Right Upper Back Pain: Is It Muscle Strain or Lung Issues?

Q: Right Upper Back Pain: Is It Muscle Strain or Lung Issues?

Hello： If there is no severe coughing, it is unlikely that food particles have aspirated into the lungs.

Occasional mild pain near the spine on the right side of the back?

Hello, doctor.
While I was eating, my nose suddenly became very itchy, and I felt the urge to sneeze but couldn't.
At that moment, I had taken a bite of white rice and felt like something had momentarily gone down my throat, though I'm not sure if it went into my nasal cavity.
Later, when I tried to blow my nose, nothing came out.
However, I then experienced a sudden pain in my right upper back near the spine, which still feels slightly painful now, especially when I try to straighten my chest.

Could it be possible that a grain of rice went into my lungs, leading to pneumonia or similar issues? I asked my brother, and he said it might just be muscle or bone pain, suggesting that I might have strained my back muscles when I felt the urge to sneeze but didn't actually sneeze.
He mentioned that the pressure from trying to sneeze without actually doing so could have caused the strain.

However, I read online that pain in the right upper back could be related to pneumonia and other issues.
I only felt the urge to sneeze, and since I was eating, I'm worried that the rice might have gone down the wrong way, even though I didn't feel like coughing at that time.
I'm concerned about whether this could pose any danger or if it's more likely just a muscle strain that doesn't require a visit to a major hospital.
I apologize for bothering you at night, and thank you for your help.

zz, 10~19 year old female. Ask Date: 2020/04/24

Dr. Yang Wenda reply Pulmonology

Hello: If there is no severe coughing, it is unlikely that food particles have aspirated into the lungs.

Reply Date: 2020/04/24

More Info

It's understandable to feel concerned about sudden pain, especially when it follows an unusual event like trying to sneeze while eating. Based on your description, it seems that the pain in your right upper back could likely be attributed to muscle strain rather than a serious lung issue like pneumonia.

When you mentioned that you felt a sudden pain near your spine after trying to sneeze while eating, it’s possible that the action of trying to sneeze, combined with the act of eating, may have caused a strain in the muscles of your back. Sneezing, or in this case, the attempt to sneeze, involves a rapid contraction of the muscles in your chest and back. If you were in an awkward position or if your muscles were tense, this could lead to a strain. The fact that the pain is more noticeable when you straighten your posture suggests that it may be related to muscle tension or strain rather than an issue with your lungs.

Regarding your concern about food particles entering your lungs, while it is possible for small particles to be aspirated into the airway, this typically leads to coughing or a sensation of choking. If you did not experience any coughing or difficulty breathing immediately after the incident, it is less likely that food has entered your lungs. Pneumonia usually develops after a significant aspiration event, and it is often accompanied by symptoms such as persistent cough, fever, and difficulty breathing. If you were to develop any of these symptoms, it would be important to seek medical attention.

Your brother's suggestion that the pain could be due to muscle strain is quite plausible. Muscle strains can occur from sudden movements or awkward positions, and they can cause localized pain that may feel sharp or aching. If the pain persists or worsens, or if you develop any new symptoms such as fever, persistent cough, or shortness of breath, it would be wise to consult a healthcare professional for a thorough evaluation.

In the meantime, here are some recommendations to help manage your discomfort:
1. Rest: Avoid activities that exacerbate the pain. Give your muscles time to heal.

2. Ice and Heat Therapy: Applying ice to the affected area for the first 24-48 hours can help reduce inflammation. After that, switching to heat can help relax and soothe the muscles.

3. Gentle Stretching: Once the acute pain subsides, gentle stretching exercises can help improve flexibility and reduce tension in the back muscles.

4. Posture Awareness: Be mindful of your posture, especially when sitting or standing for long periods. Maintaining good posture can help alleviate strain on your back.

5. Over-the-Counter Pain Relief: If necessary, over-the-counter pain medications like ibuprofen or acetaminophen can help manage pain and inflammation.

If your symptoms do not improve within a few days or if you have any concerns about your health, it is always best to consult with a healthcare provider. They can perform a physical examination and, if necessary, imaging studies to rule out any serious conditions. Remember, it’s always better to err on the side of caution when it comes to your health.

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