Vancouver Chiropractor: Altered Breathing Patterns & Chronic Low Back Pain

October 28, 2009 by Dr. Carla Cupido

A very interesting paper was published in European Spine Journal this month entitled Altered Breathing Patterns in Chronic Low Back Pain Patients.

The research proved that patients with chronic low back pain often experience altered breathing patterns while performing movements involving the core muscles.  This is relevant for anyone who moves and has low back pain!  Let’s define each of the patterns that were considered impaired:

Breath holding:  Pretty self explanatory.

Paradoxical breathing:  Chest wall moves in on inspiration and out on expiration (reverse of the normal movements).

Upper costal breathing:  Upper chest moves with inspiration and expiration while the diaphragm is not properly engaged.

Mixed pattern breathing:  Any of the above patterns mixed together.

The ideal breathing pattern was deemed to be costodiaphragmatic breathing.  This pattern is defined by the ribcage displacing upwards, outwards and forward with outward abdominal movement (which is reversed on expiration).

The core muscles that surround our lumbar (low) spine take on the shape of a cylinder with the diaphragm at the top, the pelvic floor at the bottom, the abdominals at the front and the back muscles bringing up the rear.  If there is a sense of instability in the low back, it is thought that individuals alter their breathing patterns, using their diaphragm to aid in stabilization.  Therefore if you have chronic low back pain, you may be utilizing one of these abnormal breathing patterns to help stabilize your low back (which is not good).

Much research is still needed on this topic, but breathing patterns should be assessed in chronic low back pain patients as they could be perpetuating the problem.

Rousell et al., Altered Breathing Patterns in Chronic Low Back Pain Patients. European Spine Journal. Volume 16, Pages 1066-1020.