The most common symptom associated with chronic obstructive pulmonary disease (COPD) is an unpleasant sensation of shortness of breath, which is called dyspnea. A recent review indicates that, although pain is not usually listed as a prominent symptom of COPD, it occurs in 32% to 96% of COPD patients. In fact, 18% of patient report severe or very severe pain.
The source and cause of pain in patients with COPD has several explanations for its existence. COPD is a disease of inflammation like many others. This inflammation is systemic, which means it affects the entire body which may induce so-called neuropathic pain. Additionally, patients with COPD usually have significant co-morbidities (other health problems). Pain may be related to musculoskeletal disorders such as chest wall pain due to coughing, or the marked increase work of breathing in severe cases. Problems with arthritis are common since COPD patients tend to be in older age groups, and limited activity causes muscle weakness and more difficulty with any activity. Another common problem causing pain in COPD patients is osteoporosis, which results from aging, inactivity, and can be accelerated by the use of some medications such as prednisone.
Obesity, along with depression and anxiety, seem to contribute to the perception of pain and its intensity. Strangely enough, the degree of COPD does not have a direct association with the occurrence or perception of pain. However, lowered oxygen levels may play a role, especially in patients with peripheral vascular disease as well as heart disease.
