Diaphragmatic Breathing and Chronic Pain

16th June 2007 at 07:26 BST by Dr C.A.Jenner MB BS, FRCA. Permalink.

This article highlights the role of diaphragmatic breathing in the management of chronic pain.

Diaphragmatic Breathing and Chronic Pain

Introduction

Chronic pain is defined as a persistent, long-lasting pain that lasts longer than six months inspite of the required medical treatment. Individuals with chronic pain often tense their muscles in reaction to pain, which in turn aggravate pain altogether. Chronic pain can present itself in a series of forms including:

• Headaches
• Arthritis
• Shingles
• Sciatica
• Back pain
• Neck pain
• Cancer pain

Besides chronic pain leads to impairment of the normal functioning in life and is usually accompanied by fatigue, difficulty in sleeping, anxiety and depression.

Diaphragmatic Breathing – The Basics

Diaphragmatic breathing is typically defined as an act of breathing deep into the lungs by flexing the diaphragm instead of breathing shallowly by flexing the rib cage. This form of breathing is marked by expansion of the stomach rather than the chest and is considered to be a healthier and fuller way to ingest oxygen. Also known as deep breathing, diaphragmatic breathing aims to help an individual use the diaphragm correctly, while breathing in order to:

• Strengthen the diaphragm
• Decrease the work of breathing by slowing the breathing rate
• Decrease oxygen demand
• Use less effort and energy to breathe

The diaphragm is the most efficient muscle of breathing. It is basically a large, dome-shaped muscle located at the base of the lungs. The abdominal muscles help in moving the diaphragm and give you more power to empty your lungs.

Diaphragmatic breathing is an essential component of relaxation training and is often recognized as a part of the bio-behavioral pain control. When used for the treatment of chronic pain, this also involves the development of proper breathing techniques in coordination with body movement to avoid muscular guarding and the resulting referred pain.

Effect on Chronic Pain

Diaphragmatic breathing has an extremely therapeutic effect on chronic pain. It has a major influence on relaxing the muscles which tense up as a result of pain and in turn further aggravate the pain itself. Experts insist that individuals with tensed muscles and in an anxious state of mind are generally known to breathe through their chest. This type of breathing will lead to a disruption of the balance of oxygen and carbon dioxide, which are essential to be in a relaxed state. It is this state of health that the correct technique of diaphragmatic breathing facilitates. Diaphragmatic breathing helps in the treatment process of chronic pain in a number of ways. Here we list the key benefits.

1. Helps in relaxation – Deep breathing is perceived crucial to many relaxation procedures and can independently induce a relaxed frame of mind.

2. Distraction strategy – Deep breathing makes you concentrate hard on the breathing process, thus taking your mind away from pain or other stressors.
3. Reverses physical symptoms of anxiety – When anxious or stressed, people often take shallow, rapid breaths or might even hyperventilate. This can further result in dizziness, blurred vision, pins and needles and chest pain. Slow and deep breathing helps reduce these symptoms to a major extent.

It also improves circulation and facilitates the most efficient exchange of oxygen and carbon dioxide with the minimum amount of effort.

The Steps

Learning to breathe diaphragmatically requires practice, concentration and awareness of your system. Diaphragmatic breathing can basically be done in two postures .i.e. lying down and in the sitting position. Here we list the main steps involved in each of the forms.

A) Lying Down

1. Lie on your back on a flat surface or in the bed. Keep the knees bent and head supported. If required, use a pillow under the knees to support the legs. Place one hand on your chest and other below the rib cage.

2. Breathe in slowly through the nose allowing your stomach to move out against your hand. Try to keep the hand on the chest as still as possible.
3. Tighten the stomach muscles, letting them fall inward as you exhale through pursed lips.

B) In sitting posture

1. Sit comfortably, with knees bent and the shoulders, head and neck relaxed.
2. Place one hand on the upper chest and the other below the rib cage.
3. Tighten your stomach muscles, letting them fall inward as you exhale through pursed lips.

To begin with, diaphragmatic breathing should be done for 5-10 minutes about 3-4 times a day. You can gradually increase the amount of time once you are comfortable doing the same.

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