Breathing Problems

Medically Reviewed by Dany Paul Baby, MD on May 02, 2023
6 min read

Allergies, asthma, inflammation, and infection are just some of the conditions that can cause you to have breathing problems. The right diagnosis and treatment, along with better understanding of your condition, can help you manage your breathing problems.  

Talk to your doctor right away anytime you notice problems with breathing -- especially if you also have symptoms like chest pain, a long-lasting cough, or fatigue. Some cases might require immediate treatment. If your shortness of breath is severe or comes with other symptoms such as confusion, chest pain, jaw pain, or pain down your arm, call 911 right away.

Picture of lungs

Some people have trouble breathing when they get a cold. For others, it’s caused by infections like sinusitis. Sinusitis can make it hard to breathe through your nose for a week or two, until the inflammation eases and your congested sinuses begin to drain.

Many breathing problems are long-term (chronic). These include chronic sinusitis, allergies, and asthma. They can cause symptoms such as nasal congestion, a runny nose, itchy or watery eyes, chest congestion, coughing, wheezing, trouble breathing, and shallow breathing.

Your nasal passage is a pathway for viruses and allergens to enter your lungs. So your nose and sinuses are often linked with many lung disorders. Sinus or nasal passage inflammation may trigger asthma attacks. And one of the most common triggers for asthma is allergies.

More than 50 million Americans have allergies. And almost 26 million American adults have asthma. The two often happen together. Without treatment, they can make life miserable.

Smoking causes breathing problems because it damages the tubes, or “airways,” that carry air to your lungs. It also damages the tiny air sacs, or “alveoli,” in your lungs that move oxygen into your blood and remove carbon dioxide. Even secondhand smoke can lead to breathing problems.

Cigarette smoking causes most lung cancer as well as most cases of chronic obstructive pulmonary disease (COPD).

Millions of Americans have breathing problems because of COPD, which includes emphysema and chronic bronchitis. Lung cancer is less common and often doesn't cause symptoms in its early stages. But it can lead to breathing problems, along with issues like chest or back pain and a cough that doesn't go away.

Breathing problems may also stem from other serious problems such as tuberculosis, pneumonia, COVID-19, and lung disease related to HIV or AIDS.

Doctors diagnose breathing problems by doing a physical exam, asking about your overall health, and using various tests. For instance, pulmonary or lung function tests can measure lung function in people who have asthma. Some of these tests include:

  • Methacholine challenge. Doctors use this test to diagnose asthma. You inhale methacholine, which narrows your airways. The test is done to check on how responsive or reactive your lungs are.
  • Six-minute walk: Doctors use this to see how far you can walk in 6 minutes to get an idea of your fitness level.
  • Plethysmography. You'll stand in a box that looks like a telephone booth to check your lung capacity.
  • Spirometry. You'll breathe into a mouthpiece that connects to a machine and measures your lung capacity and air flow. This device measures how much air you can blow in and out of your lungs and how fast and how easily you can do this. It can tell whether your airways are blocked and how much.  
  • Chest X-ray. Your doctor may take an X-ray to see inside your chest, including your heart, lungs, and bones. A chest X-ray may help diagnose pneumonia. But it can't identify most breathing problems by itself. 
  • CT scan of your chest. A CT scan uses X-rays and a computer to create detailed images. If you have long-term sinusitis, your doctor may order a special sinus CT scan.

Other tests you may get include:

Electrocardiography (EKG). You might get this test in your doctor’s office or a hospital. A technician will attach small electrodes to your chest with gel or tape, and a machine will measure the electrical impulses that make your heart beat. An EKG helps to check the heart's overall health, including whether it has any defects, irregularities, or heart rhythm problems. It can show your doctor if blood flow to the heart is impaired.

Blood test. A doctor or nurse will use a needle to take blood from a vein in your arm and send it to a lab for tests. The results can tell them whether or not conditions such as anemia or heart failure are making you short of breath.

Doctors sometimes adjust the range of what's normal when they interpret lung function tests. When adjustments are based on a person's race,  it’s called a race correction. 

Earlier reports claimed that lung volume for Black people is 10% to 15% lower than for White people. But that's not accurate. Those assumptions didn’t consider social determinants of health that are linked to lower lung capacity. These include exposure to air pollution, which is more likely in Black people than in White people.

When doctors use race correction calculations, some people with lung problems may not get the right diagnosis. As a result, their lung condition may go untreated. In one study, removing race correction helped more people receive a diagnosis that otherwise would have been left out.

Medical experts and professional groups have called for an end to race corrections. They say doing so would help doctors better understand lung function differences while removing a source of bias and improving equity.

Allergy tests may help your doctor find the cause of your breathing problems. One example is the prick technique. Your doctor puts a tiny drop of an allergen on your skin and pokes a needle into the drop. If you’re allergic to that allergen, your body will react by turning red at the site. You may also have itching and swelling.

Another type of skin test involves your doctor injecting the allergen extract directly under your skin. Other tests include:

  • Allergy blood tests (called a RAST or radioallergosorbent test)
  • A challenge test, in which your doctor gives you tiny amounts of the suspected allergen through your nose or mouth

These are less common than skin testing.

Things that cause breathing problems are known as triggers. Avoiding triggers is the top way to control allergies and asthma. It may help to wear a dust mask when doing housework or yard work, limit contact with a furry pet, wash bed linens at least once a week, stay indoors during peak pollen times, and change the filter on your air conditioner often.

Medications are also important in treating breathing problems. Oral or nasal allergy drugs such as antihistamines and decongestants may make it easier to breathe.

Inhaled steroids can help. These drugs reduce inflammation in your airways. Allergy shots lower your sensitivity to allergens and may ease some breathing problems.

For asthma, inhaled or oral drugs help open airways and fight inflammation. These medications help ease or even prevent airway blockage and extra mucus. People who have asthma must control inflammation in order to keep their airways open and lower sensitivity to asthma triggers including:

  • Viral infections (COVID-19, cold or flu)
  • Pollen
  • Pet dander
  • Mold spores
  • Dust mites
  • Cockroaches
  • Irritating pollutants in the air
  • Fragrances and fumes
  • Smoke
  • Food allergies

Even exercise and cold weather can trigger asthma in some people.

People sometimes seek medical help only after they’ve had breathing problems for weeks or months. By the time they start taking medications, they may have damage that takes longer to heal.

The right diagnosis is important before you can treat and prevent breathing problems. Each of us is different. The specific medication and treatment that works for a family member or friend may not be the best one for you.

If you have symptoms of one or more common breathing conditions, talk to your doctor. Prevention and treatment measures can help relieve and possibly end the problems.