Does COPD Cause Pain?

Prevalence of Pain is More Common in COPD (41%) Than Healthy Subjects (29%)

Background: Pain and shortness of breath are both unpleasant experiences which affect an individual’s quality of life. In different studies, the frequency of pain ranges from 44% to 88% in those with COPD. Study: Dr. Annemarie Lee and colleagues at the West Park Healthcare Centre in Toronto studied 64 patients with COPD referred to a pulmonary rehabilitation program and 64 healthy subjects of the same age. All answered questionnaires about pain over a one week period, including location, its frequency, and how long it lasts, as well as questionnaires about shortness of breath, quality of life, etc.. The study is published on-line in the Journal of the COPD Foundation [2017; 4(3): In press. doi: http://doi.org/10.15326/jcopdf.4.3.2016.0172] Results: Age range was 48 to 91 years in the COPD group and 47 to 94 in the healthy group. Those with COPD had either severe or very severe COPD based on results of breathing tests. Pain frequency was 41% of those with COPD and 29% in healthy subjects.
anatomical locations for chest and upper back pain

Chest and upper back pain are more common in those with COPD

Pain was more common in the chest and upper back areas in those with COPD compared to healthy subjects. It was described as aching (30%), tiring (17%), and penetrating (17%). The location in the chest and upper back was associated with more air in the lungs (higher total lung capacity) as measured on breathing tests. Those with painful experiences also had more shortness of breath with activities and higher depression scores.
Locations of the chest for pain

Rib cage

Conclusions: The authors proposed that hyperinflation of the lungs (too much air trapped in the lungs) could cause stretching of the chest wall and cause strain on ligaments between ribs as well as excessive forces on the joints. My Comments: Unfortunately, the researchers did not evaluate the cause of pain experienced by the subjects. For example, could some of those with COPD have arthritis of the spine?  It is important to remember that there are no pain sensors in the lung itself, but rather in the lining around the lung (called the pleura) and in areas of the muscles, joints, and ligaments in the chest wall. The treatment for too much air trapped in the lungs includes bronchodilators (inhalers that open up the breathing tubes allowing more air to exit), oxygen, and exercise training.

Donald A. Mahler, M.D. is Emeritus Professor of Medicine at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. He works as a pulmonary physician at Valley Regional Hospital in Claremont, NH, where he is Director of Respiratory Services.