What is the cause of thoracic back pain that radiates to the anterior chest with coughing?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: April 9, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for Back Pain Radiating to the Front with Cough

  • Single Most Likely Diagnosis
    • Musculoskeletal strain: This is often the most common cause of back pain that can radiate to the front, especially if it worsens with coughing. The strain could be due to overuse, poor posture, or direct injury to the muscles or ligaments in the back.
  • Other Likely Diagnoses
    • Pneumonia or lung infection: Infections in the lung can cause pleuritic chest pain that radiates to the back and worsens with coughing due to the inflammation of the pleura.
    • Pulmonary embolism: Although less common, a pulmonary embolism can cause sudden onset of back pain that radiates to the front, especially if the embolism is large and affects the lung's pleural surface, leading to pain that worsens with coughing.
    • Gastroesophageal reflux disease (GERD): GERD can cause chest pain that may radiate to the back and can worsen with coughing due to increased abdominal pressure.
  • Do Not Miss Diagnoses
    • Aortic dissection: A life-threatening condition where the inner layer of the aorta tears, causing severe pain that can radiate from the back to the front and can be exacerbated by coughing due to increased blood pressure.
    • Pneumothorax: A collapsed lung can cause sudden, severe chest pain that radiates to the back and worsens with coughing or deep breathing.
    • Esophageal rupture: A rare but serious condition where the esophagus tears, leading to severe chest pain that can radiate to the back and worsen with coughing or movement.
  • Rare Diagnoses
    • Pancreatitis: Inflammation of the pancreas can cause severe abdominal pain that radiates to the back and can worsen with coughing due to the proximity of the pancreas to the diaphragm and the resulting referred pain.
    • Boerhaave's syndrome: A rare condition characterized by a spontaneous rupture of the esophagus, leading to severe chest pain that can radiate to the back and worsen with coughing or movement.
    • Spinal tumors or infections: Although rare, tumors or infections affecting the spine can cause back pain that radiates to the front and can worsen with coughing due to the mechanical stress on the spine.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.