Gentle exercise

Yoga, swimming, and other low-impact exercises can help you build strength in your muscles. Stretches can also be helpful if your back muscles are tense. This can also relieve stress, which contributes to back pain from many different underlying causes.

Stress reduction

Stress contributes to back pain. Back pain may increase your stress level. This can create a feedback loop that may delay recovery.

Reducing stress can reduce your pain. Consider music, imagery, deep breathing, yoga, or nature to relieve stress.

Ergonomics

If you work at a desk or on a computer, assess your setup to be sure your spine remains aligned while working. Change positions frequently to avoid stiffness and strain.

Posture

Improve your posture by aligning your spine correctly and strengthening your core muscles to support your back better.

Stop smoking

If you are experiencing middle back pain while breathing, you should stop smoking. Smoking will slow the healing of tissues, increase shortness of breath and cough, and constrict blood vessels.

How to get relief from middle back pain if your back pain seems not to improve with simple measures

If you have symptoms associated with severe conditions, you should see a healthcare provider to determine the cause. The most important treatments are aimed at the underlying cause of your middle back pain while breathing.

Your provider may suggest physical therapy, massage therapy, or chiropractic manipulation if the cause is musculoskeletal. They may also prescribe stronger pain medications or muscle relaxers. If your middle back pain is related to another condition, your doctor can discuss treatment options.

When to see a doctor about back pain when breathing

When you have middle back pain with breathing accompanied by other symptoms, you should see your doctor to determine the underlying cause and receive effective treatment. If your symptoms suggest a serious cause, you should go to the emergency room or call 911.

You should see a doctor right away if:

Your pain:

• Persists or gets worse despite home measures.
• Wakes you up at night.
• Is accompanied by a cough.
• Comes with unexplained weight loss.

You should go to the emergency room if:

Seek immediate medical attention if you experience one or more of the following:

• A fever or chills.
• Chest, jaw, or shoulder pain with your mid back pain while breathing.
• Chest or back pain that feels like “tearing.”
• Nausea, vomiting, or sweating.
• Severe pain.
• Numbness, tingling, muscle weakness, or bowel or bladder incontinence.
• Coughing up blood.
• Swelling in one leg.
• Nails or lips that are a bluish color.

Questions to ask your doctor about back pain when breathing

• Is my pain related to a musculoskeletal disorder?
• Could this be related to a heart or lung problem?
• What tests do I need to diagnose the cause of my middle back pain while breathing?
• What treatment options are available?

How a doctor can help treat back pain when breathing

Your doctor can diagnose the underlying cause of your pain and suggest treatment options. If your back pain while breathing is caused by a musculoskeletal condition, they may recommend the treatments listed below:

Radiological imaging

Doctors sometimes order imaging studies like X-rays, CTs, or MRIs to evaluate structural problems or severe conditions.

Prescription medications

The doctor can prescribe anti-inflammatory pain medications that may be more effective than OTC medications. It is important to realize that back pain is not always an indication to prescribe opioids. Some NSAIDs can be effective when injected, such as ketorolac (Toradol). Intravenous Tylenol is also very effective. They can also prescribe muscle relaxants if indicated.

Physical therapy

A physical therapist can help you better understand how to align your posture and will provide exercises to strengthen the core muscles to support your back better. Physical therapists can also use treatment modalities like therapeutic ultrasound or myofascial release to relieve pain and spasms in your back muscles, at least temporarily.

Chiropractic treatment

Your doctor may recommend treatment by a chiropractor to correct misalignment of the spine.

Surgical consultation

In some cases, your problem may require surgery. If that is the case, your doctor may refer you to an orthopedic surgeon or neurosurgeon.

Frequently asked questions: back pain while breathing

You may have questions if you are experiencing middle back pain with breathing. Below are some frequently asked questions by people who have these symptoms:

What if your back pain is only felt when taking a deep breath?

Many causes of back pain are only felt while taking a deep breath. They include pneumonia, pneumothorax, pulmonary embolism, and fractures of the vertebrae and ribs. You should see your doctor for evaluation if you only feel your back pain when taking a deep breath.

How long should back pain while breathing last before consulting a doctor?

Back pain usually improves within a few days with rest and home treatment. If your back pain lasts over a week, consult your doctor.

Takeaway message: Middle back pain with breathing

While there are many possible causes of back pain while breathing, many are not serious. While symptoms often resolve without treatment, the treatment may vary depending on the underlying cause. Recognizing symptoms associated with severe causes of middle back pain with breathing is important so you can see your healthcare provider promptly for evaluation and care.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Lane Thaut, DO.

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