Pain below the clavicle when coughing may be due to several reasons.1. Pathological fractures of the bone or muscle may occur, for example, when the patient has severe osteoporosis and an infection in the lungs. Repeated coughing may cause a pathological fracture here, which can lead to pain. In addition, if the patient coughs repeatedly and violently for a long period of time, it may also cause muscle fatigue in this area, resulting in pain during the coughing process. 2. It may be caused by lung infection, such as pneumonia or tuberculosis, which are more common here. 3. This is often caused by the presence of serious lung diseases, such as severe chronic obstructive pulmonary disease, which may induce a pneumothorax during coughing, followed by significant pain in this area and progressive dyspnea. 4, may be caused by adhesions of the pleura, such as when the patient has a serious infection of the chest, which may complicate the adhesions of the pleura here, and then pull the pleura here during the patient’s cough, resulting in pain.