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Chest pain before, during and after asthma attacks.

Chest Pain Before, During, And After Asthma Attacks

Chest pain, or chest pressure, is a common symptom felt prior to, during, and after asthma attacks. So why do asthmatics experience such chest discomfort, what does it mean, and what can you do about it?

Disclaimer. Chest pain is kind of a generic symptom, and can refer to anything from a tickling or burning sensation or actual pressure, tightness, or pain in your chest. It can be caused by asthma, allergies, anxiety, gastrointestinal reflux, and it can also be cardiac related. According to the Mayo Clinic, If you experience unexplained chest pain lasting more than two minutes, it is better to seek medical help than to try to figure out the cause on your own.

Chest pain prior to asthma attacks

When this happens, it is considered an early warning sign of asthma. It means an asthma attack is imminent if you don’t take action right away.

Here I would like to use myself as an example. I have a severe allergy to dust mites. I take Advair 500 to make my airways less sensitive to them. Still, even this is not enough to prevent my airways from getting twitchy when I’m exposed to dust mites.

As a kid, back in the 1980s, I collected baseball cards. Freshly removed from packs, they smelled like bazooka bubble gum. I spent many hours sorting them, or admiring them. This was something I could do, even when the asthma was acting up.

Fast forward 30 years, and they smell like old, musty cardboard. When I sort through them for any length of time the chest pressure begins. Why does this happen? Its’ because dust mite feces gets into the air I inhale, and my immune system recognizes it as harmful, and initiates a full out onslaught.

This causes worsening airway inflammation, resulting in a tickling feeling in my chest. So, dust mite exposure causes airway twitchiness resulting in airway itchiness. This can become chest tightness, and even shortness of breath, if I don’t take action.

What is the treatment for this?  The treatment is to follow your asthma action plan. My plan calls for me simply to remove myself from whatever is causing the symptoms, in this case the baseball cards. If needed I can use my rescue inhaler. If needed I can take a benadryl. In most cases, my chest pressure gradually dissipates simply by finding something else to do.

Chest pain as a sign of acute asthma

So, say I don’t pull myself away from those cards. In fact, let’s give another example. I have a lot of boxes in my basement. So, say I decide to go through those boxes in order to clean out the basement. Lord knows this has happened before. I become passionate about the project. I am finding some old things I haven’t seen in 30 years. I am having a lot of fun.

Now,  I notice the tickling, then the chest pressure, but I do not pull myself away. I continue sorting things out. I find a pile of old pay stubs and decide to see how much I made back in 1988  (it was $1.25).

So now it’s been over an hour, and my chest is tight. I ignore this. After a while, my chin starts to itch (another common early warning symptom of asthma for me). I am rapt in the project and having fun, so I delay and delay and delay. I want to get the project done. Then the anxiety/panic hits. This is when I start to break things or rip important papers, such as the cover of my yearbook from Madison Elementary in 1976. When this happens is the cue that I cleaned too long, and must finish the project later, or let someone else do it.

As I get up to go upstairs, I realize that I am in a full-fledged allergy and asthma attack. My chest pain is scorching, but so too is the itchy chin, itchy face, itchy scalp, and shortness of breath. I might also be sneezing, have itchy eyes, etc. I am now able to only take in about a half of breath at a time. My shoulders are hunched, and I’m using accessory muscles to breathe. Yes, now I realize I should have heeded the early warning symptoms and signs of asthma. But now it’s too late.

What is the treatment for this?  The treatment, again, is following your asthma action plan. For me, this entails getting away from the dust mites, treating myself with albuterol, and probably taking a benadryl. Then I wait until my breath comes back, which it usually does in an hour or so.

Chest pain after an asthma attack

So it’s 24 hours later. My breathing is normal, but my chest is sore and stiff. This is normal after an asthma attack, especially if it was bad enough that your accessory muscles were utilized to help yo inhale. They hurt because they normally aren’t used, and when they are used small muscles fibers on these muscles are torn, causing pain and stiffness the next day.

This is no different than the pain and soreness you feel after a good, strong workout, the kind of workout you do to make your muscles bigger and stronger. Of course, in our case, we don’t want our accessory muscles getting bigger and stronger. Still, because I used them yesterday, they hurt today.

What is the treatment for this?  As with the pain and soreness due to any other workout, this pain and soreness will go away in a day or two. If you want to take a Tylenol or something that is up to you and your doctor to determine. As for me, I just wait it out. Actually, as for me, I don’t let myself get this bad anymore. Of course, if you are as familiar with this thing we call asthma as I am, sometimes it happens even when we don’t plan on it. So that’s why we take our daily asthma controller medicines, have asthma action plans, and avoid our asthma triggers the best we can.>

Bottom line. Chest pain, however you want to describe it, is a common early warning sign of asthma. While it may cause discomfort, pain is actually a good thing: it’s your body saying that you should heed the warning and take action. Sore, stiff muscles the day after an attack is normal and usually goes away in a day or two. If you continue to have concerns about any chest discomfort you feel, don’t hesitate to seek medical consultation.

So, I shared my experience with asthma-related chest pain. For me, it is a common early warning sign. Every asthmatic is different. So, do you ever experience it? Let us know in the comments below?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Nacoran
    2 years ago

    Hi. I’ve had asthma most of my life. It got a little better in my college years but has gotten worse again as I’ve gotten older. I recently started seeing a pulmonologist for the first time instead of just managing it through my primary care doctor. I got a full slew of allergy tests and none of them reacted enough for them to be considered allergies (although a couple were close). I’ve also been seeing a rheumatologist. I mentioned I’d been getting muscle cramps recently and their first question was if I was on a steroid inhaler. I’d just switched from Qvar to Dulera, and within a week or two started getting the cramps. My pulmonologist didn’t think it was the cause but lowered my dose. She also took me off loratadine since I didn’t have any allergy tests that came back inflamed enough to count as positive. Since then I’ve been consistently horse. I complained that I was getting chest pain with my asthma attacks. I always have since I was a kid, and the type of pain hasn’t changed at all. What she said next kind of floored me. She said asthma NEVER involved pain. I asked her again, because, like I said, I’ve always got this. She believes it’s related to GERD. (I know that can cause the problem, but to my knowledge I didn’t develop reflux until my 30s and I’ve had an upper endoscopy that came back normal within the last year or so.) When I got home I googled and the first result was a study I found said that 76 out of 100 patients with asthma reported chest pain with it (I know that’s a small sample size but the percentage result seems pretty overwhelming.) The mayo clinic site says it’s a symptom as well, as does just about every other site.

    Is this a case where a related condition is causing the pain in all the people or does the fact that my pulmonologist doesn’t recognize a very common sign a sign that I should find another pulmonologist? I mean, I’m fine with investigating other causes, but should this be a deal breaker. (She was really insistent about the muscle cramps too, despite the timing, my rheumatologist saying it was one of the most under reported side effects and google saying similarly.)

  • John Bottrell, RRT moderator author
    3 years ago

    Hi. Renay. Glad you found my article helpful. It’s always neat to know there are others who experience asthma similar to how you experience it — so you always know you are not alone. Sounds like you are taking all the right steps to controlling your asthma given the recourses you have available to you. Also glad to hear you are eager to learn more about this disease, as a good asthma education is the best way to learning to cope with it. As Leon noted, our site is a community of asthmatics and asthma educators who share “me too” stories, tips on how to best gain control of it ( and so much more. Thanks for sharing. John. Site Moderator.

  • rrsfap
    3 years ago

    My name is Renay Spears-Fort and I just read your article and I have similar symtoms regarding allergies and just recently developed asthma including Lupus but I get most of my attacks in my sleep although it can trigger from old things, dust mites, pollens in the air, heat etc but most of the time I would be asleep and I would get the attack in my sleep where I would jump up, choke, cough & gasp for air etc…I always had bad allergies where I had the watery & itchy eyes, sneezing, itching (exzema) especially when I was younger up until I reached the age of 55 but now it has developed into asthma, coughing with wheezing and I get a lot of sinus & allergy infection – in fact, I am experiencing an infection right now and my chest is sore and I am coughing, wheezing etc. and I am glad that you explained how the muscles are being used which makes sense and explains why my chest is sore but I tend to cough so much where my throat is sore as well but I am currently on a treatment plan but it seems to pretty much control it but it never goes away completely or it may go away for several days, weeks or as close as a month or more and then it may return or flare up when the pollen count is high or when it’s humid plus whenever I may get an attack in my sleep; it burns, I gag and phlegm comes up to the point where I even regurgitate etc…I have taken benedryl, zyrtec but now the doctor has me on inhalers but I realize they are very expensive and I can’t afford them – I have also taken cough medicine for lungs to treat bronchitis as well so I am eager to learn more about asthma and more treatments that are inexpensive so I appreciate you sharing your story and I am eager to learn new things – Thanks

  • Leon Lebowitz, RRT moderator
    3 years ago

    Hi rrsfap and welcome. You’ve certainly come to the right place. We are all about all things asthma. Now that you’ve found our website, you may also want to check us out on our Facebook page. You can find it here: You will find many of our members exchanging ideas, anecdotal stories, scientific information or just conversing about asthma and all related issues.
    We will look forward to your continued participation.
    All the best,
    Leon (site moderator)

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