Explore These 5 Breathing Exercises to Alleviate Low Back Pain
- Julian Simpson
- Apr 15, 2025
- 5 min read
Updated: May 1, 2025
Explore These 5 Breathing Exercises to Alleviate Low Back Pain
Chronic low back pain (CLBP) is particularly prevalent and enduring, which results in long-term disability, economic losses from reduced work hours, and increased use of healthcare services. Lumbar instability (LI) is one of the most common causes of CLBP, defined as the mechanical low back pain subgroup
These symptoms are often exacerbated by activities that challenge spinal stability, such as lifting, prolonged standing, or carrying objects
The core trunk muscles are categorised into global and local stabilizers. Global muscles are crucial for controlling trunk and pelvis movements.
Local muscles play an essential role in maintaining the stability of the lumbar segments of the spine, significantly contributing to overall spinal health and function. These muscles, which include the lumbar multifidus (LM), transversus abdominis (TrA), pelvic floor muscles (PF), and the diaphragm, work in concert to provide support and stability to the lumbar region.
The lumbar multifidus, for instance, is a series of small muscles located along the spine that help to stabilize the vertebrae during movement and maintain proper posture.
The transversus abdominis acts as a natural corset, helping to compress the abdominal contents and stabilize the pelvis and lower back.
The pelvic floor muscles contribute to core stability and support the organs in the pelvic region, while the diaphragm plays a crucial role in respiration and also aids in intra-abdominal pressure regulation, which is vital for spinal stability.
Research has indicated that alterations in the functioning of abdominal and back muscles are commonly observed in individuals suffering from chronic low back pain (CLBP), particularly those with lumbar instability (LI). In these cases, there is often an increase in the activity of the superficial abdominal muscles, such as the rectus abdominis (RA) and external oblique (EO). These muscles, while important for movement and posture, may become overactive as a compensatory mechanism when the deeper stabilizing muscles are not functioning effectively.
Conversely, there is typically a decrease in the activity of the deep abdominal muscles, including the transversus abdominis and internal oblique (IO), which are crucial for providing the necessary support to the spine. Furthermore, individuals with CLBP and LI frequently exhibit weakness in the deep back muscles, particularly the lumbar multifidus, compared to those with CLBP who do not have lumbar instability.
This imbalance in muscle activity can lead to further instability and pain, creating a vicious cycle that exacerbates the condition. Understanding these muscular alterations is vital for developing effective rehabilitation strategies aimed at restoring balance and function to the lumbar region.
The diaphragm is the primary respiratory muscle and also plays a crucial role in postural control by regulating intra-abdominal pressure (IAP)20. During physical activities such as jumping, running, or lifting, IAP increases
Research released in 2025 revealed significant findings regarding individuals suffering from chronic low back pain. The study demonstrated that these individuals experienced a DECREASE in total diaphragm excursion, which is the movement of the diaphragm during breathing.
This reduction in diaphragm movement was attributed to a notable decrease in the activation of both the low back muscles and the diaphragm itself. The implications of this finding are profound, as the diaphragm plays a crucial role not only in the mechanics of breathing but also in stabilizing the core and supporting overall spinal health. When the diaphragm is not functioning optimally, it can lead to a cascade of issues that exacerbate low back pain and hinder recovery.
Furthermore, it is important to understand the anatomical relationship between the diaphragm and the lumbar spine. The diaphragm is directly connected to the first four vertebrae in the lumbar region (L1 to L4). This anatomical connection highlights the importance of maintaining proper spinal alignment and function to ensure optimal diaphragm performance. Therefore, it becomes essential to improve breathing capacity by addressing any spinal subluxations that may be present in the L1 to L4 vertebrae. These subluxations can interfere with the nervous system's ability to communicate effectively with the diaphragm and surrounding muscles, leading to diminished respiratory function and increased discomfort.
To address these issues, your local chiropractor will conduct a thorough assessment of your spine to identify any areas that require correction through spinal adjustments. This assessment may involve physical examinations, postural analysis, and possibly imaging studies to pinpoint the specific locations of misalignment.
Once identified, chiropractic adjustments can help restore proper alignment and function to the affected vertebrae, which may lead to improved diaphragm activation and increased total diaphragm excursion.
By enhancing the mechanics of breathing, patients may experience a reduction in chronic low back pain and an overall improvement in their quality of life. Ultimately, the interconnectedness of the diaphragm and spinal health underscores the importance of a holistic approach to treating chronic low back pain.
Examples of exercises to help build up your diaphragm 1. Diaphragmatic Breathing (Belly Breathing):
How to:
Lie on your back with knees bent and feet flat or sit comfortably in a chair.
Place one hand on your chest and the other on your belly below your rib cage.
Inhale slowly through your nose, allowing your belly to rise and your chest to remain relatively still.
Exhale slowly through pursed lips, feeling your belly fall.
Repeat for 5-10 minutes, 3-4 times a day.
Focus: Pay attention to the movement of your belly, ensuring it rises and falls with each breath.
Variation: You can also practice this while standing or walking.
2. Quick Sniffles/Quick Inhalations:
How to:
Sit in a supportive chair or lean back in bed.
Take a deep breath through your nose, then quickly sniff in through your nose at least 3 times (without breathing out).
Breathe out slowly through pursed lips.
Relax for a second or two, then repeat 3 times.
3. Box Breathing:
How to:
Inhale deeply through your nose for 4 seconds.
Hold your breath for 4 seconds.
Exhale slowly through your mouth for 4 seconds.
Hold your breath out for 4 seconds.
Repeat the cycle 5 to 10 times.
4. Pursed-Lip Breathing:
How to:
Inhale slowly through your nose.
Exhale slowly through pursed lips, as if you're blowing out a candle.
Repeat for 5-10 minutes, 3-4 times a day.
5. Alternate Nostril Breathing (Nadi Shodhana):
How to:
Sit comfortably.
Close one nostril with your thumb and inhale deeply through the other nostril.
Close the nostril you just inhaled through and exhale through the other nostril.
Inhale through the same nostril and exhale through the opposite nostril.
Repeat for 5-10 minutes.
6. Crocodile Breath:
How to:
Lie facedown on the floor with arms in a T shape, legs extended, and toes pointed away from you.
Breathe in for two seconds through the nose, pushing the belly into the floor.
Exhale through the mouth for four seconds, drawing the belly away from the floor.
Repeat for 1-3 minutes.
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Bunphrom W, Chatprem T, Puntumetakul R, Siritaratiwat W, Phimphasak C, Leungbootnak A, Boucaut R. Diaphragm excursion and thickness in patients with chronic low back pain with and without lumbar instability. Sci Rep. 2025 Mar 18;15(1):9353. doi: 10.1038/s41598-025-93761-4. PMID: 40102508.
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