If you have side pain when coughing, you most likely have been coughing forcefully for a while and strained a muscle. When you cough, you are forcing the air out of your lungs. This is a natural reaction to help clear your lungs of something irritating and uses the accessory muscles in the chest, sides, and ribs. 

However, it may not always be a strained muscle.

Coughing may be caused by an infection, lung disease, or cancer. Sudden coughing with pain may need to be checked immediately, while coughing with pain in the side over a long period of time may warrant a visit to your doctor. This article explains some of the common causes and when to be concerned.

Causes of Side Pain When Coughing

1. Strained Muscles

When you cough forcefully, you can cause the fibers in your chest, sides, and abdomen to stretch too far and sustain small tears. Coughing is considered something very strenuous and hard on your body. These are only minor tears and will heal up over a few weeks after your coughing subsides.

Symptoms:

• Side pain when coughing in the sides, ribs, or abdomen
• Trouble bending or twisting
• Unable to flex side muscles
• Muscles in sides tender to the touch
• Pain when breathing

2. Pneumonia

Pneumonia is an infection in the lower respiratory tract. It can be either bacterial or viral. With pneumonia you can suffer from a severe productive cough for days to even weeks after the infection has cleared. This chronic coughing can cause side pain or even rib pain. Pain can also be caused when fluids build up inside or outside of the lungs due to infection.

Symptoms:

• Coughing with pain
• Trouble thinking clearly
• Excess phlegm
• Fever and chills
• Feeling tired
• Trouble breathing
• Nausea and vomiting

3. Pleurisy

Inflammation to the lining of your lung cavity causes pain with coughing and breathing. This is known as, pleurisy or pleuritis. The pleura lines the area between the chest wall and the lung tissue. It has a fluid that lubricates it and sometimes this can become infected. This causes pain with coughing and/or breathing, and the pain is usually sharp and stabbing.

Symptoms

• Chest wall pain
• Cough
• Trouble breathing
• Pain with touching the area

4. Tuberculosis

Tuberculosis is a highly contagious and hard to treat lung infection. It is bacterial and requires months of antibiotic treatment. TB is commonly found in hospitals, jails, and other places where people live in close quarters. It can cause side pain when coughing and overall chest pain from chronic coughing over a period of months.

Symptoms

• Night sweats
• Cough
• Blood in sputum
• Fever
• Chills
• Weight loss
• Chest pain

5. Fractured Rib

If you have side pain when coughing, you may have a cracked or fractured rib. This may be caused by trauma to the ribs or even prolonged coughing. When you cough, you expand your ribcage and this may displace the fracture.

Symptoms

• Tenderness when touching the area
• Swelling
• Redness
• Pain when taking a breath in

6. Blood Clot in Lungs

A blood clot in the lungs is a serious medical emergency and needs medical attention right away. It can occur suddenly with no warning. You may at first have a sudden cough with pain in your side, chest, back, or ribs. Then you may experience trouble breathing. If this happens, call 9-1-1 right away.

Symptoms

• Pink sputum
• Heart palpitations
• Chest pain that is crushing
• Feeling of doom or anxiety
• Feeling lightheaded

7. Aspergillosis

This fungus can enter your lungs and cause either a fungal lung infection or an allergic reaction. Most people can fight off the fungus after breathing it in, but if your immune system is weak then you can become infected. The fungus is inhaled and people around vegetation regularly are at a higher risk.

This infection can cause severe coughing due to fungal spores in the lung tissue, resulting in side pain when coughing.

Symptoms

• Cough
• Blood in sputum
• Pain in the joints, bones, and chest
• Headaches
• Low urine output
• Blurred vision
• Chills
• Sores on the skin

8. Costochondritis (Rib Inflammation)

Costochondritis occurs when the cartilage and joints in between your ribs become inflamed. This is not an injury or an illness, but something that just happens for seemingly no reason. Doctors are not sure what causes it, but it may be autoimmune in nature.

The pain of costochondritis is most often noticed when coughing and is felt in the affected ribs. This can happen on the side, front of your chest, or your back.

Summary

• Pain in ribs
• Tenderness to the touch
• Pain with deep breathing or coughing
• Difficulty bending or twisting

9. Lung Cancer

Lung cancer is the rapid overgrowth of abnormal cells in lung tissue. Lung cancer may also start elsewhere in the body and invade the lung tissue. If the tumor is near your side, you may feel pain when coughing. Lung cancer can also cause a chronic cough that can pull muscles and make you feel pain in your side.

Symptoms

• Cough
• Wheezing
• Shortness of breath
• Fatigue
• Hoarse voice
• Weight loss
• Swelling
• Chronic lung infection
• Headaches

When to See a Doctor

Side pain when coughing usually isn’t anything to worry about if you have an illness that causes excessive coughing. This usually goes away and heals shortly after you recover from your cough. However, if the pain becomes severe and interferes with your breathing, you may need to check with your doctor. Symptoms you need to have checked by your doctor include:

• Coughing up blood
• Fever over 100.3
• Cough that lingers
• Wheezing/tightness
• Side pain that radiates when coughing
• Nausea/vomiting with coughing
• Night sweats with cough
• Weight loss
• Cough with chronic illness

Certain things that cause pain with coughing could be a medical emergency. Call 9-1-1 or get emergency medical attention if the following symptoms occur:

• Blue discoloration of lips, fingers, toes
• Sudden severe pain in chest or side
• Severe shortness of breath
• Chest tightening
• Cough with weakness
• Feeling dizzy
• Fast heartbeat with cough