Can coughing cause chest pain

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Can Coughing Cause Chest Pain?

Coughing is a common symptom experienced by many individuals, often associated with respiratory infections, asthma, and other underlying conditions. However, a frequently asked question is whether coughing itself can lead to chest pain. This article explores the relationship between coughing and chest pain, drawing insights from various research studies.

Cough-Induced Chest Pain: Mechanisms and Causes

Rib Fractures from Severe Coughing

Severe coughing can lead to rib fractures, which are a direct cause of acute chest pain. In a study involving three patients, stress fractures of the ribs were induced by coughing. These fractures were not initially visible on standard radiographs but were later identified using bone scintigraphy and helical CT scans. This highlights that intense coughing can exert enough force to cause structural damage to the ribs, resulting in significant chest pain.

Lung Herniation Due to Coughing

Another rare but notable cause of chest pain from coughing is lung herniation. A case study reported a 67-year-old man who experienced lung herniation through an intercostal space following severe coughing. This condition was confirmed through computed tomography (CT) scans. Lung herniation can cause sharp, localized chest pain and requires medical attention.

Post-Surgical Pain Exacerbated by Coughing

Postoperative patients, particularly those who have undergone thoracotomy for coronary artery bypass graft surgery, often experience chest incision pain. This pain can be exacerbated by deep breathing and coughing exercises. A study demonstrated that cold application could significantly reduce this pain, suggesting that coughing can indeed intensify chest pain in postoperative settings.

Chronic Cough and Chronic Pain Interrelationship

Shared Pathophysiological Mechanisms

Chronic cough and chronic pain share common neurobiological mechanisms and pathophysiology. A large population-based cohort study found a significant association between chronic cough and chronic pain. Subjects with chronic pain were more likely to develop chronic cough and vice versa, indicating that these conditions may share common risk factors and underlying mechanisms. This interrelationship suggests that chronic cough can contribute to persistent chest pain.

Respiratory Conditions Leading to Chest Pain

Asthma and Pneumonia

Respiratory conditions such as asthma and pneumonia are significant causes of chest pain, often accompanied by cough. Children with these conditions typically present with associated respiratory symptoms, including wheezing, tachypnea, and respiratory distress. Treating the underlying respiratory condition usually alleviates the chest pain. This indicates that while the primary cause of chest pain is the respiratory condition, coughing exacerbates the discomfort.

Exercise-Induced Cough in Athletes

Athletes frequently experience cough, particularly after intense exercise. Common causes include asthma, exercise-induced bronchoconstriction, and upper airway cough syndrome (UACS). These conditions can lead to chest pain, especially when the cough is persistent and severe. Managing the underlying cause of the cough is crucial in alleviating the associated chest pain.

Conclusion

Coughing can indeed cause chest pain through various mechanisms, including rib fractures, lung herniation, and exacerbation of postoperative pain. Chronic cough is also interrelated with chronic pain, suggesting shared pathophysiological mechanisms. Additionally, respiratory conditions such as asthma and pneumonia, which involve coughing, can lead to chest pain. Understanding these relationships is essential for effective diagnosis and management of chest pain associated with coughing.