Is Proper Breathing the Answer to Your Chronic Neck or Low Back Pain?

Statistics show that 31 million Americans suffer from low back pain at any given time, while neck pain ranks as the fourth leading cause of disability. Americans also spent more than $134 billion between 1996 and 2016 on treating chronic neck and low back pain, $12 billion of which patients paid out of pocket.

How Traditional Physical Therapy Helps

Many seniors and adult patients of all ages have low back and neck pain mismanaged with unnecessary surgeries, injections, and other procedures. Opioids are also frequently prescribed, but there are better alternatives to unneeded surgeries and habit-forming prescription drugs that only treat the symptom. 

Traditional physical therapy works wonders for the chronic neck or low back pain adults feel because it addresses strength deficits, alignment issues, and muscle imbalances. Manual techniques by experienced physical therapists also help with muscle spasms and tension that aggravate pain. 

Is Your PT Overlooking Your Diaphragm?

If you’re still experiencing pain despite regular PT sessions, talk to your physical therapist and ask if creating a protocol that focuses on your diaphragm could address the root cause.

The diaphragm is a dome shaped muscle found at the base of the ribcage and plays a vital role in breathing. During inhalation it drops down and flattens in order to create a negative pressure in the lungs to pull air in. In order for this to occur the ribcage needs to expand outwards with mild distension of the abdominals. During exhalation it relaxes and recoils into a dome shape. 

Stress often causes us to change our breathing mechanics so that it’s suboptimal. And because we experience stress frequently in our modern culture, poor breathing patterns become the default until we relearn diaphragmatic breathing. 

With suboptimal breathing mechanics it puts our diaphragm in a weak position and cause neck muscles not only weakens our diaphragm but causes our neck muscles to compensate, leading to chronic neck stiffness and pain. 

Dr. Greer Mackie at HLPT believes the diaphragm is also a commonly overlooked muscle that’s crucial in stabilizing lumbar spine muscles and providing core stability. It naturally decompresses the lumbar spine and works with specific ab muscles to counter the pull of hip flexor muscles, often tight in those with sedentary lifestyles. 

How to Prioritize Your Diaphragm When Breathing

Sometimes it’s easier to relearn to use your diaphragm when you’re lying down. Then you can progress to diaphragmatic breathing when sitting in a chair and finally when standing up. Here’s what you need to do:

  1. Start by lying on the floor or your bed. Have a pillow under your head and knees for support.
  2. Place one hand on your upper chest and the other  at the bottom ribcage.
  3. Breathe in through your nose. (chest should expand outwards not upwards towards your ears) to fill your lungs with air. Both hands should rise towards the ceiling. (The cue of keeping chest still can also cause people to “valsalva” or hold their breath)
  4. When exhaling, breathe out through your mouth while slightly pursing your lips. The hand on your stomach should fall toward your spine with the use of abdominals 


Practice diaphragmatic breathing three to four times a day, five to 10 minutes each time. As you feel comfortable, increase your practice time and move to using diaphragmatic breathing while sitting or standing. You want this way of breathing to become second nature again. Be sure to stop and sit down if you feel light-headed at any point. 

Want to learn more exercises you can do at home? Schedule your appointment with Heather Lane Physical Therapy for a tailored solution to your chronic neck or low back pain.

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