Q I am a 52-year-old man. My chest only hurts when I breathe in deeply or roll over in bed. Why is that?
A If the pain changes with breathing and posture, it is likely related to rib movement. The ribs rise and fall with every breath, and when those joints or the surrounding muscles are stiff, the movement itself becomes painful. Lung causes can present similarly, so they need to be distinguished.
Detailed Answer
The ribs are joined by small joints to the spine at the back and to the breastbone at the front, so they open and close slightly with every breath. When those joints stiffen or the surrounding muscles knot up, pain appears only at moments when the ribs move a lot: a deep breath, a cough, a sneeze, turning over in bed.
However, chest pain that comes with sudden breathlessness, or with fever and coughing, requires the lungs to be checked first. Even if the pain tracks with your breathing, do not assume a musculoskeletal cause if shortness of breath or fever is also present. Get examined.
Korean Medicine Clinic Perspective
It is common for stiffness where the ribs begin at the back to be felt as pain at the front of the chest. For that reason we examine the back and shoulders rather than only the painful spot. Releasing tension in the back with acupuncture often narrows the range of pain during breathing, and for chronically stiff patients we combine moxibustion.
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