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Why Does It Hurt When I Cough?

Understanding Pain Caused By Coughing

Camille Freking, MS Pharmacology Profile Photo

Written by Camille Freking, MS Pharmacology on November 1, 2021

It can be alarming and uncomfortable to experience pain when you cough. This article will take a look at ten of the most common causes of painful coughing.

Although it is helpful to know what may be causing you pain while coughing, it is best to see a doctor if your cough becomes too painful in order to get a proper diagnosis and treatment plan.

You should see your doctor immediately if you find that you’re coughing up blood as that can indicate a severe problem that requires immediate medical attention.

Although it can be distressing and uncomfortable to experience a painful cough, it is also important to keep in mind that several treatment options are available depending on the cause of your cough.

10 Causes Of Painful Coughing To Be Aware Of

This section will cover ten of the most common causes of painful coughing. Chest pain during coughing can indicate a wide range of medical ailments, so it is important to know some of the potential causes.

#1: Acid Reflux

As a digestive disease, acid reflux can cause regurgitation and nausea. However, many people also experience coughing. Acid reflux occurs when the acid in your stomach flows back into your esophagus. This can be a painful and intense sensation, and coughing might occur as you try to swallow the acid.

#2: Acute Bronchitis

Acute bronchitis results from inflammation of the bronchial tubes, which are tubes that carry air to and from your lungs. Inflammation of these tubes can make it difficult to breathe, which can cause pain and pressure in the chest. Another name for acute bronchitis is a chest cold.

Bronchitis can be a chronic disease, but for most people, it is a short, acute infection much like the common cold. Usually, bronchitis precedes or follows a cold or the flu. When your bronchial tubes are irritated, you can experience several, severe bouts of coughing. However, the symptoms of acute bronchitis should clear up after about a week or so. That being said, in some cases, the cough can last for several weeks.

 #3: Asthma

Asthma causes a narrowing and inflammation of the airways that makes it difficult to breathe and can lead to chronic, painful coughing in some people. The excess mucus created by asthma can also lead to a painful cough. With asthma, it is common to experience chest pain after a round of coughing.

Depending on the type of asthma you have, different environmental conditions and activities can trigger inflammation and swelling in your airways, greatly restricting your ability to breathe. This is known as an asthma attack. During an asthma attack, you might experience wheezing and a painful tightening in your chest.

#4: Cancer

Lung cancer could be the cause of a chronic, painful cough for someone that is not fighting off an infection, such as a cold or the flu.

That being said, lung cancer often results in several other symptoms that you can watch for such as:

  • A general feeling of weakness
  • Inexplicable weight loss
  • Fatigue
  • Shortness of breath
  • Wheezing and coughing
  • Loss of appetite
  • Hoarseness

Lung cancer is more common in people who have a history of smoking. Although there may not be symptoms of lung cancer in the early stages, it is possible to develop a cough that produces blood as the cancer progresses.

#5: COPD

COPD, or chronic obstructive pulmonary disease, is the name for a group of conditions that cause inflamed, swollen, and blocked airways. These conditions include bronchitis, emphysema, and refractory asthma. Over time, the symptoms of these diseases are known to get worse. The primary symptom of COPD is shortness of breath.

Other symptoms include:

  • Painful coughing
  • Shortness of breath
  • Lack of energy and sluggishness
  • Trouble breathing
  • Wheezing

Much like lung cancer, smoking and exposure to poor quality air over a long period of time can make the symptoms of COPD worse. As the inflammation in your lungs gets worse, more mucus is produced. This mucus is what causes chronic cough and tightness in the chest.

#6: Flu

The flu, also known as influenza, is a contagious respiratory illness. Although it is often confused with the common cold, the flu is a more severe illness.

A painful cough is a possible symptom of the flu along with:

  • Fever
  • Muscle aches
  • Runny nose
  • Fatigue
  • Headache
  • Body aches

Usually, as your body produces less mucus, your cough will lessen. Given that a cough caused by the flu can often lead to chest pain, it is likely that the discomfort in your chest will also improve as the cough goes away.

#7: Lupus

Lupus is an autoimmune disease that affects your joints, skin, and lungs. When lupus affects your lungs, the lining on the outside of your lungs becomes infected which can lead to chest pain, shortness of breath, and a chronic, painful cough. Along with these symptoms, lupus might also cause fever, fatigue, and joint pain.

#8: Pneumonia

Pneumonia is a lung infection that is common and can be dangerous, especially for older people, children, and anyone with a compromised immune system. If you have pneumonia, the air sacs in your lungs have been infected by a virus, bacteria, fungus, or a parasite. It is also common for viral pneumonia to develop in people after they have a cold or the flu.

Although pneumonia can be dangerous, people usually recover from pneumonia with appropriate treatment.

Along with a cough that causes a sharp, stabbing pain in the chest, people with pneumonia often experience:

  • Shortness of breath
  • Shallow breathing
  • Rapid breathing
  • Chills
  • High fever
  • General feeling of being very ill
  • Confusion and disorientation in older people
  • Nausea and vomiting in children

#9: Muscle Exhaustion

When you cough, you use muscles in your chest, back, and abdomen. If you have an intense cough, after days of coughing you may exhaust the muscles in these regions of your body. This exhaustion might lead to soreness and pain around the chest area. This soreness is similar to what you might experience after an intense, taxing exercise.

Usually, the pain caused by coughing gets better as your cough improves over time. Although this type of pain is usually nothing to be concerned about, it can be difficult to distinguish the pain caused by muscle exhaustion during a cough from that of an inflamed lung or other types of pain. For this reason, if your body aches when you have a cough, it is important to see a doctor.

#10: Pleurisy

Pleurisy is characterized by inflammation of the pleural tissue. The pleural tissue lines the outside of your lungs and the inside of the chest wall or cavity. This type of inflammation can lead to sharp chest pain that gets worse when you breathe, sneeze, or cough. It can also cause fluid to develop in between layers of the pleural tissue.

It is common for pleurisy to develop during or after pneumonia. Other infections and conditions can also cause pleurisy. In extreme cases, this condition can be life-threatening.

Other symptoms of pleurisy include:

  • Difficulty breathing
  • Shortness of breath
  • Fever
  • Chest pain that gets worse when coughing
  • Trouble breathing

Diagnosing Painful Coughing

Unfortunately, there is no one, single way to diagnose the underlying cause of a painful cough. It is possible for doctors to determine the cause of your cough through performing a physical examination, asking about your symptoms, and conducting a series of tests. The tests that they order might be used to check your chest and look for signs of infection, inflammation, or tumors. It is important to be as honest as possible with your doctor, so they can get an accurate understanding of your cough and adjoining symptoms.

The tests your doctors perform may include:

  • Imaging tests such as an X-ray, CT scan, or MRI
  • A sputum test that can check if your mucus contains signs of an infection or allergy
  • A pulmonary function test to measure if or how well your lungs are transporting oxygen in your blood
  • A complete blood test to confirm or rule out if you have lupus. The test will evaluate the number of red blood cells in your body. A low red blood cell count can indicate anemia, which is a symptom of lupus. Blood tests can also check for antibodies that could confirm a lupus diagnosis.


There are several reasons that you might experience a painful cough. The ten most common causes of a painful cough include acid reflux, acute bronchitis, asthma, cancer, COPD, flu, lupus, pneumonia, muscle exhaustion, and pleurisy.

Given that the symptoms of many of these ailments are similar, it can be difficult to determine what the exact cause of your painful cough is. In order to properly diagnose your cough and find the best treatment method, it is best to see your doctor to get a full diagnosis.