By Andrew Siyabalawatte, posted April 2021.
What’s The Connection?
Back pain when breathing can be uncomfortable and, understandably, a little worrying. Sometimes it is simply the result of a tight muscle, stiff ribcage, poor posture or an irritated joint. But pain that gets worse when you breathe can also occasionally be associated with problems affecting the lungs, chest or heart.
So, while not every case of back pain when breathing is serious, it is worth understanding what may be causing it and knowing when you should get checked.
In this guide, we’ll look at the relationship between breathing and your back, some of the more common causes of breathing-related back pain, simple things that may help, and where a device such as the BackAid may fit into a broader approach to improving movement and reducing tension.
What’s the Connection Between Breathing and Back Pain?
Many people don’t realize how closely back breathing and spinal function are connected. If you’re experiencing back pain when breathing, the diaphragm may play an important role.
The diaphragm is the primary muscle responsible for breathing. Located beneath the lungs and ribcage, it works continuously to help air move in and out of your body. Because the diaphragm attaches to structures that influence the spine, dysfunction in this area can contribute to back pain when breathing.
Every breathing you take requires coordinated movement between your ribs, chest, abdomen, diaphragm, and back muscles. When any part of back this system is restricted, it may lead to back pain when breathing, especially during deep inhalation.
Why Does Your Upper Back Hurt When Breathing?
One of the most common complaints related to back pain when breathing is discomfort in the upper back.
Try taking a slow, deep breathing. Place one hand on your chest and the other on your upper back. As you inhale, you’ll notice your ribs expand, your chest rises, and your back gently moves as well. This movement highlights the close relationship between breathing and spinal function.
The upper portion of the lungs extends toward the first rib near the back and shoulders. The shoulder blades, collarbones, and ribcage all work together during breathing with back. Any restriction in these structures can contribute to back pain when breathing, particularly in the upper back.
Poor posture, muscle tightness, or joint stiffness can all increase the likelihood of developing back pain when breathing in this area.
Breathing involves much more of your body than just your lungs.
Every time you inhale, your ribs expand, your diaphragm contracts, your chest moves and the muscles around your spine, shoulders and abdomen respond. Your thoracic spine—the middle and upper section of your back—is closely connected to the ribcage, so movement in one area can influence the other.
Take a slow, deep breath and pay attention to what happens.
Your ribs move outward, your chest expands and your upper back moves slightly. The diaphragm moves downwards to allow the lungs to expand, while surrounding muscles help stabilise the trunk.
If the muscles, ribs, joints or spine are already stiff or irritated, this normal movement can sometimes make the discomfort more noticeable.
This is one reason why back pain when breathing deeply can occur after something as seemingly simple as exercise, lifting, prolonged sitting or even a bout of coughing.
Common Causes of Back Pain When Breathing
There isn’t one single explanation for pain that appears when you breathe. The location of the pain, how it started and what other symptoms you have all matter.
1. Muscle Strain
A strained muscle is one of the more common explanations for back pain when breathing.
Lifting, twisting, sport, repetitive movements, coughing or simply overdoing an activity can irritate the muscles around the back and ribcage.
When you take a deep breath, the ribcage expands and the surrounding tissues move. If a muscle is already sore or strained, that movement may reproduce the pain.
Muscular pain is often–
- Localised to one area
- Worse with certain movements
- Tender when touched
- More noticeable after exercise or physical activity
- Associated with stiffness or tightness
In many cases, mild muscular pain settles gradually with relative rest, gentle movement and a sensible return to normal activity.
2. Tightness Around the Ribs and Upper Back
The ribs and thoracic spine move together as you breathe.
If your upper back is stiff or the muscles around your ribs are particularly tight, your ribcage may not move as freely as it normally would.
You may then notice discomfort between the shoulder blades, around the side of the ribs or through the middle back when taking a deep breath.
This can be particularly common in people who spend long periods sitting at a desk, driving or working in one position.
3. Poor Posture
Posture can influence both how your back feels and how comfortably you breathe.
When the shoulders remain rounded forward and the upper back stays flexed for long periods, the chest and ribcage can become less mobile. The muscles around the neck, shoulders and back may also have to work harder.
Over time, this can contribute to tension and may make back pain when breathing more noticeable.
This doesn’t mean that there is one “perfect” posture that you need to maintain all day. In reality, regular movement and changing position are often just as important as how you sit.
4. Rib or Chest Wall Irritation
Because your ribs move with every breath, irritation around a rib joint or the muscles between the ribs can make breathing painful.
This type of discomfort may become more obvious when you-
- Take a deep breath
- Cough or sneeze
- Twist
- Reach overhead
- Turn in bed
- Press on the affected area
If the pain began after a fall, collision, sports injury or direct blow to the ribs, it is sensible to have it assessed—particularly if breathing has become difficult.
5. Thoracic Spine Stiffness
Your thoracic spine sits between your neck and lower back and connects with your ribs.
When this part of the spine becomes stiff, normal rib movement can sometimes feel restricted. You may experience aching or discomfort around the shoulder blades or middle back, particularly during a deeper breath or certain movements.
Gentle mobility work, strengthening and improving your general movement habits may help when the problem is mechanical.
6. Breathing Patterns and Muscle Tension
Breathing and muscle tension can influence each other.
When we’re stressed, anxious or in pain, it is common to change the way we breathe. Breathing can become faster, shallower or more chest-dominant, while the muscles around the neck, shoulders and upper back become more active.
That extra tension can contribute to discomfort.
This doesn’t mean that back pain when breathing is “just anxiety.” New, unexplained or significant symptoms should always be taken seriously. But for some people, learning to slow their breathing and relax unnecessary muscular tension can be a useful part of managing mechanical back discomfort.
Train The Diaphragm
The diaphragm is the muscle that’s responsible for 80 percent of your breathing. This muscle’s main function is to support breathing, which can help your body adjust to increases in intensity during your workout. Like your other muscles, you can do exercises to train your diaphragm and boost your overall aerobic performance.
The diaphragm is the main muscle involved in breathing. It sits underneath the lungs and attaches to structures around the lower ribs and spine.
Because of these connections, breathing and spinal movement are closely linked.
When you breathe well, the diaphragm, ribcage, abdominal muscles and back muscles coordinate their movements. When you’re in pain or under prolonged physical or emotional stress, that coordination can change.
This is one reason we often encourage people with persistent back problems to consider how they breathe as well as how they move.
The goal isn’t to force huge breaths into a painful area. Instead, breathing should be comfortable, controlled and relaxed.
The exercises shown here focus on improving strength and endurance throughout whilst being mindful of respiration.
Can a Herniated Disc Cause Back Pain When Breathing?
A disc problem is not necessarily a direct cause of pain every time you breathe.
However, an irritated disc or spinal structure can change the way you move. Your body may instinctively tighten the surrounding muscles to protect the area.
That protective tension can affect the way your chest, abdomen and back move, potentially making a deep breath uncomfortable.
If back pain is accompanied by numbness, tingling, weakness or pain travelling around the body, it is worth seeking professional assessment rather than assuming the symptoms are simply muscular.
When Back Pain When Breathing May Be More Serious
Most mechanical causes are not dangerous, but pain associated with breathing can sometimes come from outside the musculoskeletal system.
For this reason, don’t simply stretch or exercise through the symptoms if you also have-
- Shortness of breathing
- Chest pain, pressure or tightness
- Sudden or severe pain
- Coughing up blood
- Fever or chills
- Dizziness or fainting
- A racing or irregular heartbeat
- Sweating or unexplained nausea
- Pain spreading into the arm, jaw, neck or shoulder
- New weakness, numbness or loss of bladder or bowel control
These symptoms can have a number of causes, including problems affecting the lungs, heart or nervous system.
What Can Help Back Pain When Breathing?
The right approach depends on the cause.
If your symptoms appear mild, mechanical and clearly related to movement, some people benefit from-
- Regular gentle movement
- Improving sitting and working habits
- Thoracic mobility exercises
- Gentle stretching
- Gradual strengthening
- Relaxed breathing exercises
- Reducing activities that aggravate the pain
- Physical therapy or osteopathic treatment where appropriate
The important thing is not to force movement simply because an exercise is supposed to be good for your back.
If a particular exercise causes sharp pain, dizziness, worsening symptoms or difficulty breathing, stop.
Try Gentle Breathing First
One simple place to start is with relaxed diaphragmatic breathing.
Sit or lie comfortably. Place one hand on your chest and one around your abdomen.
Breathe in slowly through your nose and allow your abdomen and lower ribs to expand naturally. Then breathe out slowly without forcing the breath.
The aim is not to take the biggest breath possible. It is to make the breath feel comfortable and controlled.
For someone with muscular tension or a guarded breathing pattern, this can be a useful way of reconnecting breathing with relaxed movement.
Where Does the BackAid Fit In?
This is something we have been particularly interested in because back pain isn’t always just about the painful spot itself.
Sometimes the body becomes stiff and guarded around the pelvis, lower back and hips. When that happens, people may compensate elsewhere in the body- including through their posture and breathing mechanics.
This is where we developed the BackAid.
The BackAid is a portable device designed to help mobilise the tailbone and pelvis into a supported position. It can be positioned in either a forward or backward tilt depending on what feels appropriate for the individual.
Learn more about the BackAid Device for Back and Leg Relief
The purpose isn’t to “cure” every type of back pain, and it certainly isn’t something we would recommend using to mask unexplained pain with breathing.
Instead, we see it as one tool within a wider approach to movement, relaxation and back care.
Using the BackAid With Relaxed Breathing
One of the things we particularly like about the BackAid is the opportunity to combine supported positioning with relaxed breathing.
Once you’re comfortably positioned, rather than forcing the spine or trying to stretch aggressively, the idea is to allow the body to settle into the support.
From there, focus on slow, comfortable breathing and consciously relax the muscles around the device.
This approach is described in our BackAid guide, where we encourage users to focus on deep, controlled breathing and allow the body to relax into the support.
For someone whose back discomfort is associated with muscular guarding, stiffness or the physical demands of everyday life, this combination of position, relaxation and breathing may be a useful addition to their routine.
It is not a replacement for medical assessment, and it is not appropriate for every cause of pain.
But it is another way of thinking about back care: rather than constantly fighting against discomfort, sometimes the body benefits from being given a position in which it can relax.
Why We Developed the BackAid
After years of working with people experiencing back and postural problems, we noticed a recurring pattern.
Modern life places a surprising amount of physical demand on the body. Sitting, driving, working, exercising, lifting, commuting and simply trying to keep up with everyday life can gradually build tension.
That tension doesn’t always disappear at the end of the day.
The idea behind the BackAid was to create a simple, portable tool that could help people work with that accumulated tension and support the lower back and pelvis. The device was designed with two positioning options to provide different ways of supporting the area.
We don’t believe one product is the answer to every back problem.
Instead, we believe good back care comes from understanding why your body is hurting and then choosing the right combination of movement, support, rehabilitation and professional advice.
Try This Simple Hip Mobility Test
Sometimes, back discomfort isn’t only about the back. Limited hip movement can change how your pelvis and lower back move, potentially placing extra stress on the surrounding muscles and affecting how comfortably you move and breathe.
A simple hip mobility test can give you an idea of how freely your hips are moving.
Hip Rotation Test
Lie on your back with both knees bent and your feet flat on the floor.
Keep your knees together and slowly allow both knees to move from side to side, without forcing the movement.
Notice-
- Does one side move further than the other?
- Do you feel stiffness or restriction through one hip?
- Does your lower back move excessively to compensate?
- Do you experience any pain rather than simple tightness?
The movement should feel controlled and comfortable. You’re not trying to push your knees as far as possible- you’re simply noticing how freely your hips and pelvis move.
What Does It Tell You?
This isn’t a diagnostic test, but it can be a useful way to become more aware of your movement.
If one hip feels considerably stiffer than the other, or your lower back has to compensate during the movement, improving hip mobility may be worth considering as part of a broader approach to back care.
And if you’re experiencing back pain when breathing, it’s worth remembering that the body works as a connected system. The hips, pelvis, spine, ribcage and breathing muscles all influence how you move.
A Few Gentle Exercises to Consider
Shoulder Blade Movement
Sit or stand comfortably and gently draw your shoulder blades back and down. Hold briefly, then relax.
Don’t force the movement. The aim is simply to encourage comfortable movement through the upper back.
Cat-Cow
On your hands and knees, slowly move between a rounded-back position and a gentle extension.
Keep the movement within a comfortable range and breathe naturally throughout.
Thoracic Extension
Sit on a chair and place your hands behind your head. Gently extend your upper back over the chair without forcing the movement.
This can help introduce movement into a stiff thoracic spine.
Gentle Side Stretch
Reach one arm overhead and gently lean to the opposite side.
You should feel a mild stretch through the side of your body and ribs—not pain.
Diaphragmatic Breathing
Finish with a few slow breaths, allowing the abdomen and lower ribs to expand comfortably.
Again, don’t force a huge inhalation. Comfortable breathing is the priority.
What Should You Avoid?
When you have back pain when breathing, more isn’t necessarily better.
For the time being, avoid anything that clearly aggravates your symptoms, including-
- Heavy lifting
- Sudden twisting
- Aggressive stretching
- Forceful spinal manipulation
- Training through sharp pain
- Excessive breathing drills
- Trying to “push through” unexplained pain
And importantly, don’t use a stretching or decompression device to self-treat symptoms that could be coming from your heart or lungs.
Get the underlying problem checked first.
When Should You See Someone?
If your symptoms are mild and clearly connected to an activity such as exercise, lifting or prolonged sitting, they may settle with sensible self-care.
However, if the pain keeps returning, doesn’t improve, is getting worse, or you aren’t sure what’s causing it, getting assessed can save you a lot of guesswork.
Our practitioner can look at how your spine, ribs, pelvis, muscles and breathing mechanics are working together and help determine whether the problem is primarily mechanical or whether further medical investigation is appropriate.
Frequently Asked Questions
Why does my back hurt when I breathe?
Back pain when breathing can occur when the muscles, ribs, joints or spine are irritated or stiff. Deep breathing moves the ribcage and surrounding tissues, which can make an existing mechanical problem more noticeable. However, pain with breathing can occasionally have a non-musculoskeletal cause, so other symptoms are important.
Can a muscle strain cause back pain when breathing?
Yes. A strained muscle around the back, ribs or chest wall can become painful when the ribcage expands during a deep breath. This is particularly common after lifting, twisting, exercise or prolonged coughing.
Can poor posture cause pain when breathing?
Poor posture may contribute to stiffness and muscular tension around the chest, shoulders and upper back. This can make deeper breathing uncomfortable in some people.
Can breathing exercises help?
They may help when breathing-related discomfort is associated with muscular tension, stress or altered breathing mechanics. Breathing exercises should be gentle and comfortable rather than forced.
Is back pain when breathing always serious?
No. There are many relatively straightforward musculoskeletal causes. However, sudden severe pain, shortness of breath, chest pain, coughing blood, fainting or other concerning symptoms require prompt medical attention.
Can I use the BackAid if I have back pain when breathing?
The BackAid may be useful as part of a broader routine when discomfort is mechanical and related to stiffness, posture or muscular tension. It should not be used as a substitute for medical assessment when symptoms are unexplained, severe or accompanied by chest or breathing symptoms.
Back pain when breathing can have a surprisingly simple explanation-but it shouldn’t automatically be dismissed.
Your breathing system and musculoskeletal system are constantly working together. The diaphragm, ribs, spine, abdominal muscles and back muscles all have to coordinate every time you breathe.
For some people, improving mobility, reducing muscular tension and learning to breathe more comfortably can make a meaningful difference.
For others, the cause needs proper medical investigation.
The important thing is to look at the whole picture rather than focusing only on where the pain happens.
And if your symptoms are mechanical and you’re looking for another way to support your back and pelvis, the BackAid is one of the tools we’ve developed to help people incorporate supported positioning and relaxation into their everyday back-care routine.
It isn’t about promising a quick fix.
It’s about giving your body another opportunity to move, breathe and relax more comfortably.
There it is, I hope you now know have a better understanding of why the back hurts when you breathe. If you need more engaging info, click here to read our December newsletter.