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July 19, 2022


Posted In: Back Issues, Pain

Simply breathing can be a cause of low back pain. For some people, it will make it better. What could be wrong with our breathing? Most people don’t even realize their breathing patterns are abnormal.

Many people go to Chiropractors, massage therapists, acupuncturists, medical doctors for the relief of low back pain in Edina. Worldwide, back pain is a single leading cause of disability to work as well as engage in everyday activities (1). Worldwide, low back pain has increased by 54% between 1990 and 2015(2). Low back pain costs to American are at least $50 billion in health care costs each year (3)

Causes of Back Pain?

The back is a complicated bone structure of joints, ligaments, muscles, and nerves. You can sprain or strain muscles and ligaments, rupture discs, and irritate joints. You can induce this from injuries during sports, motor vehicle accidents, or simply picking up trash off the floor. Additional conditions such as arthritis, poor posture, obesity, and psychological stress can cause or complicate your back problem. Pain in the back can also be results of kidney stones, kidney infections, blood clots, or bone loss(4).

Your Breathing is Causing Back Pain?

Simply breathing can be a cause of low back pain. For some people, it will make it better. What could be wrong with our breathing? Most people don’t even realize their breathing patterns are abnormal. Once people assess their breathing using one hand on the chest and one hand the stomach and observe where the breathing starts. It will be apparent that the majority of people will be breathing from their chest primarily and we call this hyperventilation. This is called the Hilo test. Proper breathing requires slow expiration with abdominal breathing with their stomach moves more than the chest. (5) How does this abnormal breathing patterns lead to low back pain?

Breathing Pattern Disorders

Hyperventilation is a version of Breathing Pattern Disorder (BPD), and it is frequent in females. BPD can lead to respiratory alkalosis, constriction of smooth muscles, and variety of neurological, cardiac, gastrointestinal and emotional symptoms. The resulting reduced oxygen (hypocapnoea), can also induce anxiety with altered neurological function, muscular imbalance, disturbed postural balance, and the enhanced myofascial trigger points. This influence on motor function will compromise the core stabilizing muscles involving the spine(5).

Hyperventilation starts with a psychological state such as anxiety or panic. This is a stress response that everyone experience on a daily basis. The muscular system changes its function under this condition of pain and anxiety. This is mostly due to the involvement with the limbic system in the brain. The limbic system involves amygdala, locus coeruleus, hippocampus that regulates emotion and memory. When we remember a bad experience and even if there was no danger, our body will respond and create a hyperventilation breathing pattern from any stimulation that triggers the memory of danger you experienced.

BPD (Breathing Pattern Disorder) will cause increased biochemical change for your nerves to be a sensitive and/or excited state. Eventually an imbalance of the whole chemistry of the autonomic nervous system. The result of the nerves being sensitive and/or excited state often creates more trigger points and creates more problems with our muscles for breathing and induce more pain. Mostly the core stabilizing muscles are going to be stressed and will dysfunction and create instability and eventually lead to low back pain.

Breathing Pattern Disorders symptoms that you might be experiencing the following(6):

  • Lightheadedness
  • Head neck and upper body aching/pain
  • Giddiness/Dizziness
  • Anxiety
  • Shortness of breath
  • Heart palpitations
  • Numbness
  • Chest pains
  • Dry mouth
  • Clammy hands
  • Difficulty swallowing
  • Tremors
  • Sweating
  • Weakness
  • Fatigue

Assessment of Breathing Pattern Disorder

Having a quick assessment will be best to use a Functional Outcome Assessment. These are questionnaires that you can fill out and score the results at the end. Nijemgen Questionnaire and Self-Evaluation of Breathing Questionnaire (SEBQ) is a great way to start and evaluate your breathing patterns(6,7). These questionnaires are very accurate and reliable but it is subject to the person who answers the questions.

More in-depth objective assessments will need a physician or specialist that will do all the evaluation methods. Using very sensitive machines, and complex computer software that will be able to measure the efficiency of your breathing functions and strategy for getting a better breathing pattern.

One of the easy methods that you can use to evaluate yourself is to videotape yourself doing the HiLo test. As mentioned earlier, the HiLo test simply is putting one hand on the middle of your chest and the other hand right over the lower abdomen/naval area. Take a deep breath and see which hand moves more or starts to move first. If your hand on the chest moves first or more then the lower abdomen/naval area then you may need further evaluation. Check out your score and see if you need to see someone about this.

Breathing Re-training

Finding someone that will re-train your breathing pattern may require more then you think. If you do have a diagnosis, you will be having a physician or therapist to be helping you with the Breathing Pattern Disorder.

Breathing is not great…now what?

Some of you may not have enough to have a diagnosis. Remember that in my previous articles states that you need to have significant loss of function and adaptability to be diagnosable to a medical doctor to prescribe therapy and get insurance coverage. When you are not but still lacking to get a full breath, having a harder time to get good breathing habits, or you feel that you are not 100%, then finding a wellness healthcare provider is important.

Zen Chiropractic at Zen Healing Center

Functional disorders like Breathing Pattern Disorders are a special consideration at Zen Healing Center. The health condition that may not be diagnosable yet but if the breathing patterns are not adequate, then there are great ways to find out what is the problem. Breathing is a special consideration because we know that Tai Chi/Qi Gong, meditation, yoga, and many more wellness therapies are crucial for the success of gaining more health to thrive in their stressful environment. Contact our website email Dr. Zen at for any further questions regarding this topic.


1. Hoy D, March L, Brooks P, et al The global burden of low back pain: estimates from the Global Burden of Disease 2010 study Annals of the Rheumatic Diseases Published Online First: 24 March 2014. doi: 10.1136/annrheumdis-2013-204428

2. Hartvigsen J et al. Low Back Pain Series: What Low Back Pain Is and Why We Need to Pay Attention. Lancet, June 2018; Volume 391, Issue 10137; p2356-2367.

3. In Project Briefs: Back Pain Patient Outcomes Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville, MD.


5. Chaitow, Leon, “Breathing pattern disorders, motor control, and low back pain,” Journal of Osteopathic Medicine, Volume 7, Issue 1, 33 – 40


7. Bradley, Helen and Joseph Esformes. “Breathing pattern disorders and functional movement” International journal of sports physical therapy vol. 9,1 (2014): 28-39.