Mid Back Pain When Breathing in Deeply: What It Means

Mid back pain when breathing in deeply usually announces itself as a catch: you go to take a full breath, something between or under the shoulder blades stops you short, and you end up breathing in half measures for the rest of the day. In most cases the cause is mechanical, coming from the joints where the ribs meet the spine or from the small muscles between the ribs. That is reassuring. It is also not the whole story, because a handful of causes have nothing to do with muscles and need attention quickly, so the safety check comes first.

The upper back gets less attention than it deserves. One review put the prevalence of increased upper back rounding in later life somewhere between 20% and 40%, while noting that the exercise evidence is limited rather than settled (Katzman et al., 2014). A region that moves less than it could is a region where a stiff rib joint is easy to acquire.

What to rule out first

Please read this part before the movement advice.

Get urgent care if the pain came on suddenly, if you are short of breath, if you have a fever or a cough, if you are coughing up blood, if one calf is swollen or painful, if you feel faint or clammy, or if the pain spreads into your chest, jaw, or arm. Those patterns point at the lungs or the heart rather than the chest wall, and they are not something to breathe through or stretch out.

Once that has been considered, the far more likely explanations come into view.

Why a deep breath finds the sore spot

Breathing is a whole rib cage movement. Every rib has a joint where it meets the spine, and every one of those joints has to move for you to take a full breath. Twelve pairs of ribs means a lot of small joints, and if one of them has stiffened or become irritated, the deep breath is exactly the movement that finds it.

The muscles between the ribs work the same way. They lengthen as the chest expands, so an irritated one gives a sharp pull at the top of the breath and nothing much at rest.

Two things make it more likely. Long hours in one position let the upper back stop moving, so the ribs work through a smaller and smaller range. And a recent heavy cough or a bout of illness gives the rib joints and the muscles between them a great deal of unaccustomed work in a short time.

Our Feldypedia article on chronic shallow breathing covers how the habit of half breathing establishes itself, and our guide to mid back stiffness covers the background stiffness that often sits underneath.

What helps once the serious causes are excluded

The instinct is to stop breathing deeply. That is understandable and it backfires, because a rib cage that stops moving stiffens further, and the catch gets easier to provoke rather than harder.

• Keep breathing normally. Do not chase big breaths, and do not hold yourself in shallow ones either. Let the breath be whatever size is comfortable.
• Turn, do not stretch. Small slow rotations of the upper back, a short way in each direction, well below the painful point.
• Change position often. Sitting still is the single most reliable way to keep an irritated rib joint irritated.
• Warmth over force. A warm shower before you move helps more than pushing into the sore spot ever does.

Our comparison of thoracic and diaphragmatic breathing is worth a read if you have been told to breathe a particular way, because the instruction is often less useful than it sounds.

The Feldenkrais Method® takes a different route into this. Instead of stretching the sore side, lessons ask the ribs, spine, and shoulders to move together in small comfortable ranges, and the breath is left alone to follow. Our lesson on Feldenkrais for neck tension works the same region, and the Feldy program for neck and upper back sets it into a rhythm you can keep.

Find where to start

Pain that appeared after a heavy cough and pain that has been creeping up over months behave quite differently, and the second one usually needs a change in how you spend your days rather than a treatment.

Not sure which movement method fits your upper back? Take the 60 second Movement Match quiz and get one method suggested for how long this has been going on.

Common Questions about mid back pain when breathing in deeply (FAQ)

What causes mid back pain when breathing in deeply?

Most often the joints where your ribs meet your spine, or the small muscles between the ribs. Taking a deep breath moves every one of those joints, so a stiff or irritated one announces itself as a catch or a sharp point. Long hours at a desk, a recent cough, sleeping awkwardly, or lifting something heavy are common triggers. Less commonly the pain comes from the lungs or heart, which is why sudden or severe pain needs checking.

Is mid back pain when breathing serious?

Usually it is not, but it is one of the symptoms where the exceptions matter. Mechanical pain is typically sharp in one spot, changes when you move or twist, and eases when you find a comfortable position. Pain that comes with breathlessness, a fever, a cough, coughing up blood, a swollen calf, faintness, or pain spreading to the chest, jaw, or arm needs same day medical care.

How long does rib related mid back pain take to settle?

Simple rib joint irritation often eases noticeably within one to two weeks and settles over four to six. Pain that follows a heavy cough can take a little longer, because the area keeps being provoked. If it has not improved at all after two weeks, or it is getting worse, book an appointment rather than waiting it out.

What is the best exercise for mid back pain when breathing?

The best option early on is small, slow rotation of the upper back rather than any stretch that pulls into the sore spot. Sitting or lying, turn the ribs gently a short way in each direction, and let the breath come and go without controlling it. Two or three minutes, repeated through the day, usually does more than a single long session.

What should I avoid with mid back pain on deep breaths?

Avoid holding your breath or breathing shallowly all day to dodge the catch, because the area gets stiffer the less it moves. Avoid deep end range stretches and forceful twists into the painful side. Avoid having someone crack your upper back while it is acutely sore. And avoid heavy overhead lifting until it has quietened down.

How is this different from a pulled muscle in the upper back?

A pulled muscle is usually sore over a broader area, tender to press, and hurts most with movement rather than specifically with the breath. Rib joint irritation is more pinpoint, often close to the spine or along a rib line, and the deep breath is the thing that reproduces it. The two often overlap, and both respond to the same gentle early approach.