Is Breathing Giving You Back Pain?

David Donald

The diaphragm is an important muscle; it plays a vital role in breathing.

You’ve probably never considered the way you breathe and how it affects the body, but not entirely using the diaphragm can cause conditions, such as lower back pain.

First, you need to understand what this muscle is and how it works.

The diaphragm is a thin, parachute-shaped muscle located right below the lungs. It separates the abdominal cavity from the thoracic cavity, and its primary function is to pull air in (inspiration) and push air out (expiration) of the lungs. The diaphragm also attaches to the thoracic (T7 -T12) and Lumbar (L1-L3) vertebrae as well as the lower sternum. This article provides an excellent example of how the diaphragm acts as a hydraulic plunger, drawing air into the lungs.

Diaphragm Breathing

Basically, when we take a good breath, the lungs inflate fully and the diaphragm contracts, flattening as it pushes the abdominal walls outward. The belly expands. This is called “belly breathing,” abdominal breathing” or diaphragmatic breathing.” Then when we breathe out, the diaphragm relaxes, and the lungs deflate, expelling air effortlessly.

Conversely, when we take a bad breath, we often suck in our belly and the chest rises. We usually do this at the doctor’s office during an examination when asked to take a deep breath. Some people also suck in their stomach for appearances. People either breathe this way because it is a developed habit or due to a medical issue. These types of breathers are called “shallow breathers” or “paradoxical breathers.”


Reasons why people don’t breathe diaphragmatically

  • Smoking
  • Postural and movement habits (sucking in the gut)
  • Sedentary lifestyle ( sitting at a desk all day)
  • Trying to hard
  • Diaphragmatic weakness

People who suffer from chronic obstructive pulmonary disease (COPD), for example often experience diaphragmatic weakness because air becomes trapped in the lungs continually pushes down on it. Someone with COPD must call on the muscles in the neck and chest to help with breathing. This can stress those accessory muscles and lead to pain in the back

The backup respiratory muscles

Typically, the diaphragm alone can handle breathing, but during periods of intense physical activity, such as exercise, the accessory respiration muscles, or emergency breathing muscles, step in to assist.

  • Intercostals – These tiny muscles live between the ribs
  • Abdominals – responsible for pushing the diaphragm up during heaving breathing.
  • Quadratus Lumborum – the lower back muscles that pull down on the lower ribs during strong exhalations. During a violent sneeze, it’s possible to tear these muscles.
  • Pectoralis Minor – tiny chest muscles that pull up on the rib cage during emergency breathing.
  • Sternocleidomastoids – the V-shaped throat muscles. They help to lift the rib cage during heavy breathing.
  • Scalenes – powerful muscles who primary job is turning the neck, but they assist with heavy breathing by lifting the rib cage.

Controlling the diaphragm

The diaphragm is a muscle we can exercise.

Yoga experts, professional singers, and speaker, for example,  spend years learning to master the art of breathing and control their diaphragm. There is a big difference in quality between singers who know how to control their diaphragm and those who don’t. Singers who don’t master their breathing often sound flat and weak.

So what does singing have to do with back pain? Nothing, really. It only serves to illustrate the point that the diaphragm can be manipulated. We can take big breaths or small breaths unless there is an underlying medical condition affecting the mechanics of the lungs and diaphragm.

For the most part, breathing is an involuntary action driven by the nervous system.

Here are a few tips on diaphragmatic breathing. Practicing these exercises for 5-10 minutes about 3-4 times a day can help strengthen the diaphragm.

If diaphragmatic breathing is not helping to relieve your neck or back pain, please contact the BioSpine Institute and our physicians. Our team will determine if our minimally invasive outpatient procedures can help you get your life back.

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