The diaphragm is the primary muscle used in respiration, which is the process of breathing. This dome-shaped muscle is located just below the
and
. It contracts continually as you breathe in and out.
The diaphragm is a thin skeletal muscle that sits at the base of the chest and separates the abdomen from the chest. It contracts and flattens when you inhale. This creates a vacuum effect that pulls air into the lungs. When you exhale, the diaphragm relaxes and the air is pushed out of lungs.
It also has some nonrespiratory functions as well. The diaphragm increases abdominal pressure to help the body get rid of vomit, urine, and feces. It also places pressure on the esophagus to prevent
.
The phrenic nerve, which runs from the neck to the diaphragm, controls the movement of the diaphragm.
There are three large openings in the diaphragm that allow certain structures to pass between the chest and the abdomen.
These openings include the:
Esophageal opening. The esophagus and
, which controls much of the digestive system, pass through this opening.
Aortic opening. The
, the body’s main artery that transports blood from the heart, passes through the aortic opening. The thoracic duct, a main vessel of the lymphatic system, also passes through this opening.
Caval opening. The
, a large vein that transports blood to the heart, passes through this opening.
A range of health conditions can affect or involve the diaphragm.
Hiatal hernia
A
happens when the upper part of the stomach bulges through the esophageal opening of the diaphragm. Experts aren’t sure why it happens, but it could be caused by:
age-related changes in the diaphragm
injuries or birth defects
chronic pressure on surrounding muscles from coughing, straining, or heavy lifting
They’re
in people who are over the age of 50 or obese.
Small hiatal hernias usually don’t cause any symptoms or require treatment. But a larger hiatal hernia may cause some symptoms, including:
acid reflux
trouble swallowing
chest pain that sometimes radiates to the back
Larger hiatal hernias sometimes require surgical repair, but other cases are usually manageable with over-the-counter
. Proton pump inhibitors can also help to reduce acid production and heal any damage to the esophagus.
Diaphragmatic hernia
A
happens when at least one abdominal organ bulges into the chest through an opening in the diaphragm. It’s sometimes present at birth. When this happens, it’s called a congenital diaphragmatic hernia (CDH).
Injuries from an accident or surgery can also cause a diaphragmatic hernia. In this case, it’s called an acquired diaphragmatic hernia (ADH).
Symptoms can vary depending on the size of the hernia, the cause, and the organs involved. They may include:
difficulty breathing
rapid breathing
rapid heart rate
blueish-colored skin
bowel sounds in the chest
Both an ADH and CDH require immediate surgery to remove the abdominal organs from the chest cavity and repair the diaphragm.
Cramps and spasms
A diaphragmatic
or
can cause chest pain and shortness of breath that can be mistaken for a
. Some people also experience sweating and anxiety during a diaphragm spasm. Others describe feeling like they can’t take a full breath during a spasm.
During a spasm, the diaphragm doesn’t rise back up after exhalation. This inflates the lungs, causing the diaphragm to tighten. This can also cause a cramping sensation in the chest. Vigorous exercise can cause the diaphragm to spasm, which often results in what people call a side stitch.
Diaphragm spasms usually go away on their own within a few hours or days.
Diaphragmatic flutter
Diaphragmatic flutter is a rare condition that’s often mistaken for a spasm. During an episode, someone might feel the fluttering as a pulsing sensation in the abdominal wall.
It can also cause:
shortness of breath
chest tightness
chest pain
abdominal pain
Phrenic nerve damage
Several things can damage the phrenic nerve, including
traumatic injuries
surgery
cancer in the lungs or nearby lymph nodes
spinal cord conditions
neuromuscular disorders, such as
certain viral illnesses
This damage can cause dysfunction or paralysis of the diaphragm. But phrenic nerve damage doesn’t always cause symptoms. When it does, possible symptoms include:
shortness of breath when lying flat or exercising
morning headaches
trouble sleeping
chest pain
Symptoms of a diaphragm condition
A condition affecting the diaphragm can cause symptoms similar to those of a heart attack. Seek emergency treatment if you experience chest pain or pressure that extends to your jaw, neck, arms, or back.
Symptoms of a diaphragm condition may include:
difficulty breathing when lying down
shortness of breath
chest, shoulder, back, or abdominal pain
pain in your lower ribs
a fluttering or
pulsing sensation in the abdomen
bluish-colored skin
heartburn
trouble swallowing
regurgitation of food
upper abdominal pain after eating
side pain
Tips for a healthy diaphragm
The diaphragm is one of the body’s most important muscles because of its crucial role in breathing.
Protect your diaghragm by:
limiting foods that trigger heartburn or acid reflux
eating smaller portions of food at a time
stretching and warming up before exercise
exercising within your limits
Like any muscle, you can also strengthen your diaphragm with special exercises.
or abdominal breathing is the best way to do this. It involves inhaling deeply and slowly through the nose so that your lungs fill with air as your belly expands. Along with strengthening your diaphragm, diaphragmatic breathing can also
and lower blood pressure.