Skip to content

Why Does My Upper Back Hurt When I Breathe?

Understanding and Managing Upper Back Pain When Breathing

Upper back pain when breathing can be a distressing and uncomfortable experience.  It can be caused by various factors, including muscle strain, poor posture, rib dysfunction, thoracic herniated discs, costochondritis, thoracic outlet syndrome (TOS), pleurisy, respiratory infections, spinal issues, and anxiety.  Understanding the underlying causes and exploring effective ways to alleviate the discomfort is essential for a better quality of life.


Why does my Upper Back Hurt When I Breathe: Back Muscle Strain

Man with hand on lower back, wondering why does my upper back hurt when I breathe

Root Causes

Muscle strain occurs when muscle fibers are stretched or torn due to excessive or sudden exertion. In the upper back, this strain can happen during activities like heavy lifting or repetitive motions that strain the muscles. When the muscles are overworked, they become inflamed, leading to pain, particularly when taking deep breaths.

Exercises and Stretches for Back Muscle Strain

Gentle neck and upper back stretches, shoulder blade squeezes, and chin tucks can help relieve muscle tension. These exercises aim to stretch and strengthen the affected muscles and improve their flexibility.  Clasping your hands in front of you and rounding your back, then stretching your arms out in front of you, can be beneficial for back muscle strain.  This stretch targets the upper back and shoulder muscles, promoting relaxation and reduced muscle strain.

Medication and Holistic Treatment for Back Muscle Strain

Over-the-counter pain relievers like ibuprofen or naproxen may help reduce the inflammation and provide relief during the healing process. These medications can alleviate pain and swelling, making breathing more comfortable.

Rest is essential for muscle strain recovery.  Avoiding activities that exacerbate pain and the application of ice or heat packs can be extremely beneficial in the healing process. In severe cases of muscle strain, physical therapy is recommended to achieve maximum recovery. 

Practicing yoga or tai chi can prove to be both preventative and/or enhance the recovery process.  When muscles are encouraged to stretch and remain limber daily, the risks of injury due to muscle strain reduce dramatically. 


Why does my Upper Back Hurt When I Breathe:  Poor Posture

Emily’s Story: 

Emily, a dedicated female bodybuilder and single mother, loves to decompress from the stress of her work and home life by lifting heavy at the gym. Her passion for sculpting her body in preparation for upcoming shows was met with a new challenge of persistent upper back pain with breathing. When speaking with her competition trainer, she identified that long hours spent hunched over her laptop in addition to the stress of strict deadlines at work were the root cause.  Emily was unaware that the stress of her new job had led to a lack of postural awareness. This poor posture led to significant upper back pain with breathing in the gym. 

Root Causes of Poor Posture

Poor posture is indicated by hunching forward, slouching, or walking with a spine that is improperly aligned. This can lead to excessive strain and stress on the muscles and ligaments in the upper back, resulting in discomfort and pain when taking a deep breath.  Prolonged poor posture leads to structural imbalance as indicated by misalignment of the spine and chronic pain over time.

Exercises and Stretches for Poor Posture

Man with good posture and bad posture, indications for why does my upper back hurt when I breathe?

Poor posture does not have to mean a life sentence of back pain, especially when breathing.  One can improve posture by completing strengthening exercises for the upper back such as rows or wall angels.  Over time, these exercises improve posture by strengthening the muscles responsible for maintaining upright posture.  A person cognizant of posture who also has a  strong limber back is more prone to avoiding back pain related to hunching and slouching. 

Stretching the chest and shoulders can counteract the effects of poor posture.  Chest-opening stretches can alleviate the pain and tightness associated with poor posture by releasing tension in the front of the body, allowing for proper alignment of the spine and corrected posture.  Mindfulness and postural awareness techniques can promote better posture over time.  Holistic approaches often focus on the mind-body connection, helping individuals become more aware of their posture throughout the day.

Emily’s Answer to Poor Posture:  Emily worked with her trainer to focus on back stretches and strengthening her chest and upper back over time.  However, the biggest impact on her posture was made in the office at work.  At her trainer’s recommendation, she purchased a stability ball chair for her desk.  This new ergonomic addition forced her to not only become aware of her posture daily, it also strengthened her core thus alleviating back pain over time. 

Why does my Upper Back Hurt When I Breathe:  Rib Dysfunction and Structural Spinal Issues

Issues with the ribs, such as partial dislocations (known as subluxations) or injuries can result in upper back pain, especially during inhalation.  Rib dysfunction may be due to trauma, repetitive movements, or underlying medical conditions.  It is essential to note that rib dysfunction often involves discomfort near the ribcage and can sometimes be mistaken for other causes of upper back pain when breathing. 

Structural spinal issues, namely scoliosis (an s-shaped curvature) and kyphosis (a hump-shaped curvature), occur during development, and can significantly affect the alignment of the spine and have a direct impact on vertebral muscles and breathing.  This misalignment can lead to muscle imbalances, upper back pain, and pain with breathing.

Exercises and stretches for Rib Dysfunction and Structural Spine Issues:  Why Does My Upper Back Hurt When I Breathe?

Breathing exercises that emphasize deep, diaphragmatic breaths can help relieve discomfort.  These exercises encourage full lung expansion while minimizing strain on the ribcage. Gentle stretches that focus on the rib cage area can alleviate tension.  Stretching the intercostal muscles between the ribs can reduce discomfort associated with rib dysfunction.

Medications and Holistic Treatment for Rib Dysfunction and Structural Spine Issues:  Why Does My Upper Back Hurt When I Breathe?

Over-the-counter pain relief such as ibuprofen or naproxen can provide temporary relief to rib dysfunction.  However, it is imperative to address the underlying root cause to achieve long lasting relief.  This is often achieved through a holistic approach by adding chiropractic or osteopathic manipulation into the treatment regimen.   Localized pain relief can be achieved with the use of CBD with Arnica Cream applied topically to the area.

Topical CBD Skin Salve can be used when thinking why does my upper back hurt when I breathe


Why Does My Upper Back Hurt When I Breathe:  Thoracic Herniated Discs

Jessica’s Story

Jessica, a passionate marathoner, devoted herself to relentless training for her upcoming races.  However, her unwavering commitment led her to an unexpected challenge.  During her long runs, she began experiencing persistent upper back pain, particularly when she breathed deeply.  Concerned about the condition, she decided to seek professional help.  A sports medicine specialist diagnosed Jessica with a herniated disc in her upper back.  The repetitive impact of her running had taken a toll on her upper thoracic spine. 

A thoracic herniated disc occurs when the outer layer of the spinal disc weakens or tears, allowing the inner gel-like material to protrude.  This protrusion can compress nerves or the spinal cord, leading to pain and discomfort in the upper back.  A herniated disc in the thoracic spine can compress the nerves directly innervating with the ribcage and upper back, thus causing pain with breathing.  Although a herniation in the thoracic spine is very rare, when it does occur, as with Jessica, it is quite painful and has a direct impact on breathing.

Although disappointed to miss her upcoming race, Jessica embraced the road to rehabilitation and implemented the new care plan, diligently following her prescribed exercises and form corrections. Her treatment plan encompassed rest, physical therapy, and adjustment to her running form, including replacing her worn out running shoes. 


Woman doing upper body stretch, helping treat why does my upper back hurt when I breathe

Today, Jessica continues strength training with a focus on her core, to ensure her upper back remains strong throughout her marathon training journey.

Exercises and stretches for Thoracic Herniated Disc:  Why Does My Upper Back Hurt When I Breathe?

Gentle spine stretches can help alleviate pressure on the herniated disc. Strengthening the core is key for stabilization of the spine after a thoracic herniated disc. The goal of core training is to reduce the pressure on the herniated disc, thus reducing the associated back pain. These stretches and exercises should be performed with caution to avoid exacerbating the condition and preferably done under the direction of a sports medicine specialist. 

Medications and Holistic Treatment for Thoracic Herniated Disc:  Why Does My Upper Back Hurt When I Breathe?

In severe cases of thoracic herniated disc, prescription medication or injections may be necessary to alleviate back pain.  These medications often target nerve pain and focus on releasing muscle tension.  In other minor to moderate cases, acupuncture, mindfulness, and relaxation techniques have been shown to alleviate thoracic herniated disc pain holistically. 


Why does my Upper Back Hurt When I Breathe:  Thoracic Outlet Syndrome (TOS)

John’s Story

John, a 22-year-old student, wrestles at college.  On weekends, he works at a local factory to help pay for his college tuition.  His job requires lifting 10–15-pound bags and boxes into overhead bins.  Recently, John noticed upper back pain and some difficulty breathing when wrestling and after work on the walk back to campus.  After wrestling practice, he decided to see the physical therapist on campus and was surprised to find out that his weekend job was contributing to a diagnosis called Thoracic outlet syndrome (TOS). 

Root Causes of TOS

Thoracic outlet syndrome (TOS) occurs when the nerves or blood vessels in the area between the neck and shoulder (the thoracic outlet) become compressed.  TOS can occur for various reasons such as trauma, anatomic variations, but most often is due to repetitive overhead activities.  TOS results in numbness and tingling in the upper back and thoracic pain when breathing. In John’s case, it was the repeated lifting of boxes and bags overhead that caused TOS and subsequent back pain when breathing. 

Exercises and stretches for TOS:  Why Does My Upper Back Hurt When I Breathe?

  1. Scalene Stretch:
    - Begin by sitting or standing with your back straight.
    - Tilt your head to one side, bringing your ear toward your shoulder.
    - Gently grasp the side of your head with your hand, applying a slight downward pressure to enhance the stretch.
    - Hold this position for 15-30 seconds, feeling the stretch along the side of your neck.
    - Repeat on the other side.
    - Perform this stretch 2-3 times on each side.
  1. Pectoral Stretch:
    - Stand in an open doorway.
    - Raise your arms to shoulder height and place your forearms on the door frame.
    - Step forward slightly to create tension, feeling a stretch in your chest and front shoulder muscles.
    - Hold this stretch for 15-30 seconds.
    - Relax and repeat 2-3 times.
  1. Thoracic Extension Exercise:
    - Sit on a chair with your back straight and feet flat on the floor.
    - Clasp your hands behind your head.
    - Gently arch your upper back, moving your elbows backward.
    - Hold this position for 5-10 seconds, feeling the stretch through your upper back and chest.
    - Return to the starting position and repeat 10-15 times.

Remember to perform these exercises and stretches with controlled, gentle movements. Do not force any stretch or exercise, and if you experience pain or discomfort, discontinue the activity and consult a healthcare professional. These exercises and stretches can help improve flexibility, reduce muscle tension, and alleviate some of the symptoms associated with TOS. However, it's essential to consult with a healthcare provider or physical therapist for a personalized exercise plan tailored to your specific condition. 


Why does my Upper Back Hurt When I Breathe:  Respiratory Infections, Pleurisy, and Costochondritis

Erin’s Story

Erin, a 35 year old emergency room nurse and recently noticed shortness of breath, cough, and fever after work one day.  She was advised by her manager to be seen at the clinic and a chest x-ray revealed that Erin had pneumonia. 

She was given a course of antibiotics to complete and told to rest at home.  During the treatment course, Erin had a significant productive cough and nighttime coughing spells.  

Over time she noticed that her side hurt near her ribs when coughing causing a sharp, stabbing upper back pain when she took a deep breath.   Frustrated, Erin asked the attending ER physician for advice.  

After listening to her lungs, the ER physician reported that her pneumonia had resolved and her pain with breathing was most likely caused by pleurisy and costochondritis. (Read more about what they will do in the Emergency Room for severe back pain.)

Root Cause

Erin recently recovered from pneumonia but had extenuated upper back pain with breathing.  It was discovered that the pneumonia caused inflammation to the lining of her lungs, resulting in a painful condition called pleurisy.  

Even though the pneumonia had been treated with antibiotics, the cough that persisted also caused strain on the cartilage between the sternum and her rib cage.  This condition is called costochondritis. 

It can cause prolonged upper back pain with breathing for weeks to come after pneumonia or other respiratory infections. In Erin’s case, her upper back hurt when breathing due to both pleurisy and costochondritis.  

Exercises and stretches for pleurisy and costochondritis:  Why Does My Upper Back Hurt When I Breathe?

Chest and diaphragmatic stretching along with deep breathing exercises that promote relaxation can prove beneficial both pleurisy and costochondritis.  Light stretches and splinting when coughing can also alleviate continued pain.

Medications and Holistic Treatment for pleurisy and costochondritis:  Why does my Upper Back Hurt When I Breathe?

Your provider may recommend over-the-counter anti-inflammatory medication and cough remedies to help alleviate the pain associated with pleurisy and costochondritis.  Application of CBD cream directly to the affected area may also help reduce the inflammation associated with costochondritis.

In conclusion, upper back pain when breathing is a multifaceted issue with a wide range of potential causes, each requiring a unique approach to management. Whether it stems from muscle strain, poor posture, rib dysfunction, thoracic herniated discs, costochondritis, thoracic outlet syndrome, pleurisy, respiratory infections, spinal issues, or stress and anxiety, understanding the underlying factors and employing tailored strategies is key to finding relief.

The significance of consulting with healthcare professionals to receive accurate diagnoses and personalized treatment plans is very important. In many cases, a combination of approaches, including exercises, stretches, medication, and holistic therapies, can significantly alleviate discomfort and improve overall well-being. Furthermore, proactive measures such as maintaining good posture, managing stress, and seeking early treatment for respiratory infections can help prevent upper back pain when breathing from becoming a chronic issue. Ultimately, with the right knowledge and guidance, individuals can take meaningful steps towards a life free from the constraints of this discomforting condition.

comment 1 comment

Anaya Ali calendar_today

We appreciate you bringing attention to these medical conditions and offering support to people dealing with rib pain and pneumonia.
Qairuti Ard Karsina

Leave a comment

Subscribe to our newsletter

Receive emails every few days with back pain relief tips, testimonials, and resources