Between 44 and 88 percent of people with chronic obstructive pulmonary disease (COPD) experience some sort of chest pain. Being in pain can affect your quality of life and take a toll on your mental health.

When you live with COPD, there are many reasons why you may experience pain in your chest. Chest pain in COPD has several potential causes:

  • Bronchial spasms. This happens when the muscles that control the airways tighten suddenly. It can make it challenging and painful to breathe.
  • Digestive trouble. Over time, people with COPD may end up with overinflated lungs. This happens when air gets trapped and can’t be exhaled properly. When lungs take up extra space, parts of the digestive system get squished. This can worsen symptoms like bloating and acid reflux.
  • Scar tissue. There are two membrane layers (pleura) in and around the lungs. Normally, they slide smoothly over each other to regulate breathing. The inflammation of COPD can cause scar tissue to build upon one or both of these layers. The scar tissue interferes with normal function.
  • Overstretching of membranes. If the lungs are overinflated, the membrane also gets stretched out. When this happens, it loses elasticity and can activate pain receptors.
  • Coughing. Episodes of coughing can cause muscle strain throughout your chest and back.
  • Blood clot in the lungs. This is also known as a pulmonary embolism (PE). The presentation of common symptoms of COPD exacerbations, such as shortness of breath and cough, might cause the diagnosis of acute PE to be overlooked and frequently missed. Patients with COPD are at risk for developing PE due to many reasons, such as sedentary lifestyle, systemic inflammation, and increased number of red blood cells as a result of the low oxygen levels.
  • Other health conditions. People with COPD may also have other chronic health conditions that cause pain. These include arthritis and fibromyalgia.

Depending on the cause of pain, there are different things that can help. Here are tips to manage COPD chest pain:

  • Change your position. Adjusting your body’s position can help you catch your breath. You can try leaning slightly forward from your hips, resting your arms at level height on a chair or table. You can also sit in a chair and lean forward, resting your arms on your legs.
  • Improve your posture. Do your best to be aware of your posture. Standing up straight or sitting upright in a chair can better support your muscles. It’s also a more open position for your chest and airways.
  • Prevent acid reflux. If you’re prone to acid reflux, it may help to reduce spicy foods, alcohol, caffeine, and high fat foods. These can make reflux worse. Eat small meals more often throughout the day.
  • Avoid swallowing air. Bloating happens when air gets trapped in your digestive system. Make sure to eat slowly, avoid using straws, avoid talking while you eat, and don’t chew gum.
  • Deep breathing. Deep breathing exercises strengthen the muscles that control your breathing. This can help you bring in more oxygen. Deep breathing can help you catch your breath when you feel breathless. Breathe in slowly through your nose and even more slowly out through pursed lips.
  • Ice. Icing your muscles can help if you are having inflammation or swelling. You can use a bag of frozen vegetables to ice the affected areas. You can also use ice cubes wrapped in a towel.
  • Heat. A heating pad can be helpful for muscle and joint stiffness. Heat can help relax your muscles, reducing tension and pain. There are reusable heating pads available in a variety of shapes and sizes.
  • Massage. Massage has shown to help decrease pain in COPD. It can also play a role in muscle relaxation and stress reduction.
  • Activity. Being active with cardio, stretching, and strengthening activities can improve your breathing and help to build and maintain muscle. It may be helpful to work with a physical therapist to get you started.
  • Acupuncture. One randomized 2016 study showed that acupuncture improved shortness of breath in people with COPD. Acupuncture is also used as a treatment for chronic pain.
  • Take medications as directed. Medications for COPD reduce coughing, chest tightness, and shortness of breath. Those symptoms contribute to chest pain.
  • Pain medications. If your pain persists and affects your ability to get through your day, pain medications may help. Talk to your doctor about the type and dose that can help you.

Doing your best to manage your COPD is an important part of caring for yourself. There are different treatments available for COPD. Keep your healthcare team updated on how you’re feeling.

If you are experiencing a change in your symptoms, let them know. A change in the treatment strategy may help. Here are some of the ways that COPD is treated:

  • Inhalers. There are a variety of medications given in inhaler form. They help open up the airways, making it easier to breathe. They can provide quick relief or prevent breathlessness. They can be short or long-acting.
  • Nebulizers. Some people aren’t able to use an inhaler. A nebulizer turns the medication into a fine mist, which is breathed in using a mask or mouthpiece.
  • Corticosteroids. These are often delivered by inhaler but can also be given as oral medications. Typically, oral steroids would only be used for a short time to help manage a flare of COPD.
  • Phosphodiesterase-4 inhibitors. These are oral medications that help to reduce lung inflammation. They can reduce the number of COPD flare-ups.
  • Mucolytics. Excess mucus gets produced in the lungs due to the inflammation of COPD. Mucolytics are medications that help to thin and reduce the amount of phlegm.
  • Supplemental oxygen. If your lungs are having trouble bringing in enough air, you won’t be able to get enough oxygen in your body. Using supplemental oxygen increases the amount of oxygen available to you.

Chest pain is common in people living with COPD. Changes in lung structure and function can contribute to pain. Muscles in the chest can also be strained and cause pain.

There are many strategies that may help you better manage your pain. Medications to treat COPD are an important part of preventing and managing pain.