Cystic Fibrosis

Barrel Chest: Causes and Treatment

In medical terms, barrel chest is a condition in which a person’s chest appears to be partially inflated all the time, with the rib cage broadened as if they are taking a deep breath. The person may find it hard to breathe normally.

A barrel chest may be the result of arthritis or a serious respiratory problem, known as chronic obstructive pulmonary disease (COPD).

A barrel chest does not always require medical treatment, but when it is a symptom of COPD, the breathing problems that cause the condition need to be treated.

In fitness terms, a so-called barrel chest may be desirable because it means that the person is expanding their chest size through bodybuilding. This is different from the medical concept of a barrel chest.

Conditions associated with barrel chest

In an adult, a barrel chest is normally associated with either COPD or osteoarthritis. In children, it may be linked to cystic fibrosis or chronic asthma.

[man with COPD]
COPD can lead to a barrel chest.


COPD refers to a group of respiratory diseases, such as emphysema and chronic bronchitis. It is a serious condition that gets worse over time. Eventually, a patient with COPD may be unable to take care of themselves.

The National Heart, Lung, and Blood Institute notes that COPD is the third leading cause of death in the United States.

According to the National Emphysema Foundation, 11.2 million Americans are estimated to have COPD, and 3.1 million have been diagnosed with emphysema.

Individuals with COPD find it harder and harder to breathe. This is because COPD damages the lungs in four different ways:

  • The different parts of the lungs become less able to stretch or to expand and contract
  • The walls of the alveoli, the air sacs where the exchange of oxygen and carbon dioxide takes place, are damaged
  • The airways or passageways through the lungs are irritated and swollen
  • Extra mucus is produced, which clogs the airways

The chest area may change shape to resemble a barrel, and the shape of the diaphragm, a key muscle for moving air and an out of the lungs, will also change. It loses some of its length and thickness, and it gets weaker.

If lungs are not able to function properly, it can be difficult for someone to catch their breath or to breathe deeply, and they can no longer exhale completely. The lungs remain partially inflated most of the time, and the rib cage stays expanded.

This state of hyperinflated lungs can result in a barrel chest, normally in the later stages of COPD.

Individuals with a barrel chest due to COPD may look as if they are about to take a very deep breath, even though that is difficult for them to do.


Emphysema is a kind of COPD, and it may lead to a barrel chest.

[woman has difficulty breathing]
A person with emphysema may have a barrel chest and difficulty breathing.

A chronic cough and shortness of breath after physical activity are two of the most common signs and symptoms of emphysema.

Other symptoms include:

  • Difficulty inhaling
  • Higher rates of oxygen being used, even when at rest
  • High levels of carbon dioxide in the blood
  • Limited ability to exercise
  • Severe breathlessness

There is no cure for emphysema and COPD, but treatments and lifestyle changes can help.

Quitting smoking, using supplemental oxygen, inhalers, medications, and adopting healthy exercise and eating habits can all help people with respiratory problems to improve their quality of life.

Scientists have not identified whether the extent of a barrel chest reflects the severity of other symptoms of emphysema or COPD.


Osteoarthritis is a joint disease in which the cartilage at the ends of bones breaks down. It is sometimes described as the wear and tear form of arthritis because it usually develops slowly, and it most frequently occurs in older adults.

The spine, hands, hips, and knees are most frequently affected, and stiffness and swelling are two of the most common symptoms of osteoarthritis.

A barrel chest can develop if osteoarthritis develops where the ribs meet the spine. There will be stiffness, and the joints in the ribs will lose their flexibility. Eventually, the ribs can look as if they are stuck in the “out” position.

Cystic fibrosis

In children, a barrel chest may be a symptom of cystic fibrosis, a genetic condition that causes mucus to collect in organs throughout the body. In 75 percent of cases, diagnosis occurs before the age of 2 years.

Mucus in the lungs can give rise to frequent infections and lung damage, and this can result in a barrel chest.

Studies of children with severe cases of asthma also suggest a strong link between hyperinflated lungs and the development of a barrel chest. Children with a barrel chest may also have slower growth rates.

Associations with osteoarthritis and bodybuilding

When bodybuilders and weightlifters discuss techniques for building a barrel chest, this is different from the medical meaning of a barrel chest.

Bodybuilders work hard to build up their pectoral muscles and create the appearance of a so-called barrel chest. The changing dimensions of their chests are signs that their training program is working, and they are gaining strength and fitness.

For individuals with COPD or osteoarthritis, and for children with cystic fibrosis, developing a barrel chest is a sign that their condition is getting worse.

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