Everything you need to know about pain in the lung
The term “lung pain” actually is a misnomer, because there are no pain receptors in the lungs, and those in the thorax (the chest cavity) provide the brain with only vague information about the precise location of pain. What may seem to be lung pain may be related to asthma or another pulmonary concern. But since several muscles, joints, and organs are located near each other within the chest, your discomfort actually could be the result of something entirely unrelated—an inflamed joint, an injured muscle, or more seriously, a diseased heart.
There are many possible reasons for what may feel like lung pain, some of which may come as a surprise.
Issues involving the lung, of course, are a good place to start.
Asthma and COPD
Both asthma and chronic obstructive pulmonary disease (COPD) are respiratory diseases that may be associated with tightness across the chest, especially during an acute flare or attack.Other symptoms of an asthma attack include a cough that is worse at night, difficulty breathing, and wheezing (a high-pitched whistling sound). Wheezing also may occur in people with COPD, along with shortness of breath, a chronic cough, and sputum (mucus) production.
Infections ranging from pneumonia to bronchitis to a lung abscess can cause lung pain. Oftentimes, an infection in the lung is accompanied by a fever and a deep cough.
A pulmonary embolus is a life-threatening cause of lung pain that occurs when a blood clot in the legs (called a deep vein thrombosis) breaks off and travels to the lungs. Pain with a pulmonary embolism is sometimes very difficult to distinguish from pain due to other causes, although it is generally sharp and worsened when breathing.Other symptoms that may occur with a pulmonary embolism include a cough, shortness of breath, a fast heart rate, and calf tenderness, warmth, and swelling.
Pleuritis refers to an inflammation of the tissues lining the lungs (the pleura). The pain of pleuritis is generally increased with a deep breath and feels sharp rather than dull or achy. There are multiple health conditions that trigger pleurisy in the lung, including autoimmune diseases, like systemic lupus erythematosus and rheumatoid arthritis, as well as bacterial or viral infections of the lung.
Cancers including lung cancer and mesothelioma(cancer involving the lining of the lungs) may cause pain, as can benign lung tumors such as a hamartoma. Lung tumors often cause pain on the same side as the cancer and may be associated with other symptoms like coughing up blood (hemoptysis) and weight loss.
Chest Muscle Pain
People who experience muscle-related pain in their chest area may feel like it’s coming from their lungs.
Costochondritis is a muscular chest pain syndrome often involving inflammation in the regions where the ribs join the sternum (breastbone). With this condition, people commonly report stinging, gnawing, or sharp areas of pain on the front of their chest. The pain is reproduced when a doctor presses on them.
A few autoimmune conditions may cause pain in the perceived lung area. For instance, some people with rheumatoid arthritis (RA) develop inflammation of the sternoclavicular joint (the joint that connects the collarbone to the breastbone), which causes all-over pain in the front chest area.Likewise, with ankylosing spondylitis, inflammation of various joints may cause pain in the mid to upper back and ribcage, and this may be erroneously perceived as related to a lung problem.
Pain in the chest or lung area always raises concern about an underlying heart-related condition, especially angina (chest pain that is caused by coronary artery disease) and a heart attack, in which blood flow to a part of the heart is blocked.Besides a pressure, heaviness, or tightness felt in the center or left side of the chest (that is worsened with exertion), other potential symptoms of a heart attack include:
- Pain the moves to the neck, jaw, or shoulder
- Trouble breathing
- Nausea and vomiting
- Dizziness and/or passing out
Other heart conditions may also manifest as lung pain, including:
Your aorta supplies oxygen-rich blood to your tissues and is the largest artery in your body. Aortic dissection causes sudden and severely sharp chest and back pain that often feels like something is ripping inside of you. It’s a medical emergency and requires immediate surgical repair of the torn aorta.
Pericarditis refers to inflammation of the sac that surrounds the heart. It may cause sharp or stabbing chest pain that is worsened when breathing in or coughing. The pain is classically eased by sitting up and leaning forward.
The esophagus is the hollow tube that carries food and liquids from your mouth to your stomach. Sometimes conditions that affect the esophagus can cause pain that may be perceived as lung pain.
Acid reflux, or gastroesophageal reflux disease (GERD), is an under-recognized cause of pain that can be felt in the region of the lungs and heart, often behind the breastbone. The pain is often burning in nature and most commonly occurs after eating. Regurgitation of acid with some undigested foods is also common with GERD.
The pain of an inflamed esophagus tends to be felt behind the breastbone and is associated with difficulty and/or pain with swallowing. Esophagitis may occur as a result of taking certain medications, receiving radiation, or from infection with a fungus or virus. Food allergies and a buildup of an allergy cell called eosinophils may also cause esophagus inflammation (eosinophilic esophagitis).
Sometimes pain stemming from diseases of your digestive organs, like your gallbladder or pancreas, can spread to the chest. Pain can also be referred, meaning it feels like it is occurring in the chest but is really coming from a faraway location—for example, a herniated disc in your back.Besides radiating or referred pain, psychological diseases like panic attacks can cause chest pain from hyperventilation, as can shingles (herpes zoster) on the chest or back—a skin condition that causes a burning, blistering rash.
When to See a Doctor
Although it’s extensive, this list doesn’t hit on all the possible causes of lung pain. This is why it is important to make an appointment to see your doctor—even if you feel there is a clear reason for your pain.For example, while chest wall tenderness is a hallmark feature of musculoskeletal chest pain, the presence of tenderness does not exclude a life-threatening cause like a heart attack or a blood clot in the lung (pulmonary embolism).Call 911 right away and seek immediate medical attention if you experience chest pain that is severe and/or prolonged, or if your pain is associated with symptoms like trouble breathing or feeling like you are going to pass out.
The diagnosis of “lung pain” begins with a detailed medical history and physical examination.
Your doctor will ask you many questions in order to determine the source of your pain. Knowing what to expect can help you prepare and more accurately answer them.
Your doctor may ask:
- How long have you had lung pain?
- Is the pain constant or does it come and go?
- Is the pain sharp or is it vague and achy in character?
- Is the pain localized to one spot or do you feel it diffusely throughout your chest?
- Does the pain get worse with a deep breath?
- Have you been coughing or experienced fevers?
- Do you have any pain in your legs?
- Do you have any unexplained weight loss?
Besides pertinent symptoms, your doctor will also inquire about your personal and family medical history, as this can provide clues to your diagnosis. Some related questions may include:
- Do you have any medical conditions, such as heart disease or lung conditions, or autoimmune conditions like rheumatoid arthritis?
- Do you have a family history of any heart or lung problems?
- Do you have a history of smoking?
During the physical examination, your doctor will first talk with you to see how well you are breathing. Attention to your coloring is also an important step— blue lips and/or nails are very worrisome and require immediate medical attention, as they suggest low oxygen delivery throughout your body.After a cursory look at your overall comfort and breathing status, your doctor will inspect your back and chest wall to look for any rashes or chest and spine deformities.Then, your doctor will listen carefully to your lungs and heart sounds with a stethoscope, and press on your chest wall and back muscles to ensure there is no muscle source behind your discomfort. Your doctor may also perform an abdominal exam or joint exam if he suspects that the pain could be stemming from a gastrointestinal or rheumatological issue.
Labs and Tests
Depending on the results of your physical exam, your doctor may order one or more of the following tests:
- A chest X-ray to look for signs of infection
- An electrocardiogram (ECG) to evaluate for a heart attack
- Blood tests to rule out a heart attack and to look for evidence of inflammation or autoimmune conditions
Imaging tests may be used in combination with the above in some cases. These may include:
- Echocardiogram to evaluate your heart valves, look for fluid around your heart or detect heart damage
- Stress test to aid in the diagnosis of heart disease
- Spirometry, a pulmonary function test that is key to diagnosing asthma and COPD
As you can probably guess, treatment of perceived lung pain is highly variable and depends on the diagnosis.For example, if a chest X-ray reveals pneumonia as the culprit behind your pain, your doctor will treat you with one or more antibiotics, rest, and fluids. To ease pneumonia-related pain, your doctor may recommend a cough medicine that contains codeine or a nonsteroidal anti-inflammatory (NSAID). For severe cases of pneumonia, or if you are elderly, you may require hospitalization for pneumonia treatment.If angina is the source behind your pain, a cardiologist can prescribe a medication like a nitrate or beta-blocker to relax the blood vessels that travel to the heart and lessen the heart’s workload. Since heart disease is the “why” behind angina, your doctor will also likely treat you with a cholesterol-lowering medication called a statin and aspirin (a blood thinner).Given the wide variety of possible causes of your pain and the fact that treatments for them don’t necessarily overlap, it is essential to seek a medical evaluation for symptoms and to get professional advice on next steps.
Similar to treatment, lung pain prevention depends on the specific cause. In the case of pneumonia, be sure to keep up with your vaccinations, including your annual flu shot and pneumonia vaccine (if relevant).To prevent heart disease (or its progression), various lifestyle behaviors are extremely important, including smoking cessation, eating a low-fat diet rich in fruits and vegetables, regular exercise, and weight loss, if you are overweight or obese.
A Word From Verywell
While it’s good to gain knowledge about potential sources of pain in your body, try not to get too bogged down in the details. Instead, embrace the fact that your body is a complex, remarkable entity that deserves the best. With that, let your doctor do the hard diagnostic work, so you can focus on getting well.