Chest Tightness

Chest tightness is a common symptom of chronic obstructive pulmonary disease (COPD). Chest tightness is also a common symptom of asthma, which is another chronic respiratory condition.1

The symptom of chest tightness may feel a little different from one person to the next. Some patients describe chest tightness as feeling like:

  • The chest is being squeezed or crushed
  • A band is tightening around the chest
  • The chest feels stiff
  • Someone is sitting on the chest
  • Pressure on the lungs is keeping them from filling up

For people with COPD, chest tightness can often happen around the same time as shortness of breath and wheezing. Wheezing is a high-pitched whistling sound that occurs when a person breathes in or breathes out. Shortness of breath is a feeling the breathing is difficult and not working very well – the person may feel “hungry” for air. Sometimes, if one of these symptoms gets worse, the others will worsen as well. This is because the three symptoms can have similar causes.

What can cause chest tightness for people with COPD?

Chest tightness can have different causes for COPD patients2,3,4:

  • Blockage in the airways caused by COPD - this is also called “airway obstruction”
  • Bronchospasms
  • Respiratory infection

Airway obstruction

The lung damage caused by COPD is called airway obstruction. Because the airways become blocked, air cannot travel through the passages and lungs as well as it should. This can be caused by chronic bronchitis, emphysema, or a combination of both.

Chronic bronchitis causes airway obstruction in two ways. The airways of people with chronic bronchitis are constantly irritated and inflamed. Their lungs also produce excess amounts of mucus that have to be cleared through the airways. The swelling, combined with the extra mucus, causes the airways to become too narrow. This can cause a feeling of chest tightness.

Air sac damage

Emphysema can also cause a feeling of tightness in the chest. This is because it causes damage to the millions of tiny air sacs in the lungs where oxygen is absorbed into the body. The damage to the air sacs can cause air to get trapped in a COPD patient’s lungs, making it harder to breathe air out. This can cause a tight feeling in the chest, especially during physical activity or exercise.


People with COPD sometimes have “bronchospasms.” This happens when the muscles surrounding the airways get very tight all of a sudden. When the muscles tighten up, it makes the airways too narrow for enough air to pass through. This can also cause chest tightness.

Infections can also cause chest tightness, especially if the infection is in the lower part of the respiratory system. These kinds of infections include:

  • Flu
  • Acute bronchitis
  • Pneumonia
  • Tuberculosis

Flare ups and COPD chest tightness

Chest tightness that is worse than usual can be a symptom of an acute exacerbation. An acute exacerbation is also called a COPD “flare-up” or attack. If they have signs of a flare-up, COPD patients should consult their healthcare providers about the best way to treat the attack.2

How can chest tightness be treated or managed?

Treatment for chest tightness depends on the cause of the symptom and how severe the symptom is. If an infection is causing the tightness, then treating the infection with antibiotics is helpful.2

If chest tightness is caused by airway obstruction or bronchospasm, then trying to improve airflow in the breathing passages can help to treat it. This might include:

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Written by: Anna Nicholson | Last reviewed: July 2015.