Table of ContentsView AllTable of ContentsPulmonary CausesMuscular CausesCardiac CausesEsophageal CausesDiagnosisWhen to See a Healthcare Provider
Table of ContentsView All
View All
Table of Contents
Pulmonary Causes
Muscular Causes
Cardiac Causes
Esophageal Causes
Diagnosis
When to See a Healthcare Provider
The causes of lung pain are many. Some may involve thelungsthemselves (such as with pneumonia or COPD), while others may involve thechest wallor muscles (such as with fibromyalgia or rheumatoid arthritis). Conditions affecting adjacent structures like theesophagusorheartmight also be the source of pain, such as can occur with acid reflux or angina.
Pinpointing the exact cause of lung pain not only ensures the correct treatment but also the timely treatment of potentially life-threatening conditions like a pulmonary embolism, lung cancer, or heart attack.
This article explores 32 possible causes of lung pain, including how they are diagnosed and treated. It also explains when it is time to seek immediate treatment from a healthcare provider or emergency department.
Verywell / Alexandra Gordon
Pulmonary Issues
Pulmonary issues are those involving the lungs. These include conditions like asthma, COPD, infections, pulmonary embolism, pleuritis, pneumothorax, and, in rare instances, cancer.
Asthma and COPD
Asthmaandchronic obstructive pulmonary disease (COPD)are obstructive respiratory diseases in which the airways of the lung will narrow and spasm, causing tightness across the chest during a flare-up.
Other symptoms of asthma include a cough that gets worse at night, difficulty breathing, and wheezing (a high-pitched whistling sound).
Wheezing can also occur in people with COPD, along with shortness of breath, a chronic cough, and sputum (phlegm) production.
Asthma and COPD are both treated withrescue inhalerswhich open the airways and improve breathing during attacks. There are also daily medications, like long-actingbronchodilatorsand steroids, that can help control asthma and COPD and prevent attacks.
Lung Infections
Antibioticsmay be prescribed for bacterial pneumonia. Viral lung infections may benefit fromantiviral drugsor may only require the management of symptoms. Intravenous antibiotics (delivered into a vein) may be needed for a lung abscess.
Pulmonary Embolism
Pulmonary embolismis a potentially life-threatening condition that occurs when a blood clot in the legs (deep vein thrombosis) breaks off and travels to the lungs.
The chest pain is generally very sharp. Some people describe it as feeling like you’re having a heart attack. The pain can get worse when you inhale, cough, or lean over and may even stop you from being able to take a deep breath.
Other symptoms include a persistent cough, shortness of breath, a fast heart rate, and calf tenderness with warmth and swelling.
Anticoagulants(blood thinners) are the most common treatment for a blood clot in the lungs. In severe cases, a surgery called athrombectomyorembolectomymay be used to remove the clot.
Pleuritis
Pleuritis, also known aspleurisy, is the inflammation of the tissues lining the lungs (called thepleura). Pain is the central feature of pleuritis, which generally feels sharp and increases with deep breaths. There may also be generalized chest tightness.
There are many health conditions that can trigger pleuritis, including autoimmune diseases likelupusandrheumatoid arthritis. Bacterial or viral infections of the lung can do the same.
Pain relief is central to the treatment of pleuritis until the underlying case is resolved. This typically involves anonsteroidal anti-inflammatory drug (NSAID)likeAdvil (ibuprofen). Severe cases may benefit from using a stronger pain reliever likeTylenol 3 (acetaminophen with codeine).
Pneumothorax
Pneumothorax can occur for many different reasons. It can happen on its own (often in people in their 20s with no lung disease) or as a result of an underlying lung disease like COPD. Chest trauma can also cause pneumothorax.
The treatment of pneumothorax may involve removing excess air from the chest cavity with a needle or catheter. There are medications that can help lung tissues to stick together so that the lung returns to its normal state. Surgery may be needed to repair leaks or burst air blisters.
Cancer
Cancers that manifest with chest pain include:
Cancer treatment may involve lung or chest surgery,chemotherapy,radiation, andimmunotherapybased on the type of cancer you have.
Pulmonary Contusion (Bruised Lung): Causes and Treatments
Muscle Pain
Chest muscle pain can feel like it’s coming from the lungs. The underlying cause could be the result of costochondritis, fibromyalgia, or an autoimmune condition like rheumatoid arthritis.
Costochondritis
Costochondritisis a chest pain syndrome that causes inflammation in the area where the ribs join thesternum(breastbone). People with costochondritis commonly describe the pain as being sharp, stinging, or gnawing in one or several ribs.
Costochondritis more often affects the left side of the sternum. The pain tends to get worse with movement, coughing, sneezing, and when taking a deep breath. There may also be chest pressure and radiating pain to the arms or shoulders.
The treatment for costochondritis can vary based on the underlying cause. To manage pain, NSAIDs likeAdvil or Aleveare typically prescribed. A heating pad on the chest may also provide relief.
Fibromyalgia
Fibromyalgiais a central sensitivity syndrome that causes widespread nerve pain in the absence of any injury, infection, or disease. People with fibromyalgia commonly describe tender areas (called tender points) on either side of the sternum or a few inches below the collarbone.
The pain tends to be persistent but can get worse and ease off. It is often described as being aching, burning, or throbbing interspersed with pain that can feel like electrical shocks.
The prescription drugsCymbalta (duloxetine)andSavella (milnacipran)may help ease fibromyalgia pain and fatigue. The antidepressantElavil (amitriptyline)or muscle relaxantFlexeril (cyclobenzaprine)can also relieve and promote sleep.Anti-seizure drugsmay also help.
Autoimmune Conditions
Both RA and AS can be treated with NSAIDs for pain relief and oralcorticosteroids(steroids) likeprednisoneto ease inflammation.Disease-modifying antirheumatic drugs (DMARDs)likemethotrexatesuppress the abnormally reactive immune system.
Heart Conditions
Pain in the chest or lung area may be related to an underlying heart condition, such as aortic dissection, pericarditis, or a heart attack,
Aortic Dissection
Aortic dissection is sometimes treated with medications that lower heart rate and blood pressure to prevent the tear from getting worse. In other cases, surgery may be needed to repair the tear with atissue graftor to replace the aorta with a synthetic tube.
Pericarditis
Pericarditis can be the result of a viral or bacterial infection, autoimmune disease, chest trauma, cancer, medication, heart attack, and other causes.
NSAIDs, corticosteroids, or a drug calledColcrys (colchicine)may be used to reduce heart inflammation. Surgery may be needed to drain fluid from around the heart (pericardiocentesis) or to remove the pericardium entirely (pericardiectomy)
Heart Attack
Sharp, shooting chest pains (angina) along with chest pressure are characteristic of amyocardial infarction, also known as a heart attack.
A heart attack is caused when acoronary arteryin the heart is blocked. The chest pressure can be extreme and is often described as feeling like someone is standing on your chest. The pain and pressure (in the center or left side of the chest) get worse with exertion.
Othersymptomsinclude a cold sweat, shortness of breath, nausea or vomiting, heart palpitations, and pain that radiates to the neck, jaw, or shoulder.
Esophageal Issues
The esophagus is the hollow tube that carries food and liquid from your mouth to your stomach. Conditions affecting the esophagus, like GERD and esophagitis, can cause pain perceived to originate in the lungs.
GERD
Gastroesophageal reflux disease(GERD)is a chronic form of acid reflux that occurs when stomach acids seep through the muscular valve that separates the stomach from the esophagus, called thelower esophageal sphincter (LES).
GERD is usually controlled with medications likeantacids,proton pump inhibitors (PPIs), andH2 blockersas well as a change in diet. In severe cases, a surgery calledfundoplicationcan tighten the LES to prevent the backflow of stomach acid.
Esophagitis
Esophagitisis the inflammation of the esophagus. It has many of the same features of GERD, with a burning or gnawing pain felt in the middle of the chest just behind the sternum. People will often describe the sensation of having something stuck in their throat. There may also be a cough, sore throat, and hoarseness.
There are many causes of esophagitis, including infections, food allergies, drug side effects, chest radiation, and an immune overreaction calledeosinophilic esophagitis.
Other Causes
Sometimes, pain stemming from diseases of the digestive tract, like the gallbladder or kidneys, can be felt in the chest. Chest pain can also bereferred, meaning that the pain might arise from a pinched nerve in the spine. The pain might also be purely neurological (nerve-related) or psychological.
If some of the more common causes of chest/lung pain cannot be confirmed, a healthcare provider may explore uncommon causes, such as:
A Word From VerywellOther possible causes of pain in the lung region include pulmonary infarction, hiatal hernia, and esophageal perforation.—KASHIF J. PIRACHA, MD, MEDICAL EXPERT BOARD
A Word From Verywell
Other possible causes of pain in the lung region include pulmonary infarction, hiatal hernia, and esophageal perforation.—KASHIF J. PIRACHA, MD, MEDICAL EXPERT BOARD
Other possible causes of pain in the lung region include pulmonary infarction, hiatal hernia, and esophageal perforation.
—KASHIF J. PIRACHA, MD, MEDICAL EXPERT BOARD
The diagnosis of lung pain begins with a detailed medical history and physical examination.
Medical History
Your healthcare provider will ask you many questions in order to determine the source of your pain, such as:
Your healthcare provider will also inquire about your personal and family medical history, as this can provide clues to your diagnosis. Some related questions may include:
Physical Examination
During the physical examination, your healthcare provider will talk with you to see how well you are breathing.
Noting your coloring is also an important step. Blue lips and/or nails are worrisome and require immediate medical attention, as they suggest low oxygen delivery throughout your body.
After assessing your overall comfort and breathing status, your healthcare provider will inspect your back and chest wall to look for any rashes or chest and spine deformities.
They will then listen carefully to your lungs and heart sounds with a stethoscope. The provider may also perform an abdominal exam or joint exam if they suspect that the pain could be stemming from a gastrointestinal or rheumatological issue.
Tests and Imaging
Depending on the results of your physical exam, your healthcare provider may order one or more of the following tests or imaging studies:
Although extensive, this list of possible causes of lung pain is not exhaustive. This is why it’s important to make an appointment to see your healthcare provider, even if you feel there is an obvious 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.
When to Call 911Call for emergency medical attention if you experience chest pain that is:Severe, prolonged, or worseningSo bad that you feel like you’re going to pass outMaking it hard to breathe without gasping
When to Call 911
Call for emergency medical attention if you experience chest pain that is:Severe, prolonged, or worseningSo bad that you feel like you’re going to pass outMaking it hard to breathe without gasping
Call for emergency medical attention if you experience chest pain that is:
Summary
If you have pain in the lung or chest area at large, see your healthcare provider about it—and be prepared to give them plenty of time to come up with a diagnosis. There are many possible causes, including pulmonary issues, chest muscle pain, heart conditions, and esophageal issues.
The diagnosis process can also become complicated if the pain is referred, meaning that it feels like it’s occurring in the chest but really is coming from another region.
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