COPD-related pain is usually located in the shoulders, neck, lower back, and chest. And the combination of pain, anxiety, difficulty sleeping, and trouble breathing can take a toll on your quality of life. According to a review of studies published in 2014 in the journal BMJ Open, anywhere from 32 to 60 percent of people with COPD reported experiencing COPD-related pain. So if you have COPD, you may benefit from pain management strategies.
Reasons for COPD and Pain
There are direct and indirect reasons you may be experiencing pain with COPD. “COPD causes pain because the lungs become blown up like balloons. This causes pressure on the chest wall, the spine, and the diaphragm,” explains Harish Seethamraju, MD, medical director of the lung transplant program at the Methodist J.C. Walter Jr. Transplant Center in Houston. “This pain is real and severe, and it can be aggravated just by walking.” Another common cause of pain in COPD is osteoporosis, a condition that involves bone loss. Osteoporosis may affect around 35 percent of people with COPD. This link may be due to COPD inflammation, use of steroid medication in COPD management, a history of smoking, poor nutrition, or inactivity. People with osteoporosis are at an increased risk of bone fractures, which can also exacerbate COPD pain. Extreme bouts of coughing from COPD may cause muscle strains in your chest muscles or even lead to a broken rib, especially if you have osteoporosis. And if an osteoporosis fracture occurs in the spine, it can be difficult to fully expand the lungs and the rib cage, and even result in further loss of lung function in those with COPD. What’s more, “the stress of struggling to breathe can cause anxiety,” Dr. Seethamraju says. “This can cause a person’s pain threshold to decrease and pain sensitivity to increase.”
How to Manage COPD Pain
The right strategy for COPD pain management can vary depending on the cause of your pain and how advanced your COPD is. “Osteoporosis with COPD needs to be recognized and treated appropriately,” says Seethamraju. Some common options for COPD pain relief include:
Paying attention to your breathing. Focus on inhaling slowly and exhaling slowly, sitting up straight, and breathing from the diaphragm. Slowing your breathing down can help you feel more in control and relax your mind and body. Try breathing techniques like pursed lip breathing and diaphragmatic breathing.Eating a healthy diet. Fatty, fried, and processed foods can contribute to gas and bloating, which can trigger chest pain and tightness. Eating too much salt can cause you to retain water, making it more difficult to breathe. Instead, aim to eat a balanced diet that includes plenty of grains, fruits, vegetables, dairy, and lean meat, fish, and poultry. And try to eat small, frequent meals to avoid excess bloating.Pulmonary rehabilitation. “This is the best treatment for chest pain due to expanded lungs,” Seethamraju says. “Pulmonary rehab strengthens the muscles of the chest wall and reduces pain.” This approach includes physical therapy, emotional support, and breathing retraining. It can decrease anxiety as well as improve strength and endurance.Pain medication. If your pain is mild, your doctor may suggest trying over-the-counter pain medication like acetaminophen or ibuprofen. If your pain is more severe, your doctor may prescribe opioid medications, which are often used to treat chronic pain. “They must be used with caution, but they can relieve pain as well as reduce the struggle to breathe in advanced COPD,” Seethamraju says. In large doses, these medications can dangerously decrease breathing, but used at the lowest effective dose, opioids can be part of COPD pain management without significant risk of addiction.Antidepressants. “For people with COPD who are also suffering from pain aggravated by emotional stress, an antidepressant medication may be helpful,” Seethamraju says. Antidepressants may also help reduce anxiety and physical discomfort for people with COPD. Talk therapy and supportive care may also help.
While the relationship between COPD and pain is being increasingly recognized, more research still needs to be done on how to manage. If you have COPD and experience any change in your discomfort or pain levels, be sure to talk with your doctor. And if you are struggling emotionally with pain, ask for help. Work closely with your doctor to determine the cause of your pain and identify the best lifestyle modifications and treatment options for you. Additional reporting by Kerry Weiss
