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Why do I have pain in my right side while coughing?

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Internal Medicine Specialist
Practicing since : 1998
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I'm a 74 year 'young' heavy smoker 2 packs per day, am 195 pounds, 6ft. about a month ago while coughing, I've felt pain in my right area of the collar bone when coughing! Am concerned!! I have a doctor appointment on 24 XXXXXXX
Looking forward for your help!!
Jerry Zimmermann
Encino, CA.
Posted Sat, 5 May 2012 in Lung and Chest disorders
Answered by Dr. Jasvinder Singh 3 hours later

Thanks for posting your query. There're 2 likely possibilities of the pain. In view of you being smoker for such a long time, there's a possibility that you might have developed COPD changes in the lungs.

The smokers are more prone to have something called emphysema. In this, there's an irreversible damage to the lungs and there's development of small bullae within the lungs.

There's always a small risk of one of these bullae getting ruptured during intense coughing resulting in pneumothorax (presence of air in the pleural cavity covering the lungs). This can cause the pain.

There's also a possibility that it may have already developed and each time you cough, it irritates the pleura (covering of the lungs) producing the pain.

It makes sense to get an X-ray of the chest and preferably a CT scan of chest to exactly delineate the extent of damage to the lungs.

The second possibility is that it could be a muscular pain (muscle sprain due to the smoker's cough). In this a local application of some analgesic gel or spray helps in improving the pain.

Sometimes, repeated coughing can also produce a micro fracture in the ribs and this can also produce the pain. This can also be picked up by the x-ray chest. It makes sense to consult a respiratory physician for the same.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.
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