Overview

The diaphragm is a mushroom-shaped muscle that sits beneath your lower-to-middle rib cage. It separates your abdomen from your thoracic area.

Your diaphragm helps you breathe by lowering when you inhale, in that way, allowing your lungs to expand. It then rises to its original position when you exhale.

When you have a case of the hiccups, you’re experiencing minor, rhythmic spasms in your diaphragm.

But sometimes, a person can experience pain in their diaphragm that goes beyond the minor twitches caused by hiccups.

Symptoms of diaphragm pain

Depending on the cause of your diaphragm pain, you might experience one or more of the following symptoms:

  • discomfort and shortness of breath after eating
  • a “stitch” in your side when you exercise
  • inability to take a full breath
  • low blood oxygen levels
  • pain in your chest or lower ribs
  • pain in your side when sneezing or coughing
  • pain that wraps around your middle back
  • sharp pains when drawing a deep breath or exhaling
  • spasms of varying intensity

Possible causes of diaphragm pain

Diaphragm pain can have multiple causes, some benign and others potentially severe. Here are some of them.

Exercise

Your diaphragm can spasm when you breathe hard during strenuous exercise, like running, which can cause pain in your sides. The pain can be sharp or very tight. It restricts breathing and prevents you from drawing a full breath without discomfort.

If you experience pain like this during exercise, rest briefly to regulate your breathing and ease the spasms. (The pain gets worse if you keep going.)

Stitches in your side tend to be worse if you neglect stretching and proper warmups before exercising, so don’t forget to warm up before you hit the treadmill.

Pregnancy

Discomfort in the diaphragm and shortness of breath are normal during pregnancy. These aren’t symptoms you should be worried about. As your baby grows, your uterus pushes your diaphragm up and compresses your lungs, making it harder to breathe.

If you experience prolonged or severe pain or persistent cough, contact your doctor.

Trauma

Trauma to the diaphragm from an injury, a car accident, or surgery can cause pain that is either intermittent (comes and goes) or prolonged. In severe cases, trauma can cause a rupture of the diaphragm — a tear in the muscle that will require surgery.

Symptoms of diaphragm rupture can include:

  • abdominal pain
  • collapse
  • coughing
  • difficulty breathing
  • heart palpitations
  • nausea
  • pain in the left shoulder or left side of the chest
  • respiratory distress
  • shortness of breath
  • upset stomach or other gastrointestinal symptoms
  • vomiting

Although serious, a diaphragm rupture can go undetected long term. Your doctor can diagnose diaphragmatic rupture through CT scan or thoracoscopy.

Musculoskeletal problems

A muscular strain of the rib muscles, which can happen due to trauma, coughing, or pulling or twisting movements can cause pain that may be confused with pain from the diaphragm. Rib fractures can also result in this type of pain.

Gallbladder problems

One of the most prominent symptoms associated with gallbladder problems is pain in the mid- to upper-right abdomen, which could easily be mistaken for diaphragm pain. Some other symptoms of gallbladder issues include:

Some gallbladder conditions that could cause the above symptoms include infection, abscess, gallbladder disease, gallstones, bile duct blockage, inflammation, and cancer.

To diagnose a gallbladder issue, your doctor will conduct a thorough medical history and physical exam and may recommend tests like:

Hiatal hernia

You experience a hiatal hernia when the top of your stomach pushes up through an opening in the bottom of your esophagus called the hiatus. This type of hernia can be caused by:

  • injury
  • hard coughing
  • vomiting (especially repetitive, like during a stomach virus)
  • straining when passing stool
  • being overweight
  • having poor posture
  • frequently lifting heavy objects
  • smoking
  • overeating

Symptoms of hiatal hernia include:

Your doctor can diagnose hiatal hernia through barium X-ray or endoscopy, although they often require little to no treatment. For someone experiencing acid reflux or heartburn, medication may ease the symptoms.

Surgical intervention for hiatal hernia is rare but might be necessary for a person with a large hiatal hernia.

Other possible causes

Other possible causes of diaphragm pain include:

  • bronchitis
  • heart surgery
  • lupus or other connective tissue disorders
  • nerve damage
  • pancreatitis
  • pleurisy
  • pneumonia
  • radiation treatments

Treating diaphragm pain

Depending on the cause and severity of the pain in your diaphragm, there are multiple avenues for treating the discomfort.

Lifestyle changes

You can address some of the benign causes of these types of pain with remedies such as:

Medication

For conditions like heartburn and acid reflux caused by a hiatal hernia, you might need to take over-the-counter or prescription medications to control the production of acid in your stomach.

If you have rheumatoid arthritis, your doctor might prescribe anti-inflammatory medication or steroids to control the inflammation.

Strong pain management medication like morphine might be prescribed for short-term use in the event of traumatic injury or diaphragm rupture.

Surgery

A person experiencing a severe, large hiatal hernia or a diseased gallbladder might need surgery to correct it.

If there is severe trauma to the diaphragm, surgery may also be needed to repair it.

When to see a doctor

See a doctor if you’ve sustained an abdominal injury that could have affected your diaphragm.

Also make an appointment if you’re having persistent or severe diaphragm pain along with other severe symptoms, including:

  • respiratory distress
  • nausea
  • vomiting

If you’re experiencing mild discomfort in your diaphragm, take a few minutes to concentrate on deep breathing.

Place one hand on your abdomen and breathe deeply. If your abdomen moves in and out as you breathe, you’re breathing correctly.

Encouraging your diaphragm to expand and contract at its full potential should ease your discomfort. Deep breathing may also produce a sense of calm, reduced stress and anxiety levels, and lower blood pressure.