Pain in acute and chronic bronchitis: the reasons for what to do?

The pain accompanies many diseases: in some cases it is one of the signs of inflammation, and in others - the result of any accompanying disorders in the body. Thus, pain in bronchitis can be caused by immediate changes due to the inflammatory process in the respiratory system. But in some cases they indicate the presence of other health problems.

Bronchitis is a kind of border disease, which is often seriously complicated. Therefore, the appearance of pain should not only alert, but also cause a prompt call to the doctor. Some types of pain signal extremely dangerous conditions, in which medical care should be provided immediately.

[1], [2]

Causes of the hurts in the bronchi

Bronchitis can be caused by viral or microbial pathology. Sometimes it develops under the influence of an allergic process or chemical intoxication, but always with bronchitis there is an inflammatory process of a different etiology. Pain in bronchitis is a consequence of a "response" of respiratory receptors to regular arousal (cough) or other irritating factors.

Localization, depending on the source of pain in bronchitis, can be different. And this is not only the thorax, but also the back, the hypochondrium, the head. Therefore, one can not pinpoint exactly whether such pain is a consequence of the inflammatory process in the bronchi. A similar symptom occurs in other diseases that can develop against the background of the same bronchitis, for example:

• Pleurisy - accompanied by pain behind the sternum, which is worse, both with coughing and with inspiration.
• Tracheitis - most often reveals itself pain in the left side of the chest.
• Pneumonia - is manifested by severe chest pains; often the patient simply can not breathe.
• Tuberculosis - can be accompanied by pain, both in the chest, and in the back and joints.

Painful cardiovascular diseases (myocardial infarction, attack of angina pectoris), mechanical traumas of the chest or spine, irregularities in the functioning of organs located below the thorax (liver, biliary system, intestinal tract, diaphragm) are also often the causes of pain in bronchitis.

To the listed diseases which are diagnosed a little bit less often, it is possible to add and such:

• vegetative-vascular dystonia;
• hernia;
• osteochondrosis;
• acute leukemia.

[3], [4]

Risk factors

Risk factors for the occurrence of pain in bronchitis can be considered:

• hypothermia, severe decrease in immunity;
• inhalation of irritating volatile substances, chemical intoxications;
• trauma of the chest;
• smoking;
• long stay in dusty, gassy or smoky rooms;
• lack of necessary treatment for acute bronchitis.

The risk group for the occurrence of pain in bronchitis include such patients:

• workers of hot shops, cooks, barbers;
• ovens;
• workers of the grain-processing industry;
• miners, masons;
• railway and road workers;
• workers of chemical enterprises, warehouses;
• Painters, plasterers, concrete workers.

A special category of risk includes patients suffering from frequent allergic reactions and bronchial asthma.

[5], [6], [7], [8]

Pathogenesis

In the course of the bronchial tree there is a large number of nerve endings. It is because of this, with a coughing jerk, the patient can feel pain from the back, or more precisely - in the thoracic spine. Painful sensations are the result of a sharp muscle contraction, especially if the cough is long and painful.

In the process of cough, abdominal and intercostal contractions are observed not only in the pectoral musculature. At the time of contractions, pressure is exerted on the nerve fibers that extend from the spinal column in the thoracic and lumbar regions, which is also manifested by pain.

At the initial stage of bronchitis, cough is always more pronounced, which is explained by the excessive viscosity of sputum excreta, which is poorly separated and hardly leaves the bronchi. At the same time, muscular contractions occur constantly: hence - the appearance of pain in the back and chest.

However, we can assume the presence of other causes of pain in bronchitis:

• Other diseases of the respiratory system, in addition to bronchitis;
• neuritis, neuralgia;
• diseases of the cardiovascular system;
• disorders of the spinal column.

In many patients the pain provokes not bronchitis, but the main symptom of the disease is a cough. For example, with atypical pneumonia, which occurs almost asymptomatically, pleurisy can develop: this complication will already be accompanied by severe pain during coughing or body movements. In a similar situation, we can talk about the development of chronic bronchitis.

Without certain symptoms, osteochondrosis can also occur: pain can only be detected with the onset of bronchitis - when coughing. Equivalent picture is observed with intercostal neuralgia, pericardial inflammation or multiple myositis.

Considering the above, when you have pain in bronchitis, you need to undergo a series of diagnostic measures in order to find out the exact cause of the unpleasant symptom.

[9], [10], [11], [12]

Epidemiology

According to statistics, pain in bronchitis disturbs every third patient. In this case, the main cause of pain are various complications: the transition of the disease to a chronic form, the development of pneumonia,

Pain in bronchitis is more common for patients older than 40 years of age, as well as heavy smokers. Children and young people can also complain about painful feelings, but much less often.

[13], [14], [15], [16]

Symptoms

The first and most pronounced symptom of bronchitis is cough. At first it is dry, and as the disease progresses it becomes wet, with abundant mucus discharge. And only at the next stage there can be a pain at a cough and a bronchitis: such pain amplifies at intensive attacks. The chest, head, back, liver region can hurt. The exact characteristics of pain also depend on the cause of this phenomenon.

• Pain in the chest with bronchitis is usually accompanied by dry, intrusive coughing jerks. Such a pain is manifested by an unpleasant sensation of scratching in the sternum: the symptom increases during coughing and may indicate the development of tracheitis, an inflammatory process in the respiratory tube that connects the bronchi and the larynx.
• Headache with bronchitis is common, if the disease is accompanied by fever and chills. In a similar situation, pain in the head indicates a general intoxication of the body: the condition is aggravated by general weakness, drowsiness, pallor of the skin, thirst. In patients prone to hypertension, the headache may be associated with increased blood pressure.
• If the back hurts with bronchitis, then it is possible to suspect the development of complications such as pleurisy or pneumonia. With inflammation of the pleura, pain occurs in the area between the scapula. Other symptoms are: high fever, loss of appetite, dyspnea, persistent cough. Among other possible causes can act pancreatitis, which also marked pain in the back.
• Pain in the lungs with bronchitis occurs with the development of complications such as pneumonia and pleurisy: pneumonia makes breathing difficult, right up to choking attacks. With pleurisy there is a dry cough with stabbing pains, which intensify with a deep inspiration.
• Pain in the throat with bronchitis, intense "tearing" cough, tingling or rubbing in the nasopharynx, dryness, hoarseness, pershenia are signs of pharyngitis or laryngitis. The patient complains of a painful swallowing and a paroxysmal dry cough.
• Pain in the ribs with bronchitis after inhalation can become a sign of intercostal neuralgia - reflex syndrome, which is provoked by either pinching the spinal nerve root in the thoracic part of the spinal column, or by irritation of the intercostal nerves in the intercostal space. However, in some cases, such pain can become a sign of pleurisy, pneumonia, cardiac insufficiency, and even stomach ulcers. Therefore, a thorough diagnosis in this situation is extremely necessary.
• If the chest hurts with bronchitis, then you should exclude chest trauma, liver disease and tumor processes. With the localization of pain in the lower parts of the chest, the cause may be an intense strained cough, accompanied by a contraction of the musculature of the diaphragm.
• Pain in the heart with bronchitis can be associated with coronary heart disease (such pain occurs after a period of rest or intake of Nitroglycerin), with myocardial infarction (there is an arrhythmia, weakness, dyspnea), with pericarditis (pain sharp, aching in the anterior thoracic region), with insufficiency of cardiac activity (edema and ascites phenomena are observed).
• Pain in the side with bronchitis is a symptom that can indicate the occurrence of a complication in the form of unilateral pneumonia. Depending on the nature of the clinical picture, with pain in the right side, you can also suspect liver or gallbladder disease.
• Pain behind the sternum with bronchitis against a background of shortness of breath (up to paroxysmal suffocation) can be observed, as with pleurisy and pneumonia, and with heart diseases. Diagnostic measures in this situation should be urgent.
• Pain under the scapula in bronchitis can be a consequence of osteochondrosis, pericarditis, or indicate the development of pre-infarction. With such a symptom it is important to make an electrocardiogram in a timely manner.
• Pain in the muscles with bronchitis is most often associated with excessive muscular tension in a paroxysmal intense cough. The condition of muscle pain and aches is possible after a prolonged fever with a strong fever. If the pain is sharp, "shooting", then one can suspect the development of neuralgia.
• If the ear hurts with bronchitis, then it is possible to suspect not only otitis, but also other diseases of the ENT organs (because of their close anatomical connection). So, first of all it is necessary to exclude development of an otitis, a genyantritis and a tonsillitis.

[17], [18]

Diagnostics of the hurts in the bronchi

To determine the cause of the appearance of pain in bronchitis, it is necessary first of all to find out the history of the disease. The doctor carefully listens to the patient's complaints and clarifies what other symptoms are present other than pain. In addition, the length and intensity of smoking, as well as professional and household characteristics are taken into account.

A lot of information is provided by ordinary auscultation: the doctor will pay attention to the rigidity of breathing, elongation or shortening of exhalation, the presence of dry, wet or wheezing rales. If we are talking about emphysema, then percussion will be determined by a kind of boxed sound.

To confirm the various diseases of the respiratory system, instrumental diagnostics, in particular, chest X-ray, are of particular value. This method allows to identify chronic bronchitis, pneumonia, tuberculosis, emphysema, malignant process.

Sputum microscopy allows to determine the degree of its viscosity, character (mucous, purulent), the presence of neutrophils.

Sputum vaccination helps in determining the bacterial pathogen, which can act as streptococcus, staphylococcus, hemophilic rod, klebsiella, pseudomonas, enterobacteria, etc. If difficulties occur with sputum collection, then bronchoscopy is carried out with a bacilli of washing bronchial water.

Bronchography can eliminate bronchiectasis.

To eliminate diseases of the cardiovascular system, an electrocardiogram, ultrasound of the heart, monitoring of arterial pressure is carried out.

Laboratory tests include conducting a general analysis of urine and blood, evaluating the total protein with protein fractions. Fibrin, CRP, immunoglobulins, sialic acids, etc. Are also studied. If there is severe respiratory failure, the acid-base state of the blood and its gas composition are examined.

[19], [20], [21], [22], [23]

Differential diagnosis

In no case will the doctor be able to accurately answer whether the pain is a consequence of bronchitis. After all, a similar symptom is present in many other diseases. Therefore, differential diagnosis is additionally carried out, during which the following diseases are considered:

• Pleurisy (accompanied by acute pain in the chest on inspiration);
• tracheitis (accompanied by pain on the left side of the chest);
• pneumonia (pain can affect the entire chest, giving in the back);
• tuberculosis (pain can occur both in the chest, back, and in the joints).

It should also exclude heart diseases (myocardial infarction, IHD), trauma of the chest and back, diseases of the hepatobiliary system, osteochondrosis, spine diseases.

[24], [25], [26], [27]

Treatment of the hurts in the bronchi

In order to eliminate pain in bronchitis, you need to work on the main cause of discomfort. It can be, as the bronchitis itself, and other concomitant pathology.

Drug treatment is prescribed by the doctor, depending on the outcome of the diagnosis and the established diagnosis.

There are a number of rules that must be observed in order for the treatment to be successful:

• For pain with bronchitis, strict bed rest is necessary. If you endure the disease "on your feet," the condition may worsen.
• It is important to exclude excessive physical activity.
• When you have bronchitis, you should drink relatively much warm liquid in the form of pure water, herbal decoctions, tea.
• If the pain with bronchitis is caused by a dry cough, it is recommended to drink non-carbonated alkaline warm water.
• In agreement with the doctor against the background of general treatment, it is desirable to take vitamin preparations.
• According to the prescription of the doctor, you need to take expectorant, antihistamines. And in the absence of a curative effect, during the first three days after the onset of the disease the physician can insist on carrying out antibiotic therapy.
• Pain is eliminated by the appointment of painkillers and anti-inflammatory drugs.

With severe pain, you can take Ibuprofen, Paracetamol and other non-steroid drugs, and with pain in the spine or ribs - Orthofen and Nimesulid. Patients with bronchitis are often prescribed a specific drug that stops the development of the inflammatory process in the respiratory system. It's about Fenspiride. This medication is present in other medicines, for example:

• Sirep is a drug in the form of a syrup, which is taken at 3-6 st. L. Per day, before meals. In some cases, the reception may be accompanied by a disorder of the stomach, dizziness, skin itching. The duration of therapy is determined by the doctor.
• Eladon take 1 tablet 2-3 times a day. Possible side effects - tachycardia, nausea, drowsiness.
• Epistat is taken one tablet up to three times a day, with a lot of water. During treatment, there may be gastric disorders, nausea.
• Erespal take the pill in the morning and in the evening (for children, Erespal is available as a syrup). Among the most frequent adverse events are digestive disorders, diarrhea.
• Erispirus is taken before meals, 80 mg to 3 times a day (children - 4 mg per kg per day). Side-effects are rare - mostly in the form of moderate dyspeptic phenomena.

These drugs stop the development of inflammation and relieve spasms of the bronchi.

Also for the elimination of pain, it is possible to use other antispasmodics - for example, myotropic drugs that act on adenosine receptors and relax smooth muscles. Theophylline, Euphyllin can be administered orally, rectally or injectively.

Vitamins

The absence of hypovitaminosis in the body of a patient suffering from pain during bronchitis gives more chances for a speedy recovery. Therefore, in many cases, in addition to the basic treatment, the doctor can recommend the intake of vitamins. Particular attention should be paid to ascorbic acid, vitamins E and A. Ascorbic acid strengthens the vascular walls, increases the body's resistance to infectious diseases. A lot of vitamin C is present in the hips of dogrose and sea-buckthorn, in black currant, kalina, citrus, kiwi, cabbage. If the proposed products are not included in the diet for any reason, the doctor can prescribe the intake of ascorbic acid in the form of a dragee.

The presence of vitamin A in the diet helps to strengthen immunity: this vitamin is present in large quantities in dairy products, liver, carrots, spinach, apricots, herbs.

Vitamin E improves gas exchange in the lungs. Sufficient amount is available in nuts, sea fish, sea-buckthorn berries, cereals, vegetable oil.

Physiotherapeutic treatment

With pain during bronchitis, it is possible to use such basic physiotherapy procedures:

• Inhalations.

This method is easy to apply even at home. It is suitable for children as well as for elderly people, as well as for women during pregnancy. Use mainly herbal inhalation with chamomile, calendula, St. John's wort, or saline solution. In the presence of an ultrasonic nebulizer, medicinal products and mineral water can also be used as a therapeutic agent.

• Massage procedures.

Massage of the chest helps to facilitate breathing, to withdraw phlegm from the bronchi, to avoid stagnation of mucus. The duration of one procedure is 5-10 minutes. The course consists of 5-15 procedures.

• Method of ultrahigh-frequency inductothermy.

The method involves the application of thermal electromagnetic radiation, which is absorbed by the affected tissue. During the procedure, blood and lymph flow improves, the intensity of the inflammatory process decreases, and mucous tissues are restored. The session lasts 15-20 minutes, and the course will require 6-12 such sessions.

• Magnetotherapy.

This procedure removes inflammation and pain, eliminates swelling, increases pulmonary respiratory volume, accelerates the excretion of sputum secretions, stimulates the protective function of the body.

• Electrophoresis.

The method allows you to deliver many medications directly to the affected tissue, bypassing the digestive tract. This approach is more practical and effective for pain in bronchitis.

• Aerosol therapy.

The method involves the introduction of anti-inflammatory and antibacterial drugs that expand the bronchi and accelerate tissue repair. The procedure includes: saline haloing, medical inhalation and normobaric hypoxic therapy.

• Heat treatment, paraffin treatment.

The method stimulates capillary blood flow in bronchi, accelerates metabolism and improves trophism of tissues, and also has a distracting effect.

Alternative treatment

Alternative methods are allowed to be used only when the cause of pain is known for bronchitis, and the attending doctor does not have anything against such treatment. The use of prescriptions also depends on the localization of pain.

• Back pain in bronchitis can be removed with dandelion tincture. Freshly cut flowers of the plant are covered in a glass jar with a capacity of 1 l, pour 0.5 liters of vodka. Cover the container with a lid and stand in a dark cabinet for 10 days, sometimes stirring the contents. Next tincture is filtered and used to rub the painful area, 3-4 times a day.
• Intercostal pain with bronchitis can be eliminated by a compress made of black radish. Take a small cut of dense natural tissue, put it on the painful area. Radish rubbed on a grater, the gruel is evenly distributed over the fabric. Cover the fabric with gruel with a food film, and cover it with a warm towel. Hold the compress on the skin until severe burning occurs. Then the fabric is removed, and the skin is wiped with a warm damp cloth. The procedure is repeated 1-2 times a day, until complete relief from pain.
• Pain in the chest is eliminated with the help of a thermal procedure. Sew a linen pouch measuring about 30 by 30 centimeters. Fill it with dried cherry or cherry stones, sew up. When pain occurs, the pouch is heated in a microwave oven or oven to a temperature of 50 ° C, after which it is applied through a towel to the painful area. The frequency of the procedures is 1-2 times a day. The duration depends on the severity of the pain.
• Pain with bronchitis can be eliminated using birch kidney oil (sold at a pharmacy). Oil rub the painful area several times a day. Immediately after rubbing, you can take a few clean birch leaves, attach them to a sore spot and pribintovat. This method helps to "stretch" the pain and strengthen the healing effect of the oil.

[28], [29]

Herbal Treatment

• Pour 1 tbsp. L. Aspen buds 200 ml of boiling water, insist in the thermos for an hour. Filter and take inside for 1 tbsp. L. Up to five times a day.
• Fall asleep in a saucepan 3 tsp. Dried parsley root, pour 0.5 liters of water. Boil on low heat for about five minutes, after which they filter and drink twice a day for 1 tbsp. L.
• Take 100 g of dry nettle leaf, 200 g of dry leaf of burdock, 100 g of oregano. All the raw materials are poured into 1 liter. Boiling water, insist for the night. Take 1 tbsp. L. In the morning and in the evening.
• Pour 1 tsp. Adonis 200 ml of boiling water, insist for 60 minutes. Filter and drink three times a day for 1 tbsp. L.
• Mix the same amount of lemon balm leaves and dry peel of lemon. Pour 2 tsp. Mixture of 200 ml of boiling water, insist 60 minutes. In the cooled infusion add 1 tsp. Valerian tincture and 1 tsp. Honey. Drink the product on 200 ml in the morning and in the evening.

Homeopathy

As an alternative treatment you can use homeopathic remedies. Choosing this kind of drug, you need to focus not only on recommendations for use, but also on the characteristics of pain, modality (a factor that affects the reduction or enhancement of pain), as well as the pathological signs that accompany pain. Optimal, if the choice of the drug will be carried out by a doctor-homeopath.

• Aconite 6 is used for pain in muscles, joints, which are accompanied by fever, chills. Pain is worse in lying position.
• Arnica 6 is used for pain and a sense of weakness. Pain even worse from touch, accompanied by numbness and a sense of "creepy crawling."
• Rus toxicodendron 6 is prescribed for pain associated with hypothermia, with pain along the nerves. Accompanying symptoms - general weakness, tremor of extremities.
• Route 6 is used for intercostal pains, with overexertion. Pain painful, stitching, are found on the background of painful sensitive muscles.

The listed means of homeopathy are taken in granules at the same dosage 4 times a day, for one week.

Surgery

The operation can be prescribed in case of complications of bronchitis. For example, if pain associated with bronchitis is associated with bullous pulmonary emphysema, then remove the pathologically altered areas.

If there is a pattern of severe respiratory failure, which shows prolonged oxygen therapy, there may be a need for an operation for lung transplantation.

Also, surgical treatment is carried out with the development of purulent complications, or when malignant tumors are detected.

Complications and consequences

About what complications can occur with pain in bronchitis, you can judge, only knowing the original cause of these pains. Most often, doctors determine bronchopneumonia in patients: along with painful sensations, shortness of breath starts, an increase in the right ventricle of the heart, myocardium suffers. Such bronchitis can be complicated by heart failure, syncope.

Another serious complication is bronchoectatic disease. However, it is not diagnosed as often as pneumonia.

Numerous asphyxiating attacks lead to swelling of mucous tissues. As a consequence, development of bronchial asthma is not excluded.

With pains that are accompanied by hissing strained breathing, one can suspect bronchial obstruction, emphysema, diffuse pneumosclerosis.

The most severe complication is the acute form of respiratory failure. The signs of such pathology are aggravated quite quickly, and not only the respiratory capacity is disturbed, but changes occur throughout the body (as a result of disruption of gas exchange and oxygen deficiency).

Arterial pulmonary hypertension is characterized by pain in the heart, behind the breastbone, as well as a violation of the heart rhythm, an increase in blood pressure.

With pulmonary emphysema, shortness of breath is observed, heart tones are muffled, blood pressure rises.

On the background of bronchitis, complicated by exudative pleurisy or acute pneumonia, acute heart failure may develop.

[30], [31]

Prevention

Preventive measures to prevent the occurrence of pain in bronchitis can be as follows:

• The most important preventive step is the rejection of such a harmful habit as smoking. The more "smoking experience" a person has, the greater the risk of complications in bronchitis.
• It is also important to observe the basic rules of hygiene: wash your hands before meals, after walking and visiting the restroom, brush your teeth, take a shower regularly.
• In diseases of the respiratory system, respiratory exercises have a good preventive effect, preventing the development of complications. They are done daily, 3-4 times a day, for 5-10 minutes. Exercises include inhalation through the nose, mouth with the reproduction of a hissing sound (exhalation is longer, with the displacement of the maximum air volume).
• Significant value has a moisturizing - both external and internal. External is to create a comfortable humidity in the room in which the patient is (about 50-70%). Internal humidification includes the use of a sufficient amount of liquid.
• Avoiding the development of complications - including the emergence of pain in bronchitis, will help LFK procedures, chest massage, and frequent outdoor walks (walks in the parks, in the forest with coniferous trees even more welcome).
• One of the basic preventive factors is proper nutrition, with a sufficient number of plant products, greens.

To accelerate recovery, care must also be taken to normalize living conditions:

• Avoid inhalation of dust, animal hair, mold spores;
• Regularly it is necessary to aerate the rooms, check the presence of an adequate functioning of the extractor.

[32], [33], [34]

Forecast

The quality of the forecast is influenced by many factors:

• age of the patient (risk factor - elderly age from 60 years);
• long-term experience of smoking, smoking more than one pack of cigarettes every day;
• concomitant heart disease;
• associated infectious diseases;
• general immune weakness of the body.
• The most unfavorable outcome is lethal, it can happen:
• with chronic heart failure;
• with acute respiratory insufficiency;
• with the development of pneumothorax, pneumonia;
• with blockage of the pulmonary artery;
• in obstructive bronchus.

Provided a quick and qualitative diagnosis of the causes of deterioration, with the appointment of competent treatment, subject to the prescriptions and recommendations of the doctor, pain in bronchitis can be eliminated while curing the underlying disease.

[35], [36], [37]