A cough is usually your body’s way of clearing out irritants, but what if each cough comes with chest pain? While it’s easy to dismiss this as a strained muscle or lingering cold, chest pain while coughing can indicate a deeper health concern.
At Austin Emergency Center, our emergency care physicians frequently treat patients whose chest pain and cough point to more serious conditions like pneumonia, asthma, or even cardiac issues. Recognizing when your symptoms need medical attention can help prevent complications and promote faster recovery.
What Causes Chest Pain While Coughing?
Chest pain during a cough can stem from something as simple as overused muscles or as serious as a lung infection or blood clot. Here are some of the most common causes:
1. Muscle Strain
When you cough repeatedly or forcefully, it puts a lot of pressure on the muscles between your ribs, called intercostal muscles. This strain can lead to muscle soreness or even small tears, causing sharp, localized chest pain. The pain typically worsens with body movement, stretching, or taking deep breaths. Muscle strain pain is usually felt more on one side of the chest. It tends to improve with rest, ice, and over-the-counter pain relief.
2. Bronchitis or Respiratory Infection
Bronchitis and similar infections inflame the lining of the airways, making them swollen and sensitive. This inflammation leads to persistent coughing, which can irritate the chest wall and muscles. Over time, this constant irritation can cause chest pain, especially when taking deep breaths or coughing forcefully.
Other symptoms may include fever, fatigue, and wheezing. Chest pain usually improves as the infection clears and the cough subsides.
3. Pneumonia
Pneumonia is a serious lung infection that fills the air sacs in the lungs with fluid or pus, making breathing painful. The cough associated with pneumonia is often dry at first, but can turn productive. Chest pain occurs due to lung inflammation and is often sharp and stabbing, especially during coughing or deep breathing.
You may also experience fever, chills, shortness of breath, and fatigue. If untreated, pneumonia can lead to serious complications, especially in older adults or people with weakened immune systems.
4. Pleurisy
Pleurisy is the inflammation of the pleura, the thin membranes surrounding your lungs and chest cavity. When the pleura become inflamed, they rub against each other during breathing, causing intense, sharp pain. This pain often worsens with deep breaths, coughing, or sneezing. It may also be accompanied by shortness of breath and a dry cough.
5. Asthma
Asthma narrows the airways and leads to inflammation, triggering a dry cough, shortness of breath, and wheezing. During asthma attacks, the muscles around the airways tighten, making it hard to breathe and causing tightness or aching in the chest.
Chest discomfort may come and go, depending on exposure to triggers like allergens or cold air. Severe attacks can be life-threatening and require immediate treatment.
6. Acid Reflux (GERD)
Gastroesophageal reflux disease (GERD) occurs when stomach acid flows back into the esophagus, irritating the throat and chest. This acid reflux can lead to a chronic dry cough and burning chest pain, often mistaken for heart-related pain.
Symptoms often worsen after meals, when lying down, or during the night. Long-term, untreated GERD can also damage the esophagus lining.
7. Pulmonary Embolism
A pulmonary embolism happens when a blood clot blocks one of the arteries in your lungs, cutting off oxygen flow. This can cause sudden, sharp chest pain that worsens with coughing or deep breathing. Other symptoms include rapid heartbeat, shortness of breath, and feeling lightheaded. PE is a medical emergency that requires immediate attention.
Diagnosis For Chest Pain While Coughing
Diagnosis begins with a thorough assessment, including:
Medical History & Physical Exam
We ask about the duration, intensity, and nature of your chest pain, and any additional symptoms such as fever, cough, or shortness of breath.
Diagnostic Tests
To pinpoint the cause, we may recommend:
- Chest X-ray: Detects pneumonia, fractures, or lung abnormalities
- CT Scan: Helps rule out blood clots, tumors, or deep infections
- Electrocardiogram (ECG): Rules out cardiac causes of pain
- Blood tests: Check for signs of infection or clotting disorders
- Pulse oximetry: Measures oxygen saturation
- COVID-19 or flu tests, if symptoms overlap
These tools ensure we don’t miss potentially dangerous conditions.
Treatment: Managing Chest Pain While Coughing
Treatment varies depending on the cause. Our physicians provide customized care for quick relief and full recovery.
If Caused by Muscle Strain
- Rest, heat/ice therapy
- Over-the-counter pain relievers (ibuprofen, acetaminophen)
- Gentle stretching or physical therapy if needed
If Due to Infections (Bronchitis, Pneumonia)
- Antibiotics or antivirals, depending on the source
- Cough suppressants and expectorants
- Plenty of fluids and rest
- Breathing treatments for improved lung function
If Triggered by Asthma
- Inhaled corticosteroids or bronchodilators
- Avoiding known triggers (cold air, allergens)
- Monitoring oxygen levels during attacks
For Acid Reflux (GERD)
- Lifestyle changes (no late meals, elevated head while sleeping)
- Proton pump inhibitors or H2 blockers
- Avoiding spicy, fatty foods
If It’s a Pulmonary Embolism
- Emergency care with blood thinners, oxygen, and possible hospitalization
- Immediate imaging and lab testing to confirm diagnosis.
Chest Pain? Don’t Ignore It – Austin ER is Here to Help
Chest pain while coughing isn’t always an emergency, but it can be. If you’re unsure whether your symptoms are serious, it’s better to get checked than risk your health. Whether it’s a viral infection, a lung issue, or something more urgent, fast diagnosis and treatment are key.
Austin Emergency Center is open 24/7 to evaluate, diagnose, and treat chest pain with care and urgency. Walk in anytime, no appointments needed.