American Idol contestant Michael Lynche performed a cover version of the single on a Twain-themed episode for the ninth season of the show.

After collaborating on her great successes The Woman in Me (1995) and Come on Over (1997), Twain and her then-husband Robert John "Mutt" Lange decided to take a musical hiatus.

[1] She and Lange conceptualized the album to be very positive, optimistic, and uplifting; they desired to evade dark subject matters, yet still be profound through optimism.

[9] Paul Cognata of The Daily Campus stated, "Twain decides to deeply cross the line into pop music in her song, 'It Only Hurts when I'm Breathing.'

[12] Eric R. Danton of the Hartford Courant felt his heartstrings weakly tugged by "It Only Hurts when I'm Breathing", and added, "The whole endeavor feels like a calculated and spectacularly cynical attempt to make money while expending as little effort as possible.

[14] Stephen Thomas Erlewine of Allmusic noted the song's absence from Twain's Greatest Hits (2004) album; however, he said it was not greatly missed.

[19] On the week ending May 8, 2004, "It Only Hurts when I'm Breathing" debuted at number seventy-six on the United States' main singles chart, the Billboard Hot 100.

[21] On the week ending February 21, 2004, "It Only Hurts when I'm Breathing" entered the US Hot Country Singles & Tracks chart at number fifty.

[11] The singer last performed "It Only Hurts when I'm Breathing" on July 27, 2003 at a free outdoor concert held in Grant Park in Chicago, filmed for the Up!

[25] The singer donned a tan, multi-patterned halter top and black, sequined wide leg trousers, and performed sitting on a stool placed at the end of the runaway.

Contestant Michael Lynche performed a cover version of "It Only Hurts when I'm Breathing" on a Twain-themed episode of the ninth season of the singing competition American Idol, aired on April 27, 2010.

Eric Ditzian of MTV News desired for the contestant to tap into his R&B and soul music roots further and concluded, "Last night's performance was hardly the stuff of Luther Vandross, as Randy Jackson and Simon Cowell maintained, but it's a comparison that Mike should take to heart.

"[27] Leslie Grey Steeler of The Palm Beach Post acknowledged Lynche was usually cheesy in his performances, but favored his rendition of "It Only Hurts when I'm Breathing", saying, "I loved it" and calling it "awesome".

[29] Mary T. Kelly of Salon.com commented, "Big Mike went back to good, ole country basics and sang the song sweet, simple and pure.