Sometimes, one experiences back pain while breathing because the vertebrae of the thoracic spine are connected to the ribs and any muscle or soft tissue problems such as sprain causes the pain to radiate into the ribs. Sneezing and coughing could also be painful.

Causes Of Thoracic Back Pain:

  • Injury

If you have had any injury to the chest, this could be the reason for the back pain while breathing. When a rib is broken in the injury, as the chest wall continues normal respiration, the small fragments of the broken rib rub together causing pain. Bruising or muscle pull can also result in the same kind of pain.

  • Muscle or tissue problem : The muscles, ligaments, and tendons that support the spine can get sprained or strained due to overuse or straining of the muscles. The following reasons can cause a sprain or strain to the muscles:
    • Poor posture.
    • Heavy lifting.
    • Lifting incorrectly.
  • Other spinal conditions
    • Herniated Disc
    • Infection.
    • Osteoporosis
    • Kyphosis.
    • Scoliosis.
  • Other medical conditions
    • Lung infection.
    • Blood clots.
    • Cardiac conditions.
    • Acid reflux.
    • Ulcers.
    • Obesity.

Symptoms Of Thoracic Back Pain:

  • Stiffness or aching anywhere in the spine.
  • Sharp, localized pain in the neck, upper back, or lower back.
  • Chronic pain in the middle and lower back, especially after sitting or standing for long periods.
  • Pain or muscle spasm when standing straight.

In case you experience the symptoms mentioned below, please seek medical help.

  • Pain with fever, burning with urination, or frequent urination, as this could be some infection.
  • Pain that is getting worse.
  • Pain you are not able to manage at home.

Exams And Tests:

  • A detailed history and physical exam would be done by the physician where he will observe the posture, range of motion, and physical condition. This enables him to find if any particular movement is causing the pain. Also, the physician will also check the spine for curvature and alignment and check if you have any muscle spasm and tenderness.
  • A neurological examination would also be performed to check the reflexes, muscle strength, and also to find if the spinal nerves are affected.
  • Imaging tests like an x-ray, CT scan or MRI of the spine might be ordered. An x-ray will show the bones in the spine whereas the CT gives a clearer image of the bones and joints. In case, the doctor suspects some nerve involvement, then he may order MRI as the discs are clearly visible on MRI than on CT.
  • The physician might order Bone Mineral Density Test (BMD) if he suspects bone weakening condition called osteoporosis. This will help the physician determine if the bones are strong and healthy.


With the above-mentioned history and physical examinations and the appropriate imaging studies, the physician would be able to derive the possible reasons for the back pain and treat accordingly.

Treatment Options For Thoracic Back Pain

  • Physical therapy

Most cases of thoracic back pain reported are due to straining of the muscles, which arises due to poor posture. During physical therapy sessions, the therapist will help restore full, pain-free movement and help in healing. Also, techniques are taught to minimize or avoid pain in the future, which include teaching to maintain a good posture and teaching some stretching exercises.

  • Medications and Injections

Non-steroidal anti-inflammatory drugs (NSAIDs), mild opiate drugs such as codeine in case of severe pain, or muscle relaxants in case of spasms are prescribed to alleviate the pain. In case oral medications are ineffective, the physician may also prescribe injections to the spine in order to provide pain relief.

  • Alternative and Complementary therapies

Acupuncture, Ayurveda, chiropractic care, a good massage, yoga, and Pilates are some of the alternative treatments that have proven to be effective in alleviating the back pain.

  • Surgery

As a last resort, surgery is considered if the physician suspects any underlying damage to the nervous system or persistent pain not responding to any of the above methods.


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