Does your mid back, upper back, or rib area hurt when you take a deep breath?
Back pain when taking a deep breath can sometimes come from the muscles, ribs, or joints of the mid back. Because your rib cage expands and moves every time you breathe, irritation or injury involving these structures may become more noticeable with a deep breath, cough, sneeze, or certain movements.
However, pain with breathing isn’t always musculoskeletal. Problems involving the lungs, heart, or other structures can also cause chest or back pain. New or unexplained chest pain, significant difficulty breathing, or other concerning symptoms should be medically assessed.
As an Edmonton chiropractor, I regularly assess patients who describe pain around the mid back, ribs, or shoulder blade that becomes sharper when they breathe deeply. Determining where the pain is coming from is an important first step before deciding whether chiropractic treatment is appropriate.
Why Can Breathing Cause Back Pain?
Your ribs don’t remain completely still when you breathe.
Each rib connects to the thoracic spine – the mid-back portion of your spine – and most also connect toward the front of the chest through cartilage. Muscles between and around the ribs also contribute to breathing and movement.
As you inhale, your rib cage expands to accommodate the increasing volume of your lungs. This involves movement of the ribs and the joints where they connect with the thoracic spine.
If a muscle, rib, or joint in this area is irritated, that movement may reproduce pain.
This helps explain why some people feel relatively comfortable while sitting still or breathing normally but experience a sharp pain in the mid back when they try to take a deeper breath.
Common Musculoskeletal Causes of Back Pain When Breathing
There isn’t one single cause of back pain when breathing.
Several musculoskeletal problems can produce similar symptoms.
Muscle Strain
Muscles surrounding the chest, ribs, shoulder blades, and thoracic spine can become irritated or strained.
This may happen after:
- Lifting or carrying something heavy
- A new or strenuous workout
- Repetitive twisting
- Sports or recreational activities
- An awkward movement
- Prolonged or forceful coughing
Because some of these muscles move or are stretched as the rib cage expands, a deeper breath may make the painful area more noticeable.
Muscle-related pain may also be aggravated by twisting, reaching, bending, coughing, or sneezing.
Rib and Mid-Back Joint Irritation
The ribs articulate with the vertebrae of your thoracic spine through small joints at the back of the rib cage.
These joints participate in the movement of your ribs during breathing.
Irritation involving a rib or adjacent thoracic joint can sometimes cause fairly localized pain along one side of the spine or near the shoulder blade. The pain may feel sharp with a deep breath and may also be reproduced by twisting or moving your upper body.
Patients sometimes describe this as feeling like something is “caught” in their mid back or rib area.
That sensation doesn’t necessarily mean a rib is “out of place.” An examination can help determine whether reduced or painful movement in the thoracic spine or rib cage appears to be contributing.
Intercostal Muscle Irritation
The intercostal muscles are located between the ribs and help with movement of the rib cage.
Like other muscles, they can become strained or irritated.
Intercostal pain may be felt along the side, front, or back of the rib cage and can become more noticeable with deep breathing, coughing, sneezing, twisting, or reaching.
Rib Fracture or Stress Injury
A fractured rib can cause sharp, localized pain that becomes worse when taking a deep breath, coughing, sneezing, or moving the upper body.
While rib fractures commonly occur following a fall, collision, or direct blow to the chest, repetitive stress can occasionally injure a rib as well. Rib stress injuries and stress fractures may occur in athletes involved in activities that repeatedly load or rotate the upper body. Severe or prolonged coughing can also sometimes contribute to a rib fracture, particularly when bone strength is reduced.
Pain that is very localized over a rib, particularly following trauma or repetitive activity, should be appropriately assessed. Imaging or medical evaluation may be recommended when a fracture is suspected.
Sports, Exercise and Repetitive Activity
Golf, weight training, throwing sports, racquet sports, repetitive lifting, and other activities involving forceful rotation of the trunk can place considerable demands on the thoracic spine and rib cage.
Sometimes there is an obvious injury. In other cases, symptoms develop gradually following repeated activity or a change in training.
If your symptoms began following exercise or sports, assessing how your thoracic spine, ribs, shoulders, and surrounding muscles are functioning may help identify contributing factors.
Why Does My Mid Back Hurt When I Take a Deep Breath?
Mid back pain when breathing is particularly common because this is where the ribs connect with the thoracic spine.
The location can vary.
Some people feel pain directly beside the spine. Others feel it underneath or between the shoulder blades. Pain can also extend farther around the rib cage toward the side or front of the chest.
The location of the pain alone isn’t enough to determine its cause.
How the symptoms began, which movements reproduce them, whether the area is tender, and whether you have any other symptoms are all important when determining whether the problem appears musculoskeletal or requires further medical investigation.
Why Does It Hurt Between My Shoulder Blades When I Breathe?
Pain between or underneath the shoulder blades doesn’t always come from the shoulder blades themselves.
The thoracic spine, ribs, muscles, and other structures in this area can all produce pain that is felt around the shoulder blade.
If the pain changes with twisting, reaching, certain postures, or movement of your upper body as well as deep breathing, a musculoskeletal source may be one possibility.
However, pain in this region can occasionally be referred from structures inside the chest or abdomen. This is another reason not to assume that every episode of upper back pain when breathing is simply a tight muscle or rib problem.
What About Chest and Back Pain When Taking a Deep Breath?
This deserves particular attention.
Musculoskeletal problems can cause both chest and back pain. The muscles, ribs, cartilage, thoracic spine, and other structures of the chest wall can all be sources of pain.
But chest pain can also have potentially serious causes involving the heart or lungs.
If you’re experiencing new or unexplained chest pain – particularly if it is sudden or severe or accompanied by genuine shortness of breath – you shouldn’t assume it is coming from your back or ribs.
When Should I Worry About Back Pain When Breathing?
Seek prompt medical attention for back, rib, or chest pain associated with symptoms such as:
- Sudden or significant shortness of breath
- New, unexplained, or severe chest pain
- Fainting, dizziness, or feeling lightheaded
- Coughing up blood
- A rapid or irregular heartbeat
- Unexplained sweating or nausea
- Fever or significant illness
- One-sided leg swelling or pain
- Significant trauma
Conditions such as pulmonary embolism, pneumothorax, pneumonia, pleurisy, and cardiovascular problems can sometimes cause chest or back pain associated with breathing.
It is also important to distinguish between “I can’t take a deep breath because it hurts” and “I feel like I can’t breathe.”
They may sound similar, but they aren’t necessarily the same symptom. True difficulty breathing requires appropriate medical assessment.
If you’re unsure about new chest or breathing symptoms, it is safer to seek medical attention.
Can a Chiropractor Help With Back or Rib Pain When Breathing?
If an appropriate history and examination indicate that your pain is musculoskeletal, chiropractic care may be an option.
At Collins Chiropractic Health & Wellness Centre in Edmonton, assessment may include examining your:
- Thoracic spine movement
- Rib and chest-wall movement
- Muscle tenderness and function
- Shoulder and upper-back mobility
- Posture and movement patterns
- Breathing patterns and sounds
- Activities or movements that reproduce your symptoms
Treatment depends on what the examination identifies and may include chiropractic adjustments or mobilization, soft-tissue treatment, stretching, mobility exercises, strengthening, and advice about temporarily modifying aggravating activities.
The goal isn’t simply to treat the spot that hurts. It’s to determine what appears to be causing the pain and whether chiropractic care is appropriate in the first place.
If your history or examination suggests that your symptoms may not be musculoskeletal – or that further medical investigation is appropriate – you’ll be referred for the appropriate care.
Frequently Asked Questions
A deep breath expands and moves your rib cage. If muscles, ribs, or joints in the thoracic spine are irritated, that movement may reproduce pain. However, lung, heart, and other medical conditions can also cause pain with breathing, so the cause shouldn’t be assumed without considering your other symptoms.
Problems involving the ribs or the joints where they connect with the thoracic spine can sometimes contribute to pain with deep breathing. The discomfort may be felt beside the spine, around the shoulder blade, or along the rib cage.
Muscle strain or irritation around the thoracic spine and rib cage can make a deep breath uncomfortable because breathing expands the chest wall and moves or stretches muscles in the area.
Pain around or underneath the shoulder blade may sometimes originate from muscles, ribs, or the thoracic spine rather than the shoulder itself. Because other medical conditions can also refer pain to this area, persistent or unexplained symptoms should be assessed.
If your pain appears to be related to movement of the muscles, ribs, or thoracic spine, a chiropractor can assess whether a musculoskeletal problem may be contributing. New chest pain, true difficulty breathing, or other concerning symptoms should receive appropriate medical attention first.
Get Your Mid-Back or Rib Pain Assessed in Edmonton
If back pain when taking a deep breath is making it uncomfortable to breathe deeply, twist, exercise, work, or perform your usual activities, it may be worth finding out what’s causing it.
At Collins Chiropractic Health & Wellness Centre, we provide Back Pain Treatment and Sports Injury Treatment in Edmonton for patients dealing with mid-back pain, rib-area pain, and other musculoskeletal problems. We’ll assess your symptoms, determine whether they appear to be musculoskeletal, and discuss whether chiropractic care and rehabilitation are appropriate.
Book an appointment today to have your back or rib pain assessed and determine the appropriate next step.
About Dr. Dean Collins
Dr. Dean Collins has been helping Edmonton patients improve their health through chiropractic care since 1998. With over 30 years of clinical experience, he has worked with patients of all ages, helping them reduce pain, improve mobility, and maintain healthier, more active lives. At Collins Chiropractic Health & Wellness Centre, Dr. Collins focuses on identifying the underlying causes of pain and dysfunction while providing personalized care, education, and practical strategies to support long-term health and wellness.
Learn more about Dr. Collins or book an appointment today.
To learn more about how chiropractor care can help you and your family, read Dr. Collins’ comprehensive guide to chiropractic care: Chiropractic Care for Everyone.
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