My Chest Hurts When Coughing: Why?

If you or your child brings up the point, “My chest hurts when coughing,” it may not be dangerous. However, severe chest pain or trouble breathing can be serious.

Coughing is never fun! If you have a cough and tell your doctor, “My chest hurts when I cough,” they may want to look further into why you are experiencing pain in your chest. Doctors will also explain that since your lungs are in your chest, an infection in the upper respiratory area may cause pain if you are coughing a lot. This article will help to explain why your chest hurts when coughing and what to do about it.

Why Does My Chest Hurt When I Cough?

1.       Acute Bronchitis

Acute bronchitis is an upper respiratory infection in the bronchial tubes. It usually comes on after a viral infection, especially influenza. Keep in mind that influenza causes a cough, so by the time you get acute bronchitis your lungs are already overworked from coughing.

The symptoms of acute bronchitis include:

  • Coughing up to a few weeks
  • Mucus that is either clear, green, or yellow
  • Wheezing
  • Chest tightness
  • Shortness of breath
  • Chest pain

The cough with acute bronchitis can last up to 20 days. This is a lot for your lungs to take and causes strain on the chest muscles.

2.       Pneumonia

Pneumonia is inflammation deep in the actual air sacs of the lungs. An infection causes mucus to fill the air sacs blocking air passage. It can be caused by viruses, bacteria, or fungus. Pneumonia often comes on after a prolonged respiratory illness. Since the infection affects the lower airways, coughing can be worse than upper respiratory illness since the body is trying to clear the mucus. Symptoms of pneumonia include:

  • Fever
  • Chills
  • Cough
  • Shortness of breath
  • Sweating
  • Nausea
  • Vomiting
  • Diarrhea
  • Fatigue
  • Pain in the chest with coughing or breathing

3.       Pleurisy

Pleurisy is inflammation of the pleura, the thin lining of the chest wall that protects the lungs. There is fluid in between the pleura to assist with breathing. When this becomes inflamed, it can result in sharp chest pain.

Pleurisy can be felt all over the chest when coughing or even just breathing. If you tell your doctor, “My chest hurts when I cough” you may need a chest x-ray to check for pleurisy.

The symptoms of pleurisy include:

  • Pain in the back or shoulder
  • Chest pain with coughing, breathing, or sneezing
  • Occasional cough
  • Fever

Pleurisy isn’t always caused by an infection. It can be caused by autoimmune diseases, certain medications, and lung cancer. If you have a fever with pleurisy, you may need to be treated with antibiotics.

4.       Other Causes




Asthma is a chronic respiratory condition that causes inflammation of the airways. Because it makes the chest feel very “tight” it can cause excessive coughing. This can lead to chest pain when coughing.

Chest Injury

If you injure your chest area, the muscles may hurt when you cough.

Cystic Fibrosis

People who suffer from cystic fibrosis have extra thick mucus on the lungs. This may cause a chronic cough and chest pain when coughing.


Tuberculosis is a lung infection caused by bacteria. It causes severe coughing and chest pain is one of the most common symptoms. This infection is very contagious and requires treatment with antibiotics and quarantine from others.

Acid Reflux

If your chest burns when coughing, you may be suffering from acid reflux. This is when the stomach acid seeps up into the esophagus from the stomach. Acid reflux can cause a cough, often at night accompanied by pain and burning.


This is when the cartilage that cushions the ribs becomes inflamed. It causes a dull pain that is constant in the ribs and may be worsened by coughing.


Pneumothorax happens when the air escapes the lung tissue and becomes trapped between the lungs and outer chest wall area. It then prevents the lungs from expanding, causing them to collapse. One of the main symptoms is chest pain and is often caused by pneumonia, tuberculosis, or puncture wound to the lungs.

Chest Hurts When I Cough—When to See a Doctor?

Sudden severe chest pain may be serious and considered a medical emergency. If you have new onset chest pain, call 9-1-1 or go to your nearest emergency room. A cough that has lasted more than a few days and is causing your chest to become sore may just need a little TLC at home. You can try these helpful tips to see if it gets better:

  • Drink some warm tea and honey
  • Humidify the air in your home
  • Suck on cough lozenges
  • Drink extra fluids while you are sick

If you are unable to control the coughing with self-care at home and the following symptoms develop, you should contact your doctor:

  • Fever higher than 100.4
  • Moderate to large amounts of blood in the mucus
  • Coughing for more than 3 weeks
  • If you have other health issues like heart disease or weak immune system

Developing a cough after recovering from a viral infection may mean you have developed a secondary bacterial infection. Pneumonia is especially common after influenza. One of the main symptoms is chest pain with coughing. This needs to be treated promptly and can be serious. If you have recently had influenza and have chest pain with coughing, contact your doctor right away.

What Will the Doctors Do?

Doctors can perform a chest x-ray to see if there is fluid in the lungs or pneumothorax. You may also need lab testing to check for bacterial infection. They can have you cough up some mucus for culture to see what organism is causing the cough.

The treatment usually involves the following:

  • Antibiotics – If you have a bacterial infection, the doctor will put you on antibiotics to clear up the infection. One common antibiotic used is azithromycin (Z-Pak).
  • Breathing Treatments – You may be prescribed an inhaler to help open the airways. They can also give steroid inhalers to relieve inflammation in the lung tissue.
  • Expectorants – Cough medicine that contains ingredients to help thin the mucus can help prevent you from coughing too hard. One common expectorant is Guaifenesin(Mucinex).
  • Pain Medication – If the chest pain when coughing is severe and you are having trouble resting, your doctor may prescribe a narcotic pain reliever. Drugs likecodeine can help with the pain and have cough relieving properties.

If you are saying to others, “My chest hurts when I cough,” take this simple test to see what the symptoms mean and what you should do:



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