Sarah Key, the world-renowned expert in spinal
health, is an Australian physiotherapist made a Member of the Victorian Order by Her Majesty The Queen. She is the author of 5 highly successful books on spine and joint problems.
Here she explains in simple can-do language what causes upper back pain when breathing and what you can do about it.
Upper chest pain with breathing is usually related to rib dysfunction
Upper back pain when breathing is usually related to a sprained rib where it keys into the side of the spine. Equally as common is a pain at the front of the chest on taking a deep breath, more likely to come from a strained rib-to-breastbone junction. This is known as costochondritis.
WARNING: If it's on the left side, it could be heart trouble, particularly if it flows down the left arm.
Each rib moves like a bucket handle, lifting up off the rim as we inhale and settling down again on the bucket as we exhale. All the ribs do this in unison as the lungs inside inflate with air and empty again. Each rib must be fully mobile and springy so that breathing can go on unhindered while the rest of the body goes about its business and the natural contortions of everyday spinal movement.
If a rib becomes stuck the lung tissue underneath will fail to fill properly, carrying out its normal gaseous exchange. This can cause subtle erosion of health and more directly related problems of lung function. Being tired, unfit, physically overwrought, or in some other way below par, can hamper the streamlined coordination of all the moving parts and make it easier to 'rick' a rib.
The ribs rise and lower like bucket hands as we breathe
A strenuous or ill-considered wrenching arm movement can often strain a rib. A thoracic vertebra being stiffer than it should be also makes it easier to strain a rib, as does a vertebra sitting twisted off-centre. The head of rib will not notch comfortably into the side of the disc and the muscles of that rib will go into an automatic protective clench to hold the rib still.
With all chest movement, including breathing, the rib-to-spine junction will not work in a proper streamlined and coordinated way. It will feel caught (usually in the neck angle, or just lower) and painful near the spine, making you want to dig your fingers in for relief.
Rather than only working occasionally and forcefully in a phasic fashion with coughing and sneezing the intercostal muscle will stay switched on all the time in a sort of low grade (and very painful) cramp.
Spasm of the intercostal muscles can make the rib
The problem rib then feels more prominent
Muscle spasm of the intercostals can also feel like a 'stitch'. When you take a deep breath the muscles flick on harder, but you can rouse them less and get under their guard by taking the air in more slowly. You can also have what feels like a hard, permanent band of tightness from the stiffer rib sitting up proud, like a single prominent rung of a ladder.
Just as importantly, the intercostal muscles staying switched on sets the problem rib up for being hurt over and over again. The muscles keep it rigid and by not being free to move and twist where it is attached to the thoracic spine the rib itself becomes a sitting duck to future trauma. Even the most minor action can tweak it and set it off again.
An imperceptibly twisted rib can cause excruciating back pain when breathing. Chest pain too!
Upper back pain when breathing may also be brought on by repeated coughing fits as part of a chest infection, even though you may feel nothing at the time. Acute bronchitis, pneumonia, or just a bad case of the flu' often involves bouts of coughing which may leave you with one (or more) strained rib.
But if you’re plain unlucky too, it can happen with a chance errant action that is seemingly absurdly trivial.That said, an incident like this is often associated with being in some way slightly below par: a sub-clinical viral illness, extreme tiredness, a stressful (emotional) period, or when you're just running on empty.
You may want to go straight to treatment, in which case read here about using the Back Block for the Upper Back Pain Treatment. Even quicker, you can see Sarah on Video 4 of the package below showing you how to use a BackBlock to get rid of upper back pain.
Getting rid of upper back pain when breathing is usually a matter of mobilising a stuck vertebra and the rib attached to it and stretching out the muscle spasm. If you get these important exercises right you will feel almost instant relief.
You may wish to understand in greater depth about different problems of the ribs and the thoracic spine. 'Body in Action' is one of Sarah Key's highly successful self-help books, in this instance explaining with diagrams the anatomy of the spine, the rib cage and the way the ribs work. The treatment section takes you through how to treat yourself with carefully modulated yoga-based stretches that mobilise both spine and rib.