Breathing and Back Pain

As we know, various muscles play a role in lumbar stability. That is why we do lots of strengthening exercises for the abdomen and lower back. Curl-ups, planks, bird-dogs are all examples of common exercises that are usually beneficial. They target muscles like the multifidus, the transversus abdominus, rectus abdominis and obliques, quadratus lumborum and paraspinals to name a few. But what about the diaphragm, a muscle that plays a vital role in breathing? Is it helpful in stabilizing the spine?

Back Pain Breathing

Back Pain Breathing

If you imagine our lower back as being contained in a tube or cylinder, the aforementioned list of muscles create that cylinder.  The bottom of this cylinder is the pelvic floor and the top is the diaphragm. The diaphragm is known as a respiratory muscle.  Yet it is not only involved in breathing. It helps to regulate intra-abdominal pressure and contributes to spinal stability.

An interesting study published in the European Spine Journal investigated the relationship between breathing and muscular stabilization of the lumbar spine. The results found that 50-60% of chronic low back pain patients showed an altered pattern of muscle control. In particular, this was altered as it related to breathing patterns during simple tasks.

So what does this mean? We know that many different muscles play a role in stabilizing the spine and the diaphragm is one of them. When patients with lower back pain perform stabilizing exercises to protect their spine from future episodes, proper breathing patterns should be emphasized during these exercises and during day-to-day activities.


Roussel N et al.  Altered breathing patterns in chronic low back pain patients.  European Spine Journal  2009; 16: 1066-1020.