Diaphragm Spasm: Involuntary, Flutter, Can't Breathe, And More

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HealthlineSubscribeDiaphragm SpasmMedically reviewed by Suzanne Falck, M.D., FACP — Written by Ana Gotter — Updated on September 18, 2018

Causes
Treatment
Outlook

Diaphragm spasms may impede normal breathing and be uncomfortable. They can occur for a number of reasons, including a blow to the stomach, a hiatial hernia, or phrenic nerve irritation.

The diaphragm is located between the upper abdomen and the chest. It is the muscle responsible for helping you breathe. As you inhale, your diaphragm contracts so your lungs can expand to let in oxygen; as you exhale, your diaphragm relaxes to let out carbon dioxide.

Some conditions and complications can cause diaphragm spasms.

What causes a diaphragm spasm?

A diaphragm spasm can occur for a number of reasons and in varying severities. Sometimes the spasm is short-lived, particularly if it occurs as a result of a “sucker punch.”

Other causes are more involved and may have a number of additional symptoms associated with them.

Hiatal hernia

If you have a hiatal hernia, part of your stomach comes up through your diaphragm in the hiatal opening.

Hiatal hernias are caused by weakened muscle tissues, which can be a result of an especially large hiatus (muscle space), injury, or persistent pressure on surrounding muscles.

Small hiatal hernias don’t usually cause problems, whereas large hiatal hernias can cause pain and difficulty breathing. Other symptoms of a hiatal hernia include:

heartburn
difficulty swallowing
belching
feeling overfull after meals
passing black stool
vomiting blood

Phrenic nerve irritation

The phrenic nerve controls the muscle of the diaphragm. It sends signals to your brain, which allows you to breathe without thinking. If your phrenic nerve becomes irritated or damaged, you may lose the ability to take automatic breaths. The condition can be caused by a spinal cord injury, physical trauma, or surgical complications. With phrenic nerve irritation, you might also experience:

hiccupping
shortness of breath when lying down
diaphragm paralysis

Temporary paralysis

Your diaphragm can become temporarily paralyzed if you’ve “had the wind knocked out of you” from a direct hit to your abdomen. Right after the hit, you may have difficulty breathing, as your diaphragm might struggle to fully expand and contract. Other symptoms of temporary paralysis include:

hiccups
tightness in the chest
pain in the chest
pain in the stomach

Side stiches from exercise

Side stitches, or cramping in the ribcage, sometimes occur when you first begin exercise training or when that training becomes more intense. For some people, drinking juice or eating right before a workout can increase the possibility of side stiches.

If you overexert your diaphragm during exercise, it may start to spasm. When the spasm is chronic, it might be due to exercise-induced bronchospasm, and you may also experience:

chest pain and tightness
shortness of breath
a dry cough

Diaphragm flutter

A diaphragm flutter is a rare condition that can be misdiagnosed as a spasm. A diaphragm flutter can also be caused by phrenic nerve irritation. Other symptoms associated with diaphragm flutter include:

chest tightness
difficulty breathing
a feeling of pulses in the abdominal wall

How are diaphragm spasms treated?

Anecdotal evidence suggests that practicing controlled breathing can stop diaphragm spasms. To do this:

Lie flat on your back on the floor or on a bed.
Bend your knees slightly, placing one pillow beneath your knees and another under your head.
Place one hand on your upper heart near your chest and the other hand on your upper abdomen just below the ribcage.
Slowly breathe in through your nose. Feel your stomach moving against your hand.
Tighten the muscles in your stomach, having your abdomen fall inward, and exhale through your mouth, with pursed lips.

To treat a hiatal hernia

This condition can be diagnosed through blood testing, esophageal X-ray, endoscopy, or manometry.

In some cases, surgery is necessary. It’s usually performed through a small incision in either your abdomen or chest wall. Lifestyle and home remedies include eating smaller meals, avoiding foods that can cause heartburn, avoiding alcohol, losing weight, and elevating the head of your bed.

To treat phrenic nerve irritation

This condition can be managed with a breathing pacemaker, which takes over the responsibility of sending messages to the diaphragm. The electrodes, which are placed around the nerve, are activated through the pacemaker and stimulate contractions of the diaphragm.

If one nerve is affected, you will receive one implant, and if both are affected, you will receive two.

Side stitches

Raise the arm corresponding to the side of the pain and place that hand on the back of your head. Hold it for 30 to 60 seconds to allow knots to loosen. You can even continue exercising while holding the stretch.

Additionally, you can apply pressure with your hand to the pain point and bend backward and forward slowly. To prevent side stitches before a workout, perform core stretches, including the one described above.

What is the outlook for a diaphragm spasm?

The outlook for diaphragm spasms varies widely depending on the cause. However, in most cases, either at-home treatments or medical treatments can cure the symptoms.

Sometimes the spasms are due to normal overexertion and can be relieved easily. In other cases, an underlying condition may need to be addressed, and once the condition is treated, the spasm is treated as well.

With new technologies and imaging equipment, doctors are more prepared than ever to determine the cause of a diaphragm spasm and come up with a positive treatment plan.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Chiou M, et al.(2017). Treatment of idiopathic diaphragm flutter. DOI:http://dx.doi.org/10.1016/j.chest.2017.01.034
Diaphragmaticbreathing. (2017).https://my.clevelandclinic.org/health/articles/diaphragmatic-breathing
Mayo Clinic Staff.(2015). Hiatal hernia.https://www.mayoclinic.org/diseases-conditions/hiatal-hernia/basics/definition/con-20030640
Vantrappen G, et al.(1992). High-frequency diaphragmatic flutter: symptoms and treatment bycarbamazepine.https://www.ncbi.nlm.nih.gov/pubmed/1346281

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Medically reviewed by Suzanne Falck, M.D., FACP — Written by Ana Gotter — Updated on September 18, 2018

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