What Does Upper Back Pain When Breathing Deeply Indicate?

What Does Upper Back Pain When Breathing Deeply Indicate?

Experiencing pain in the upper back pain when breathing deeply can be due to a disease called “pleuritis”.

Pleuritis is an inflammation of the pleura, the double membrane that reviews the outside of the lungs and separates the lungs from the rib cage.

The Pleura Is Composed Of Two Layers Or Leaves: The outer layer (parietal pleura) is attached to the rib cage, the inner layer (visceral pleura) is found around the lungs and covers the adjacent structures, such as blood vessels, bronchi and nerves. Both layers slide on each other almost without producing friction. This is possible because there is a small amount of lubricating fluid between them, in the pleural space.

Sliding without friction allows the lungs to function properly during breathing, without causing fatigue.

If the pleura become inflamed, the layers are pushed against each other, resulting in greater friction and pressure in the lungs. A consequence of pleuritis can be the excessive accumulation of fluid in the pleural space: pleural effusion.

What Does Upper Back Pain When Breathing Deeply Indicate?

In general, this disease is bilateral and can affect the pleura in different areas, for example in the superior part (apical pleuritis) and the lower part (Diaphragmatic pleuritis).

Classification of Pleuritis:

Depending On The Cause, Pleuritis Can Be Classified As:

-Infectious pleuritis: bacterial, viral and fungal infections.

-Pleuritis due to irritation: caused by trauma, pulmonary infarction or neoplasms.

-Autoimmune pleuritis: related to autoimmune diseases such as systemic lupus erythematosus.

-Idiopathic pleuritis does not present any specific cause.

Depending on the duration, the pleuritis can be acute, which means that it manifests suddenly, causes symptoms and then disappears, or chronic, if the symptoms are persistent and recurrent.

Pleuritis affects people of all ages. However, people over 65 are at greater risk of suffering from it. Identifying the signs during the initial phases helps avoid complications. Symptoms are classified as initial or severe depending on the state of the disease.

Initial Symptoms: Pain in the chest during inspiration. The pain is preceded by a burning sensation in the outer region of the lungs, due to friction between the pleurae. The pain can even radiate to the interscapular area (between the shoulder blades), pain/discomfort in the belly, neck and shoulders, sweating, dry cough with rapid and shallow breathing. Cough can also be productive, with phlegm and blood stains.

Severe Symptoms: Fever, chills, loss of appetite and weight, high fever, sensation of thoracic oppression due to pleural effusion, dyspnea even at rest, tiredness associated with tachycardia (high heart rate), appearance of bluish discoloration (cyanosis) on the skin.


Pleuritis can heal spontaneously, or it can get worse. In the latter case, a large amount of fluid accumulates inside the pleural cavity (pleural effusion).

Sometimes scar tissue is formed, which forms adhesions, as a result of the disease. People with pleural adhesions have recurrence of frequent pleuritis, chronic pain and short of breath.

How Is It Diagnosed?

To diagnose pleuritis, the doctor performs a physical examination that includes auscultation of the lungs and the revision of the lymph nodes in case they are swollen (sign of infection).

The Doctor Requests The Realization Of Some Exams, Among Which Are:

Chest X-ray is a test to detect damage to the lungs (lung collapse, tumor). Radiography can also detect the presence of fluid in the lungs (pleural effusion).

CT Scan of The Chest: CT scan is an important test to detect possible lung diseases (for example, pneumonia or lung cancer). Blood tests are done to check the diagnosis of infections, autoimmune diseases.

Thoracentesis: For confirming the diagnosis, the doctor can perform this medical procedure that allows a sample of fluid to be extracted from the pleural space in order to analyze it.


Pleuritis can be very serious and if it is not treated it can lead to death. Viral pleuritis is cured without medication. To relieve the symptoms, the doctor prescribes non-steroidal anti-inflammatory drugs, for example ibuprofen and cough medicines (antitussives with codeine). In case of bacterial pleuritis the use of antibiotics are necessary.

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:October 16, 2019

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