Ooh! Do you mean that upper back pain that feels like somebody is driving a log splitting wedge into the vertebrae right between the scapulas? Lungs don't hurt, as most of us have been told. In fact most of the pain we suffer from, the pancreas, bile ducts, gallbladder, liver and lungs refer pain to different areas of the body like the back.
As embryos our organs start out as little buds of cells growing out from the collagen like rod that becomes the back, spine and brain. Limb buds grow into arms and legs and the chest and gut migrate out to form the G.I. tract, abdominal organs and the heart, lungs and chest from the evolving back and spine. A developing embryo is simultaneously growing organs including attachments like the arteries, veins, lymph ducts and nerves. As the embryo begins to resemble a fetus, nerves either grow and become useful or they lay dormant for all practical purposes. A classic example of these embryonic nerves is a heart attack. The heart pain isn't so much in the heart rather the jaw, left shoulder and arm or the mid thoracic spine for most women. So in men at least a vestige of the nerves that accidentally followed the vascular system from the back along with stem cells that specialized into skin, fat, muscles and bones that became our hearts and left arms. Our lungs evolved out of our backs as well.
All the organs that CF compromises are hooked up to the autonomic nervous system and it doesn't have pain sensing nerves. Two systems make up the autonomic nervous system, the sympathetic and parasympathetic nervous systems perform in concert to dilate and constrict the eye pupils, relax or contracts the bladder or stimulate dilation or constriction of the bronchials and such. The pain in the back could be from the lungs or the gallbladder, pancreas or liver and bile ducts. We can thank our embryonic development when nerves grew along with those organs to warn us of a problem.
In short your back pain could easily be from what undoubtedly is painful coughing. There are plenty of bronchial nerves that yell pain but there is no room for nerves in the alveoli excepting those formed by accident or miracle as the lungs formed in the womb. Sometimes I can differentiate between the spot in my back responsible for my lung pain from the pain coming from the pancreas or bile ducts/gallbladder. I imagine most CFers can do this as long as two or more organs aren't flaring all the time. Nebulizing hypertonic saline clauses that wedge between my vertebrae so I know it is connected. To be really specific, the pleural sacs are innervated with its own nerves, the inner sac has embryonic nerves going from the sac membrane throughout the lungs, tiny as they are. The outer pleural sac has a deliberate connection to the brain to signal any problem with sacs and possibly something else. Again embryonic nerves are attached to the back and the outer pleural sac.
The downside is the close proximity of the referred pain spots in the back. I get terrible pain in the back shortly after eating. My pancreas is the dominant CF issue for me and for decades I attrubted back pain to early arthritis from a climbing accident. It easily could have also been my gallbladder and it could be yours too. Coughing, walking, or a stressful bowel movement can exacerbate pain from the pancreas and such adding to the pain felt in the upper back. It's tricky, I saw a back specialist for years and their testing was thorough in determining the source of the myofacial back pain.
I ran the gamut from mylograms, MRI's, EMG's and such with no real answer. I even went to Back School but the one thing that helped my myofacial muscular pain was trigger point injections. In my case the pain specialist injected lydocaine into a trigger point location and followed it up with a moment of intense pressure on the spot. The idea is relieving pain locked in chemical memory and this process depolarizes the pain sensing neurons. I have no idea if this is in fact what's happening but it works for several months in my case. Just know that the pain source is not from the back and helping them helps your back.
LL
