Diaphragm Spasm: Symptoms, Causes, And Treatment

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Human Biology

Diaphragm spasms and flutters: What to know

Medically reviewed by Avi Varma, MD, MPH, AAHIVS, FAAFP — Written by Aaron Kandola — Updated on October 23, 2023

Overview
Symptoms
Causes and risk factors
Diagnosis
Prevention
Treatment
FAQ
Summary

Diaphragm spasms feel like twitches in the area between the chest and the abdomen. They can occur with or without pain. Possible causes include an injury, nerve irritation, or a rare condition known as van Leeuwenhoek’s disease.

Diaphragm spasms are involuntary contractions of the band of muscle that divides the upper abdomen and chest. In most cases, they do not pose a serious health risk. However, they can cause discomfort.

Diaphragm flutter, also known as van Leeuwenhoek’s disease, differs from spasms. It is a rare neurological condition in which the muscles of the diaphragm contract rhythmically, causing pain and discomfort.

It is also possible for diaphragm spasms to indicate an underlying health condition. This article will discuss the symptoms, causes, and treatment of diaphragm spasms.

What are diaphragm spasms and flutters?

Rear view of young woman stretching with her arms raised in front of a large window at cozy home, looking out to the beautiful scenics through window in the morning. — d3sign/Getty Images

A diaphragm spasm is a sudden, involuntary contraction that can cause pain and tightness in the chest or upper abdominal area. It affects the ways the lungs expand and contract when breathing. It can occur due to stress, injury, exercise, and other causes.

A diaphragmatic flutter is a specific condition involving unusual abdominal wall movements and difficulty breathing. It is rare, and doctors do not yet know why it happens. There is currently no specific treatment.

The diaphragm is a muscle that acts as a partition between the upper abdomen and the chest. It plays a crucial role in the respiratory system by helping a person breathe.

The diaphragm contracts when a person breathes in, allowing the rib cage to expand so that oxygen can flow into the lungs. When they breathe out, it relaxes again to help push carbon dioxide out of the lungs.

Symptoms

The way a person experiences a diaphragm spasm can vary widely.

They may experience:

chest pain or tightness
difficulty breathing
abdominal pain
heart palpitations

Depending on the cause of the diaphragm spasm, other symptoms may accompany it. These can include:

hiccups
back pain
indigestion
nausea
vomiting
difficulty swallowing
diaphragm paralysis
persistent coughing

These symptoms can range from mild to severe, depending on the underlying cause.

Causes and risk factors

Doctors do not know yet what causes diaphragm spasms. However, they tend to link with:

inflammation of the brain, known as encephalitis
spinal and chest tumors
spasm in other muscles involved in breathing
stroke

There are several possible causes of diaphragm spasms, including:

stress
injury to the abdomen or chest
a “stitch” from exercise

Other potential causes include:

A hiatal hernia

A hiatal hernia is when a part of the stomach moves up into the chest. Hiatal hernias occur when age, injury, or recent surgery weakens the muscle tissue in the diaphragm.

When a hiatal hernia occurs, part of the stomach pushes through an enlarged hiatal opening in the diaphragm. This can trigger a diaphragm spasm.

A hernia can be mild or severe, and its severity will determine any additional symptoms. The most severe cases require immediate medical attention as they can injure the stomach, cause bleeding, or interfere with breathing.

Temporary paralysis

A sudden blow to the abdomen can temporarily paralyze the diaphragm. This can lead to significant difficulties in breathing. A person may panic or feel anxious if they cannot breathe, which can worsen symptoms.

However, the paralysis will quickly pass in most cases, allowing the individual to breathe normally again.

Phrenic nerve irritation

The phrenic nerve controls the movement of the diaphragm muscle.

Irritation, injury, or any inflammation of this nerve can trigger spasms in the diaphragm, as well as causing hiccups and breathing difficulties.

A variety of factors or conditions can irritate the phrenic nerve, including:

physical injury or trauma
cancer or a tumor
cervical spondylosis
diabetic neuropathy
multiple sclerosis (MS)
Parsonage-Turner syndrome (PTS)
viral or bacterial infections
surgical complications
local anesthesia
noninfectious inflammatory causes, such as sarcoidosis and amyloidosis

Diaphragmatic flutter

Diaphragmatic flutter, also called van Leeuwenhoek’s disease, is a rare condition that involves rhythmic, involuntary contractions of the diaphragm.

Other symptoms can include:

abdominal pain
heart palpitations
difficulty breathing
chest pain

They can worsen during the day and with stress.

Doctors do not know yet why it happens, but it can link with:

inflammation of the brain, known as encephalitis
spinal and chest tumors
stroke

Although there is currently no standard treatment for diaphragmatic flutter, doctors may try the following:

antiseizure medications
antipsychotic medications
diaphragm pacer stimulation
phrenic nerve crush, which involves stopping the diaphragm from moving by damaging one of the two main nerves that lead to it

Diagnosis

It is possible to mistake the symptoms of diaphragm spasms for those of a gastrointestinal or heart problem, as they are similar. In most cases, the spasms will subside after a few minutes and will not need a diagnosis.

However, if a person has frequent diaphragm spasms without an apparent cause, it is important for them to get medical advice.

If the doctor suspects that an underlying medical condition is causing the spasms, they may use the following tests to help with diagnosis:

X-ray
CT scan
MRI
endoscopy
manometry
blood tests

How to stop diaphragm spasms

Treatments for diaphragm spasms vary according to the underlying cause.

Although diaphragm spasms resulting from a sudden blow may cause discomfort, symptoms typically subside within a few minutes, making treatment unnecessary. However, it is essential to rest and concentrate on maintaining a regular breathing pattern while symptoms persist.

Stopping spasms that occur due to the following causes will require different methods:

Exercise

Most diaphragm spasms that result from exercise also go away without treatment. If the spasms are persistent, anecdotal evidence suggests it may help to stretch or put pressure on the surrounding muscles.

For example, gently pushing into the affected muscle using the fingers can help relieve discomfort. Holding one hand over the head can also help, as holding this position stretches the chest muscles.

Hiatal hernias

Doctors treat hiatal hernias in different ways, depending on their severity. In cases when symptoms are minimal, it can help to eat smaller, more frequent meals or take medication for gastroesophageal reflux disease.

Surgery may be necessary in more severe cases, especially if the hernia causes complications.

Phrenic nerve irritation

Treating the cause of phrenic nerve irritation can be a great way to restore a regular breathing pattern. The cause will determine the treatment plan.

Treatment

If diaphragm spasms are severe, a doctor may recommend one of the following treatments:

antiseizure medications
antipsychotic medications
procedures to try to control the movement of the diaphragm, such as a diaphragm pacer stimulation
surgery to stop the diaphragm moving, for example, by damaging one of the two main nerves that lead to it

Frequently asked questions

Below are answers to some questions people may ask about spasms and flutters in the diaphragm.

Are stomach spasms the same as diaphragm spasms and flutters?

Stomach spasms relate specifically to the digestive process. They can happen if a person:

has an infection in their digestive tract
has acid reflux
eats spicy food
has dinner late at night

A diaphragm spasm occurs in the muscle that lies between the abdomen and the lungs. It can be due to digestive factors but may also indicate a lung, heart, muscle, or nerve problem.

Diaphragm flutter is a rare and specific condition. It is different from a spasm.

What are the risk factors for diaphragm spasms?

Doctors do not know exactly why these spasms happen. However, some people notice them after exercise, when they eat certain foods, or with stress. They may also be a symptom of a hiatal hernia.

How can I stop diaphragmatic spasms?

It depends on when the spasms happen. If a person experiences them after exercise, doing warmup stretches may help. If spasms occur after eating spicy food or a large meal, dietary changes may prevent them.

Breathing exercises might also help calm diaphragm muscle spasms. A doctor may recommend antiseizure or other medications if the spasms are bothersome.

How long does a diaphragm spasm last?

Most diaphragm spasms are temporary and go away within a few minutes.

If diaphragm spasms are more persistent over a longer period, this may be due to an underlying health condition. In this case, it is best for a person to consult a health professional.

Summary

Diaphragm spasms and flutters affect a muscle called the diaphragm in the upper abdomen, between the stomach and the lungs.

Diaphragm spasms are muscular spasms that can occur for various reasons, ranging from exercise to digestive problems. Diaphragmatic flutters refer to rhythmic contractions in the chest area. This is a rare and specific condition that scientists are currently working to understand better.

Anyone concerned about spasms or flutters in the chest or upper abdomen may want to seek medical advice.

Read this article in Spanish.

Respiratory
GastroIntestinal / Gastroenterology
Sports Medicine / Fitness

How we reviewed this article:

SourcesMedical News Today 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.

Acid reflux (GER & GERD) in adults. (n.d.).https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults
Bains KNS, et al. (2023). Anatomy, thorax, diaphragm.https://www.ncbi.nlm.nih.gov/books/NBK519558/
Chiou M, et al. (2017). Treatment of idiopathic diaphragm flutter.https://journal.chestnet.org/article/S0012-3692(17)30175-7/fulltext
Chronic obstructive pulmonary disease (COPD). (2023).https://www.cdc.gov/copd/index.html
Diaphragmatic flutter. (2023).https://rarediseases.info.nih.gov/diseases/13617/diaphragmatic-flutter/diagnosis
Diaphragmatic flutter. (n.d.).https://rarediseases.org/gard-rare-disease/diaphragmatic-flutter/
Dubé B-P, et al. (2016). Diaphragm dysfunction: Diagnostic approaches and management strategies.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5184786/
Hughey SB, et al. (2016). Hiatal hernia as the cause of G-induced abdominal pain.https://academic.oup.com/milmed/article/181/11-12/e1700/4158592
Krysiak W, et al. (2008). Hiccups as a myocardial ischemia symptom.https://www.mp.pl/paim/issue/article/338/
O'Toole, SM, et al. (2023). Unilateral diaphragmatic paralysis.https://www.ncbi.nlm.nih.gov/books/NBK557388/
Ramírez JD, et al. (2015). Diaphragmatic flutter: A case report and literature review.http://www.elsevier.es/en-revista-neurologia-english-edition--495-articulo-diaphragmatic-flutter-a-case-report-S2173580815000449
Roman S, et al. (2014). The diagnosis and management of hiatus hernia.https://www.bmj.com/bmj/section-pdf/778631?path=/bmj/349/7980/Clinical_Review.full.pdf
Walton D, et al. (2018) Diaphragmatic flutter [Abstract].https://pn.bmj.com/content/18/3/224
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Medically reviewed by Avi Varma, MD, MPH, AAHIVS, FAAFP — Written by Aaron Kandola — Updated on October 23, 2023

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Human Biology

What are diaphragm spasms and flutters?

Symptoms

Causes and risk factors

A hiatal hernia

Temporary paralysis

Phrenic nerve irritation

Diaphragmatic flutter

Diagnosis

How to stop diaphragm spasms

Exercise

Hiatal hernias

Phrenic nerve irritation

Treatment

Frequently asked questions

Are stomach spasms the same as diaphragm spasms and flutters?

What are the risk factors for diaphragm spasms?

How can I stop diaphragmatic spasms?

How long does a diaphragm spasm last?

Summary

How we reviewed this article:

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