Diaphragm Muscle Pain

The diaphragm is the primary breathing muscle. It is a thin dome-shaped muscle that is located under the ribs and lies between the organs of the chest and the abdominals. It can cause pain around the bottom of the ribs and contribute to a band of pain across the middle of the back.

Contents Of Article:

Muscle Location

Trigger Point Symptoms 

Trigger Points Cause

Trigger Point Prevention

Trigger Point Treatment

Interesting Facts 

Other Muscles With Similar Pain Patterns

Diaphragm Muscle Pain Pattern Diaphragm Muscle Referred Pain Pattern

Where Is The Diaphragm Located?

The muscle lies under the middle to lower ribcage. It connects to the xiphoid process, the inner surface of the lower six costal cartilages, the L1 through the L3 lumbar vertebrae and the central aponeurotic tendon.

What Movements Does The It Control

It raises and expands the ribcage when inhaling allowing the lungs to fill with air.

Diagram of the Diaphragm Muscle Diaphragm Muscle

What Are The Signs and Symptoms of Diaphragm Trigger Points?

Trigger points in the diaphragm do not radiate or refer pain to other areas of the body. The pain is concentrated around the bottom of the ribs.

Problems with the diaphragm will often cause a band of pain across the middle of the back. If you are experiencing this pain check the diaphragm, even if you are not having the typical diaphragm TrP symptoms.

  • Pain in the lower chest
  • Pain around the bottom ribs
  • Discomfort inhaling
  • Can cause a ‘stitch’ or sharp pain in the side
  • A band of pain across the middle back
  • If you have heartburn and indigestion you will often find TrPs in the diaphragm.

Trigger points are small knots found in the muscle that when pressed increase pain in the area or send referred pain to another area of the body. To learn more about trigger points read Muscle Trigger Points and How They Contribute To Muscle and Joint Pain.

What Causes Trigger Points To Develop In The Diaphragm Muscle?

If your breathing is affected, the diaphragm is affected. If you have chronic breathing conditions checking and eliminating TrPs regularly will help ease your breathing.

  • Labored breathing (asthma, emphysema, bronchitis, pneumonia)
  • Gasping for air during sports activities
  • Hyperventilation
  • Coughing
  • Hiccups
  • Slumping posture

How To Avoid Development of Trigger Points

  • It is very important that you maintain correct posture. Slumping inhibits your ability to breathe correctly.
  • If you are a shallow (chest) breather it negatively affects many muscles in the neck, chest, upper back, as well as the diaphragm. Practice deep breathing, inhaling until the stomach expands then exhale slowly. Keep practicing until it becomes a habit!
  • If you have a chronic breathing condition or experience heartburn regularly checking and treating TrPs in the muscle may bring some relief.
  • If you find yourself gasping for air during exercise or other activities, stop and catch your breath!

Tip: If you find yourself with a case of the hiccups, take a sip of apple cider vinegar and they will usually stop immediately. A spoon of sugar can work but is not as effective as the vinegar. 


TWD Recommends: Improve Your Poster To Ease Breathing Discomfort
If you have rounded shoulder or forward head posture correcting your posture will reduce your neck, back, shoulder pain, and help you breathe easier. I  recommend the HailiCare Posture Corrector The corrector fully supports the back and abdominal area while gently pulling your shoulders back which helps retrain muscle memory to maintain proper posture. You will notice immediately a reduction of pain and tension. Start slowly, wearing the brace only 20-30 minutes a day slowly increasing the time you wear it. It is uncomfortable at first, but stay with it as it does get better! 

Diaphragm Trigger Point Treatment

Eliminating trigger points in the diaphragm can help ease not only pain but can help improve your breathing, even if you have a chronic breathing condition.

There are massage therapists, physical therapists, and chiropractors trained in trigger point therapy that can show you how to find and treat specific TrPs. Not all have the specified training so ask before making an appointment.

With the help of The Trigger Point Therapy Workbook, you can learn to treat the diaphragm along with other muscles in the body. The book includes diagrams that will help you locate TrPs and treat them. It takes a little practice to learn the feel of trigger points but once you learn you can treat muscles throughout the body. I recommend this book to anyone interested in learning about muscle pain.

Another important component of treatment is learning to breathe correctly. Learn To Breathe is a DVD by internationally renowned yoga instructor Max Strom that walks you through several breathing exercises that will help you improve your quality of breathing. The exercises are especially beneficial for people who suffer from breathing problems such as asthma,  emphysema,  COPD, and allergies.  I often recommend this DVD to friends and clients who have breathing problems. Yoga experience is not necessary.

Sombra Warming Gel can help ease discomfort by gently warming the area and helping muscles relax. Rub a small amount into the lower ribcage concentrating on the bottom soft area at the bottom of the ribs. Sombra is very effective for the band of back pain.

TWD Recommends: Self-Help Methods

The best resource to learn how to treat small painful knots is The Trigger Point Therapy Workbook. The authors explain trigger points and their effects in everyday language, not medical speak. I recommend this book to anyone interested in learning to treat their own muscle pain.

Improper or irregular breathing is one of the main contributors to diaphragm muscle dysfunction.  Learn To Breathe is a DVD that has exercises to help you learn to breathe correctly. Stop shallow breathing and learn how to make deep breathing a habit. 

Sombra Warm Therapy Gel is recommended for relaxing muscles and relieving pain. It warms without the burning heat of other gels. An excellent choice for pain caused by trigger points, muscle/joint over-use and stiffness, and arthritis. (Not sold in stores)

How Long Before I Feel A Reduction In Pain?

Diaphragm trigger points often take several treatments to deactivate. Fortunately, most people feel some relief quickly.

I have found that the best treatment plan for trigger points in the diaphragm is one treatment in the morning and another in the evening. This area is sensitive and applying pressure throughout the day which is recommended for other trigger points is irritating instead of healing.

It is important to be consistent with your treatments and continue treatment until the Trp is deactivated (gone).

Interesting facts about the diaphragm muscle:

Pain around the bottom of the ribs is often diagnosed as inflammation of the ribs, separated ribs, ulcers or gallbladder trouble. These symptoms can be trigger points in the diaphragm.

Diaphragm pain and symptoms can be similar to, contribute to, and be affected by these medical diagnoses:

  • Fracture of lower ribs
  • Costochondritis
  • Shortness of breath
  • Pleurisy
  • Chronic Obstructive Pulmonary Disease (COPD, Emphysema)
  • Pneumonia or Bronchitis
  • Asthma
  • Sprain/Strain or Tear of the Rectus abdominis, Internal or External Obliques, or Intercostals
  • Gallbladder Disease
  • Splenic Disease
  • Pancreatitis

Other muscles that should be considered and examined:

Check for satellite trigger points in these muscles:

If you find trigger points in the diaphragm it is likely you will find trigger points in the Rectus Abdominis.


Other Muscles With Similar Pain Patterns You Should Consider:


Intercostal Muscles


Rectus Abdominis


Oblique Muscles


Donna Martin

Massage Therapist Owner: thewellnessdigest.com Twelve years of experience working with clients with chronic pain, post injury pain, and post surgery pain. Muscle dysfunction is often overlooked but can hold the key to many pain conditions.

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