What Causes Difficulty Breathing When I Lay Down?

Posted on Sat, 29 Nov 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 29 Nov 2014 Answered on

Tue, 23 Dec 2014 Last reviewed on

Question : I have severe COPD. When lying down or sitting I can manage my breathing and have no pain and minimal discomfort. As soon as I stand up, it feels like someone is squeezing my lungs. The pressure is unusual and different than COPD pressure. New sympton - pain (kinda like muscle pain) in right side only just below breast level now moving across chest. Had recent development where suddenly felt wonderful -- all symptons gone except regular COPD. Lasted about a week then worse than ever. Recent Dr visits and current blood work -- everything perfect - all numbers exactly where they should be. Pain severly affecting breathing; oxygen not helping.

Answered by Dr. Prasanna Heijebu (1 hour later)

Brief Answer:
Intercostal nerve injections will be helpful.

Detailed Answer:
Hi Madam.

I understand your concern.

As per your symptoms you might have been experiencing intercostal neuralgia which could be unrelated to the underlying COPD.

To control this posture relating pain its important intercostal nerve injections of analgesics under expert medical guidance.

A periodical lung testing is needed to document the oxygenation status of the lung pre and post injection status.

Breathing exercises are often practised in addition to the pain management.

Thank you.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Prasanna Heijebu (22 hours later)

That does sound like a possibility. What kind of doctor do I see? Also as I read about procedure, I cannot do anestesia(sp?) (twilight is OK) and I am alergic to contrast. Any additional ideas? Especially need to know what kind of dr I need to see. Thank you.

Answered by Dr. Prasanna Heijebu (12 hours later)

Brief Answer:
Pulmonologist and Critical care specialist required.

Detailed Answer:
Hi.

You need to consult both pulmonologist and a critical care medicine specialist.

The anesthesia can be given even without contrast.

Twilight can be okay with few doctors, but not all.

Inhalation anesthesia can be a better option, as the effects are rapid and short lasting.

Thank you.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Prasanna Heijebu (8 hours later)

One more question. I am especially bad today. I feel like a XXXXXXX is sitting in the middle of my chect. Oxy level is 96; heart rate 85. What is done to determine if, in fact, this is intercostal neuralgia? Is there anything I can take OTC to help relieve the pain? Ibuprofel seemed to help yesterday but not so much today.
Going to call my pulmologest and primary care today. Thanks again.

Answered by Dr. Prasanna Heijebu (14 hours later)

Brief Answer:
Pregabalin with diclofenac helps.

Detailed Answer:
Hi

Intercostal neuralgia is primarily a clinical diagnosis. Routine tests are generally not employed to make the diagnosis.

Drugs like Pregabalin and Diclofenac 75mg each for 3-6 days can produce effective pain relief.

Note these drugs have to be taken only on strict medical prescription.
Thank you.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju