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"It Only Hurts When I'm Breathing" is a song recorded by Canadian singer Shania Twain. It was the fifth and final U.S. country single released from her 2002 album Up!. The song was written by Mutt Lange and Shania Twain. "It Only Hurts When I'm Breathing" was only released to North American country and AC. There was no commercial single for this song, and no remixes were made either, however a digital download was made available to purchase online of the song recorded live from Chicago. The song originally impacted country on February 9, 2004. The song is, as Shania puts it, "the only heartbreak song" off of Up!. An Indian artist, Dayal Thakar provides backing vocals on the Blue version of the song.

The music video for "It Only Hurts When I'm Breathing" was taken directly from Twain's 2003 Up! Live in Chicago special. It was filmed on July 27, 2003 and released on February 13, 2004. Directing credit is given to Beth McCarthy Miller. The video is the second of two live videos taken from the special, the first was "She's Not Just a Pretty Face". As it was the second consecutive live video, airplay was generally weak, forcing Mercury Records to release "When You Kiss Me" as a video only single. The video for "It Only Hurts" is not officially available on any DVD or single, but the performance can be seen on the Up! Live in Chicago DVD.

"It Only Hurts When I'm Breathing" debuted on the Billboard Hot Country Singles & Tracks chart the week of February 21, 2004, at number 50, the highest debut of the week. The single spent 20 weeks on the chart and climbed to a peak position of number 18 on May 15, 2004, where it remained for three weeks. "It Only Hurts When I'm Breathing" became Twain's twenty-first (sixth consecutive) top twenty single. It also peaked at number 71 on the Billboard Hot 100 and 69 on the Hot 100 Airplay chart.

At adult contemporary radio, "It Only Hurts When I'm Breathing" debuted at number 29, the highest debut of the week, on April 10, 2004. The single spent 19 weeks on the chart and climbed to a peak position of number 16 on May 29, 2004, where it remained for four non-consecutive weeks. "It Only Hurts When I'm Breathing" became Twain's eighth consecutive top twenty single.


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