How to Tell the Difference Between a Pulled Muscle or Lung Pain

Chest pain is your body’s version of a “check engine” light. Sometimes it’s a harmless (but dramatic) muscle complaint.
Other times, it’s your lungsor something else in the neighborhoodasking for immediate attention. The tricky part?
A pulled muscle and certain lung-related problems can both hurt when you breathe, cough, or move. So let’s sort it out
in a practical, not-panicky way (with just enough humor to keep Google from calling it “thin content”).

Important safety note: This article can help you recognize patterns, but it can’t diagnose you. If you have
chest pain that feels severe, new, or scaryespecially with shortness of breath, fainting, sweating, confusion, or coughing
up bloodtreat it like an emergency and get urgent medical care.

First, what people call “lung pain” usually isn’t your lung tissue

Here’s a weird-but-useful fact: the lung tissue itself isn’t great at producing pain signals. Pain that feels like it’s “in the lung”
often comes from the pleura (the thin lining around the lungs), the chest wall, the ribs, or the muscles between your ribs.
That’s why lung-related problems often cause sharp pain that worsens with deep breathing or coughing.

Quick cheat sheet: pulled muscle vs. lung-related pain

Use this as a pattern-matchernot a final verdict.

What a pulled muscle in the chest can feel like

A “pulled muscle” in this area often means an intercostal muscle strain (muscles between the ribs) or a strain
in nearby chest/upper-back muscles. It can happen from sports, heavy lifting, a sudden twist, repetitive movement, or
even aggressive coughing. Yesyour body can absolutely injure itself while trying to “clear its throat.”

Common pulled-muscle clues

• Tender to touch: pressing along the ribs or muscles recreates the pain.
• Worse with certain moves: twisting, reaching overhead, pushing/pulling a door, getting out of bed.
• Worse with cough/sneeze/deep breath: because those muscles assist with breathing mechanics.
• Feels tight or sore: sometimes with spasms or a “grabby” feeling when you move.
• Timing makes sense: pain starts after activity, a fall, an impact, or a coughing episode.

A simple at-home pattern check (not a diagnosis)

1. Find the spot: if one specific area is very tender when you press it, that leans musculoskeletal.
2. Move without breathing hard: twist gently, reach, or roll your shoulders. If pain spikes with movement, that leans muscular.
3. Now breathe deep: if deep breathing hurts but movement and touch are the main triggers, that still can be a strain.

Reality check: Lung-lining irritation can also hurt with movement, and muscle strains can also hurt with breathing.
That’s why we look at the whole cluster of cluesnot a single “magic symptom.”

What lung-related pain can feel like (and why it matters)

Lung-related pain is often described as pleuritic chest painsharp, stabbing pain that worsens when you breathe in,
cough, or sneeze. It can come from inflammation of the pleura (pleurisy), infection (like pneumonia), a blood clot in the lung
(pulmonary embolism), or a collapsed lung (pneumothorax). Some of these are serious emergencies.

Pleurisy (inflamed lung lining)

Pleurisy often causes sharp chest pain that gets worse with breathing or coughing. Some people also have shortness of breath,
cough, or fever depending on the underlying cause. It may radiate to the shoulder or back.

Pneumonia (lung infection)

Pneumonia can cause chest pain that worsens with breathing or coughingplus symptoms like fever/chills, cough (sometimes with mucus),
fatigue, and shortness of breath. Older adults may experience confusion rather than classic symptoms.

Pulmonary embolism (blood clot in the lung)

A pulmonary embolism often causes sudden shortness of breath and chest pain that may worsen with deep breathing or coughing.
It can also cause rapid breathing, fast heart rate, lightheadedness/fainting, and sometimes coughing up blood. This is an emergency.

Pneumothorax (collapsed lung)

A collapsed lung typically causes sudden chest pain (often on one side) and shortness of breath. It can be life-threatening,
especially if symptoms are severe or worsening.

Red flags: when it’s not a “wait and see” situation

Don’t try to win a toughness medal with chest pain. Seek emergency care (call 911 in the U.S.) if you have chest pain plus any of these:

• Severe or sudden shortness of breath
• Fainting, confusion, or blue lips/nails
• Chest pressure/squeezing, or pain spreading to jaw/arm/back
• Coughing up blood
• Fast heartbeat, rapid breathing, or you feel “impending doom” (your body sometimes knows)
• New, unusual, or worsening chest painespecially if you have heart or clot risk factors

Muscle strain “look-alikes” that can confuse the picture

Costochondritis (inflamed rib cartilage)

Costochondritis is inflammation where ribs connect to the breastbone. It often causes chest wall pain that can feel sharp or aching,
and it may worsen with deep breaths, coughing, or certain movements. Like muscle strain, it can be tender to touchso it can be tricky.

Acid reflux or esophageal spasm

Burning pain after meals, sour taste, or symptoms that improve with antacids can point toward reflux. It can mimic chest pain and create
anxiety, which then makes breathing feel worse. The human body is nothing if not dramatic.

Anxiety and panic symptoms

Panic can create chest tightness, rapid breathing, tingling, dizziness, and a sense of danger. But (important!) you should never assume
chest pain is “just anxiety” if it’s new, severe, or paired with warning signs.

What clinicians do to tell the difference

If you go to urgent care or the ER, your clinician will usually combine:

• History: what you were doing when it started, illness exposure, travel, injuries, risk factors.
• Exam: listening to lungs, checking oxygen level, pressing on chest wall, evaluating movement.
• Tests when needed: EKG, chest X-ray, blood tests, sometimes CT imagingespecially if clot or collapsed lung is a concern.

What you can do if it seems like a pulled muscle (and no red flags)

If your symptoms strongly fit a strain and you don’t have red flags, supportive care often helps:

• Relative rest: avoid movements that spike pain, but don’t immobilize completely for days on end.
• Ice/heat: ice in the first 24–48 hours if it feels inflamed; heat later for tightness (choose what feels better).
• Gentle breathing: shallow breathing can make you feel worse overall. Take slow, comfortable breaths to avoid guarding.
• OTC pain relief: follow label instructions and confirm safety if you have ulcers, kidney disease, blood thinners, etc.
• Gradual return to activity: as pain calms down, ease back inyour ribs would like you to stop speed-running recovery.

When to call a clinician even if you suspect a strain

• Pain is intense, worsening, or lasts more than a week without improvement
• You develop fever, productive cough, wheezing, or shortness of breath
• Pain began after significant trauma (car accident, fall, sports hit)
• You have clot risk factors (recent surgery, long travel, cancer, pregnancy/postpartum, prior clots)

Real-world examples: putting the clues together

Example 1: The “weekend warrior” rib twinge

You carried a heavy box upstairs, twisted to set it down, and felt a sharp pull along your ribs. Now it hurts when you reach overhead,
laugh, or press the spot. No fever, no cough, breathing is okay except it hurts to inhale deeply. This pattern is very consistent with an
intercostal muscle strain.

Example 2: The “I thought it was a muscle” infection

You’ve had a cough for several days, feel worn out, and now you have chest pain when you breathe or coughplus fever and chills.
That cluster leans more toward pneumonia or pleurisy related to an infection and deserves medical evaluation.

Example 3: The “out of nowhere” emergency

You’re sitting still and suddenly feel sharp chest pain and shortness of breath. Your heart is racing, and you feel lightheaded.
That’s not a “stretch and see” situation. Call emergency servicesconditions like pulmonary embolism or pneumothorax need urgent care.

Experiences related to “pulled muscle vs lung pain” (for extra clarity)

The stories below are composite, illustrative experiencesnot real patient recordsmeant to highlight common patterns people report.
If any story sounds like you and includes warning signs, treat it seriously and seek care.

Experience 1: “It hurt exactly where my bra line sits”

A middle-aged office worker noticed a sharp pain on one side of the ribs after a long day of poor posture and a quick attempt at “core day”
(ten sit-ups, maximum ambition). The pain was pinpoint and very tender to touch. Twisting to grab a seatbelt made it flare, and a deep breath
made it stingbut only because the area felt tight. No cough, no fever, and walking around didn’t cause breathlessness. With rest, gentle movement,
and time, the pain eased over several days. The biggest giveaway was reproducible pain with pressing and torso movement.

Experience 2: “I was sure I pulled something coughing”

A college student had a stubborn cough for a week and developed sharp chest pain when coughing and breathing in. At first, it felt like a muscle
strainuntil the fever arrived, along with fatigue and a cough producing mucus. The pain wasn’t especially tender when pressed. Breathing felt
“tight,” not just painful. A clinician visit led to evaluation for an infection. The lesson: coughing can cause muscle pain, but fever, worsening
fatigue, and breathing symptoms shift the odds toward a lung-related cause.

Experience 3: “It only hurt when I reached uplike a zipper snag”

Someone renovating a kitchen felt a sudden “zip” under the shoulder blade while drilling overhead. After that, reaching, pulling, and rolling over
in bed triggered pain along the side of the chest. They could recreate it by pressing between the ribs. Deep breaths were uncomfortable but not
scary, and there was no shortness of breathjust frustration. This pattern fits a chest wall strain where the mechanical use of the muscles is the
main trigger, and breathing pain is secondary.

Experience 4: “The pain was sharp, but the weird part was the air hunger”

A traveler returned from a long flight and developed sudden shortness of breath and a sharp chest pain that worsened with deep breathing. They
tried stretching, thinking it might be a muscle cramp from travel posturebut the breathlessness felt out of proportion. Walking across a room
felt harder than usual, and the heart felt like it was sprinting while the body was not. This is the kind of pattern that should trigger urgent
evaluation, because conditions like a pulmonary embolism can present this way.

Experience 5: “I could not get comfortable unless I lay on one side”

A person recovering from a viral illness reported stabbing chest pain with deep breaths and coughing. Oddly, lying on the painful side made it feel
slightly better, like bracing the area reduced the “rub.” Pressing the chest wall didn’t reliably reproduce the pain. They also had mild fever and
felt drained. That combinationbreathing-linked pain after illness, possible fever, and relief by limiting chest wall motionoften matches the way
pleuritic pain is described.

Experience 6: “I thought it was a pulled muscle… until the breathing got fast”

A recreational runner felt sudden one-sided chest pain during an easy jog, followed quickly by shortness of breath. The pain was sharp and worse
with breaths, but there wasn’t an obvious twist or strain moment. They stopped running, but breathing still felt difficult. That “sudden + one-sided
+ breathless” pattern is a reason to seek emergency care, because a collapsed lung can feel like this and may worsen quickly.

Bottom line

Pulled muscles tend to be mechanical: tender to touch, linked to movement, and tied to a clear trigger like lifting, twisting,
or overuse. Lung-related pain often feels pleuritic: sharp with deep breaths or coughing and more likely to come with cough, fever,
unusual fatigue, or real shortness of breath. When symptoms are sudden, severe, or paired with red flagsdon’t self-diagnose. Get evaluated.