What is lung pain?
Lung pain is often felt when you breathe in and out, either on one or both sides of your chest. Technically, the pain isn’t coming from inside the lungs, since they have very few pain receptors. Instead, the pain may come from the lining of the lungs, which does have pain receptors.
People who think they are feeling lung pain are often describing a pain in the chest. This pain can be from any of the structures in the chest that sense pain, including skin, muscle, bone, chest wall lining, lung lining, esophagus (food pipe), and heart. It is important that you see your doctor to determine what is causing the pain. —Dr. Benjamin Ranard
Lung pain can also come from the chest wall or from organs or structures in your chest, such as your heart, esophagus (food pipe), trachea (windpipe), or muscles and bones in your chest.
There are many conditions that cause lung or chest pain, ranging from viral infections to fluid around your lungs to blood clots.
Treatments include inhalers, medications such as diuretics, nonsteroidal anti-inflammatory drugs, and blood thinners and, in some cases, surgery.
- Chest pain that is worse when taking deep breaths
Pleurisy, also called pleuritis, is an inflammation of the lining of your lungs and the inside of your chest. It feels like a sharp or burning pain in your chest when breathing in or out.
Viral infections are a common cause of pleurisy. There are also many illnesses that can cause it, such as autoimmune diseases (lupus, rheumatoid arthritis), heart problems, inflammatory bowel disease, sickle cell disease, and cancers of the respiratory system.
The underlying cause of pleurisy needs to be treated. If pleurisy is caused by a viral infection, it may go away on its own. You may take non-steroidal anti-inflammatory drugs like ibuprofen for the pain as well.
- Sudden chest pain, often on one side of your chest
- Shortness of breath
Pneumothorax, also called a collapsed lung, occurs when air gets into the space between the lung and the chest wall (the pleural space). It can be caused by air leaking from a hole in the lung or a hole in the chest wall.
The hole can be from a trauma like a car accident or gunshot wound, or a hole can happen spontaneously. Some lung diseases and smoking (cigarettes or marijuana) can increase the chance of pneumothorax.
This condition can be life-threatening, so go to the ER or call 911 if you have symptoms. If you have a minor lung injury, you may need oxygen therapy. But if the injury is more severe, your doctor may temporarily place a tube in your chest. This removes air from your chest as your lung re-inflates and heals.
3. Fluid around the lungs
- Pain on one side of the chest
- Chest heaviness or tightness
- Shortness of breath
Some illnesses can cause fluid to build up around the lungs. The fluid collects in the space between your lung and the wall of your chest. The type of fluid depends on the illness you have and include:
- Pleural effusion. This refers to fluid collecting around the lungs. According to the journal American Family Physician, causes include pneumonia, congestive heart failure, lung cancer, and autoimmune diseases.
- Empyema. This occurs when pus (infection) collects between the lung and the inner surface of the chest wall. It usually develops after pneumonia.
- Hemothorax. In this case, blood collects between the lung and the inner surface of the chest wall. It is usually caused by an injury, but lung infections, heart and lung surgery, and cancer may lead to the condition.
Treating fluid around the lungs
Treatment varies depending on the condition that caused the buildup of fluid. The fluid may need to be drained by your doctor. You may need to take diuretics (water pills) if there is too much fluid in your body or antibiotics if you have an infection. In some cases, surgery may be necessary.
- Shortness of breath
- Coughing that may bring up greenish, yellow, or bloody mucus
- Chest pain when taking deep breaths
Pneumonia is an infection of the lungs. It’s most commonly caused by bacteria or viruses (including the coronavirus that causes COVID-19). If the infection affects the lining of the lung, you may have pain with breathing (pleuritic chest pain).
Pneumonia that is caused by bacteria is treated with antibiotics. Antiviral medication is sometimes used to treat pneumonia from a virus. Mild pneumonia can often be treated at home.
Severe pneumonia is treated in the hospital, where you can receive oxygen and close monitoring. Hospitalization is often necessary for young children, older adults, and people with chronic health conditions.
Pneumonia often improves after a few days of treatment, but you may still have shortness of breath and fatigue for several weeks.
5. Pulmonary embolism
- Shortness of breath
- Sharp chest pain, especially when you breathe deeply
- Coughing that may produce blood
- Rapid heartbeat
- Leg swelling
A pulmonary embolism is a blood clot in the blood vessels that connect your heart to your lungs. The clot prevents parts of the lungs from receiving enough blood flow. These areas of the lungs become damaged and painful. If the blood clot is big enough, the clot can make it difficult for your heart to pump blood.
Treating pulmonary embolism
A pulmonary embolism can be life-threatening, so you should always call 911 or go to the ER if you develop symptoms.
Treatment varies depending on how big the blood clot is and how quickly it needs to be treated. Most clots can be treated with blood thinners, which allows the blood clot to dissolve over time.
Large clots, however, may be treated urgently with thrombolytics (clot-busting medication) or with surgical removal of the clot (often by devices inserted into the blood vessel in the leg).
Other possible causes
What feels like lung pain may be caused by conditions that affect other organs in the chest. These include:
Conditions that affect the esophagus
- Esophagitis (inflammation of the esophagus from heartburn or other causes)
- Esophageal cancer
- Esophageal trauma or rupture
- Hiatal hernia (when the esophagus and stomach slide up higher in the chest then they’re supposed to be)
- Heart attacks
- Pericarditis (inflammation of the lining of the heart)
- Damage to the lining of the aorta (aortic dissection)
Pain that can be caused by pressing on the area is generally more reassuring—often a musculoskeletal issue. Pain that is worse with exercise, sudden onset, or associated with shortness of breath is more concerning and needs immediate workup. —Dr. Ranard
- Broken ribs
- Muscle strain and soreness (caused by things like coughing)
- Costochondritis, an inflammation of the cartilage that connects the ribs to the sternum
Should I go to the ER for lung pain?
You should go to the ER if your lung pain is new, severe, or comes on suddenly. Other worrisome signs include lung pain that occurs with walking or exercising and improves with rest, as well as lung pain that radiates to your back, jaw, or arm.
You should also go to the ER if your chest pain occurs with any of these symptoms:
Dr. Ranard is a Pulmonary and Critical Care fellow at Columbia University Irving Medical Center / NewYork-Presbyterian Hospital. He received his undergraduate degree in Biological Sciences from Cornell University (2011) and his Doctor of Medicine and Masters of Science in Health Policy Research from the University of Pennsylvania Perelman School of Medicine (2016). In addition to pulmonology and critical care medicine, Dr. Ranard is interested in health care redesign, health policy, and looking for ways to improve the quality of care for all patients.