By Andrew Siyabalawatte, posted April 2021.
Why Does My Back Hurt When I Breathe?
If you are searching “why does my back hurt when I breathe?”, there are several possible explanations. Pain in the back when breathing can sometimes come from the muscles, ribs, joints or thoracic spine, particularly when the discomfort changes with movement or deep breathing.
For some people, back pain when breathing may be related to muscle tension, a pulled muscle in the back, stiffness around the ribcage or changes in posture. In other cases, the cause may involve structures outside the musculoskeletal system, which is why new, severe or unexplained symptoms should not simply be assumed to be muscular.
Breathing requires coordinated movement between the diaphragm, ribs, chest, abdomen and muscles surrounding the spine. When one of these areas is irritated or restricted, taking a deep breath can sometimes make the discomfort more noticeable.
This is why pain in the back when breathing can have a number of different causes, and why the location, onset and associated symptoms are important.
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 I Breathe?
If you are wondering “why does my upper back hurt when I breathe?”, the answer may involve the muscles, ribs, thoracic spine or surrounding joints.
The upper back and ribcage work together during breathing. Every time you inhale, the ribs expand and the thoracic spine and surrounding muscles accommodate that movement.
If these tissues are stiff, irritated or excessively tense, breathing deeply may make the discomfort more noticeable.
Common possibilities include-
- Muscle tension around the upper back and shoulders
- A pulled muscle in the back
- Stiffness around the thoracic spine
- Irritation around the ribs or chest wall
- Prolonged poor posture
- Repetitive lifting, twisting or exercise
- Coughing or other activities that repeatedly load the muscles around the ribs
Some people describe this as aching, tightness, tenderness or even a burning sensation in the middle of the back.
Pain may also be felt more towards one side, including left back side pain, depending on which muscles, ribs or joints are involved.
The important point is that pain location alone cannot establish the cause. If the pain is new, severe, persistent or associated with breathing difficulty or other concerning symptoms, it should be medically assessed.
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.
Middle Back Pain When Breathing
Middle back pain when breathing is often noticed around the thoracic spine, between or underneath the shoulder blades, or around the ribs.
The thoracic spine connects with the ribcage, so movement in one area can influence the other. When the muscles, joints or ribs are stiff or irritated, taking a deeper breath can sometimes reproduce the discomfort.
Middle back pain when breathing may be more noticeable after-
- Sitting for long periods
- Lifting or twisting
- Exercise or sport
- Repetitive movements
- Prolonged coughing
- Sleeping in an awkward position
- Spending a long time in one posture
The sensation may be aching, sharp, tight or burning. Some people may also notice that the discomfort changes when they rotate, bend or move their upper body.
If your middle back pain when breathing is accompanied by shortness of breath, chest pain, coughing blood, fainting or sudden severe symptoms, seek urgent medical attention rather than treating it as a muscular problem.
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, Muscle Tension and Muscle Spasm
A pulled muscle in the back is one possible explanation for pain that becomes more noticeable when breathing.
Lifting, twisting, exercise, repetitive movements, coughing or suddenly increasing your activity can place additional stress on the muscles around the spine and ribcage.
Another possibility is muscle tension. When muscles remain contracted or guarded for prolonged periods, they can become uncomfortable and sensitive to normal movement.
So, what causes muscle tension around the back? Common contributors can include prolonged sitting, repetitive activity, stress, poor recovery, overuse and protective muscle guarding following an injury.
In some cases, a clinician may describe particularly strong or sustained contraction as a paraspinal muscle spasm or paravertebral muscle spasm. The paraspinal and paravertebral muscles help support and move the spine, and increased tension in these muscles can contribute to local back discomfort.
When you breathe deeply, the ribcage and surrounding tissues move. If the muscles are already irritated or tight, 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
- Influenced by posture or movement
However, not every case of pain when breathing is muscular. The presence of muscle tension does not automatically explain unexplained, severe or persistent breathing-related pain.
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?
There are several possible causes, including muscle tension, a pulled muscle, rib irritation, thoracic stiffness or postural strain. Deep breathing moves the ribs and surrounding tissues, which can make existing discomfort more noticeable. If the pain is severe, sudden or accompanied by breathing difficulties or chest pain, seek medical advice.
Why does my upper back hurt when I breathe?
Upper back pain when breathing may be linked to muscle tension, rib irritation, thoracic stiffness or prolonged poor posture. A deep breath can make the discomfort more noticeable because the ribs and surrounding muscles move.
What causes middle back pain when breathing?
Middle back pain when breathing can occur with muscle tension, a pulled muscle, rib irritation or stiffness in the thoracic spine. It may also change with movement, twisting or coughing.
Can muscle tension cause back pain when breathing?
Yes. Muscle tension around the back, ribs, shoulders and chest can make breathing uncomfortable. It may develop through prolonged sitting, repetitive activity, exercise, stress or muscular overuse.
Can a pulled muscle in the back hurt when breathing?
Yes. A pulled muscle in the back or around the ribs can hurt when the ribcage expands during a deep breath. It may also be painful with movement, coughing or touching the affected area.
Can a paraspinal muscle spasm cause back pain when breathing?
A paraspinal muscle spasm can cause localised pain, stiffness and restricted movement. Because these muscles work with the trunk and ribcage, significant tension may make deep breathing uncomfortable.
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.
If your back pain when breathing is persistent, related to stiffness or recurring back discomfort, it may be worth exploring whether spinal decompression could form part of a wider approach to managing your symptoms. Learn more about our Spinal Decompression Machine and how it may support people experiencing mechanical back discomfort.
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.