Chest wall pain with a cough

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Chest wall pain with a cough

Prolonged or violent coughing can strain the muscles or ligaments of the chest wall. When these muscles are strained, even normal breathing can cause mild chest pain, and the chest wall may become tender to the touch. The entire chest wall may ache continuously, and pain may increase with coughing, especially in certain spots. You may feel general soreness along the base of your lungs with sharp areas of pain when you cough, take a deep breath, or press on your ribs. When your coughing goes away, so will the muscle aches.

Chest wall pain may cause more rapid, shallow breathing, but it does not cause true shortness of breath. This discomfort will get better or go away as your cough improves. True shortness of breath is a feeling that you can't get enough air or that you are smothering.

If chest wall pain becomes intolerable, you may try to suppress your cough. However, this may increase your risk of developing a bacterial infection or a partial lung collapse (atelectasis) and keep the lungs from fully expanding. Coughing helps clear mucus from the lungs and keeps the lungs fully inflated.

Chest pain is more serious when it:

• Occurs with a sense that you can't get enough air or that you are smothering.
• Is localized and sharp or stabbing and makes it impossible for you to take a deep breath.

Chest pain that occurs with other respiratory symptoms may be caused by an infection or inflammation of the lungs or the tissues surrounding the lungs. Similar symptoms may occur when a person's lung suddenly collapses (spontaneous pneumothorax).

Chest pain that occurs suddenly without respiratory symptoms may be caused by a blood clot that has moved from the leg to the lung (pulmonary embolus), especially if it occurs with coughing up blood or deep pain and swelling in one leg.

Episodes of violent coughing can fracture a rib. This usually causes sharp, severe pain that increases with inhaling, coughing, or pressing on the affected area.

Do not use a rib belt, elastic (Ace) bandage, or tape for chest wall pain. This may help the discomfort but limits natural rib cage motion and may allow the underlying lung to collapse.

Credits

Last updated:	February 25, 2008
Author:	Jan Nissl, RN, BS
Reviewed By:	William M. Green, MD - Emergency Medicine, H. Michael O'Connor, MD - Emergency Medicine
Editors:	Susan Van Houten, RN, BSN, MBA, Tracy Landauer