Pain in Diaphragm: Causes, Symptoms, Treatment, Diagnosis

Pain is a common condition that can occur to anyone and everyone, at any point of time. Certainly there are conditions that can cause this pain. Though the external pains are easier to treat, there are some internal pains also that need to be taken care of very cautiously. Amongst them, the diaphragm pain is something that most people do not pay much attention to.

Diaphragm is the muscle that separates the abdomen from the thorax. Lying under the lower and middle ribcage, this mushroom shaped muscle is a very important muscle in the body cavity. It helps in the breathing process by helping the lungs to expand and elevate and by decreasing the pressure put on lungs. During this breathing process or even in general, pain can be felt in the diaphragm. Pain in diaphragm can happen due to varied reasons like spasm, anatomical defects, stroke, etc.

• Pain around the ribs
• Pain in the chest
• A sharp pain or ‘stitch’ in the sides of the chest can be a symptom of pain in diaphragm
• A band of pain in the middle back.

In most cases, these symptoms of pain in diaphragm are felt during sports activities, when a person gasps for breath. If a person has asthma, pneumonia, bronchitis or emphysema, these too can be the causes for this kind of pain.

Pain in the diaphragm is actually a symptom that can be a consequence of many other clinical conditions. The most common causes are –

• Pain in Diaphragm Caused Due to Anatomical Defects: When the causes of pain in diaphragm are defects in the anatomy, such as –
  • Congenital: This is a birth defect of the diaphragm.
  • Acquired: In most cases, these are the results of post-operative conditions, traumas and injuries.
• Innervation Defects Causing Pain in Diaphragm: These are –
  • Stroke: When due to a stroke, one side of the diaphragm is paralyzed; the other side has to work harder, causing pain.
  • Neuropathic Problem of Phrenic Nerves: If phrenic nerves are injured during surgeries or if tumours develop on them, it can cause pain in the diaphragm muscle. This is because these phrenic nerves are responsible for the diaphragm innervation.
  • Spinal Cord Problems: When there is disease associated with the spinal cord.
  • Myasthenia Gravis: Symptom of the disease includes impaired breathing capacity.
• Various Other Causes of Pain in Diaphragm: These are more usual or common causes. These include –
  • Injury and trauma:
    • Trauma and diaphragmatic rupture
    • Fracture of the lower ribs.
  • Certain Diseases:
    • Neurological disorders like ALS or Amyotrophic Lateral Sclerosis, Multiple Sclerosis and Poliomyelitis can cause pain in diaphragm
    • Hyper– and hypothyroidism
    • Muscular dystrophy or other disorders associated with diaphragm
    • Rheumatoid arthritis and other diseases of the connective tissue
    • Pneumonia, bronchitis, asthma
    • Pleurisy
    • Costochondritis
    • Pancreatitis
    • Splenic disease
    • Gallbladder issues
  • Other Conditions:
    • Hiatal hernia
    • Infection
    • Malnutrition
    • Inefficient breathing pattern
    • Chiropractic manipulation
    • Strain, sprain and tear of the internal organs in the body cavity.
  • Pregnancy: During pregnancy, pain in diaphragm can be normal. This is because, to accommodate the baby in the space, the uterus expands and this pushes the diaphragm. As a consequence, pain and shortness of breath can be felt.
  • Coughing: During severe cough and cold, or for those, who have a chronic coughing condition, pain in the diaphragm can occur. This is because, while coughing, the diaphragm undergoes a lot of pressure. Hence, pain is inevitable.
  • Overeating: Those, who overeat, have a tendency of developing hiatal hernia. In this condition, the stomach bulges through the diaphragm muscle and causes pain.
  • Running: When you run, along with the other muscles, the breathing capacity must also cope with the running pace. Therefore, warming up is a must. Those, who start without increasing this capacity, will experience pain in the diaphragm. The reason being the diaphragm contracts as much as it can, to maintain the breathing pace which exerts a lot of pressure in the diaphragm causing pain.

These are some of the most common reasons, why pain in the diaphragm is felt. What is the cause of the pain must be identified well by an experienced physician as one can have more than one reason contributing towards the pain in diaphragm. Hence, a proper diagnosis is a must.

Diagnosis of the pain in diaphragm is very important. X-ray, CT scan or MRI scans are run by the doctor in order to diagnose the underlying condition that has caused the pain. Often misdiagnosis and ignorance leads to serious troubles and complications. In order to avoid that, timely and proper diagnosis is a must.

There are different treatment options that need to be opted for treating pain in diaphragm. The proper option entirely depends on the type of underlying cause behind the pain in diaphragm. The treatment option includes:

• Surgery for Treating Pain in Diaphragm: In case of anatomic defects as a cause for pain in diaphragm, surgery is the best way to treat the problem. Once the defect is corrected, the pain will subside. Often, a phrenic nerve pacemaker is placed in the diaphragm to guide the phrenic nerves for respiration. To treat extreme cases of hiatal hernia and other traumas, surgery can be helpful.
• Medication: When the cause of the pain in diaphragm is a stroke, medication for coronary diseases that can lead to stroke, are prescribed. These can guarantee that the stroke doesn’t occur and thereby, the pain can be managed. Spinal cord disorders can also be treated with neurologic medication. In case the pain of diaphragm is associated with rheumatoid arthritis, anti-inflammatory medicines are prescribed. If the pain is severe, corticosteroids are prescribed. When the problem is with diaphragm rupture, morphine is given.
• Physical Therapy to Treat Pain in Diaphragm: When the problem is associated with immobility, moving pattern, difficulty in coming out of bed, physical therapy can be of great help.
• Other Therapies for Treating Pain in Diaphragm: There are some other therapies that have proven to be quite useful for pain in diaphragm. These are –
  • Occupation therapy for those, who face difficulty in doing daily activities and for some neurological disorders.
  • Oxygen therapy for treating myasthenia gravis.
  • Hormone therapy to treat thyroid disorder.
  • Treating malnutrition with proper diet.
  • Developing a slow eating habit.

Hence, it can be seen that pain in the diaphragm can occur due to a number of reasons. To make sure that the pain is treated well and fast, you need to see a doctor immediately. Sometimes, when the causes are associated with running or eating habits, small changes can bring huge relief.

Also Read:

• What is Paralyzed Diaphragm & How is it Treated?
• Diaphragm Spasm: Symptoms, Causes, Treatment, Epidemiology, Complications