Breathing seems like such a simple thing, and it is in a sense. However, when you think about how many breaths we take a day, altering your breathing can have a huge impact. When I have a patient with low back pain, I’ll always look at their breathing pattern. 9 times out of 10, I find that they are chest breathing. This is not necessarily a ‘wrong pattern’, but it gives me some insight into how their full system is operating. To explore this, I’ll explain 5 ways breathing can have a role in reducing low back pain. 

The first way it can help is through movement. When someone is in pain, it’s almost instinctual to stop moving. The nervous system goes into a sort of panic mode and movement becomes sensitized. When you are laying on your back and just breathing, you are getting a gentle flexion and extension with each breath you take. Taking some time to do some intentional breathing will help the nervous system calm down as the spine is moving in a non-threatening way. 

Secondly, there is usually swelling associated with low back pain. Generally it is in the joint spaces between the vertebrae. Being still allows it to fester. The lymphatic system is responsible for mitigating swelling. It just so happens that there is a major collection tubule of the lymphatic system, called the cisterna chyli, that sits right under your diaphragm. So belly breathing (diaphragmatic breathing) works like a pump, every breath squeezes that tubule and moves swelling out of the system. 

I mentioned belly breathing. That is usually what I’ll recommend. That doesn’t mean the chest does move, it just means that the breath is initiated by the diaphragm rather than the chest. This has an effect on the nervous system. Chest first breathing is associated with the sympathetic system, whereas belly first breathing is associated with the parasympathetic system. When we are in a sympathetic state, muscle tone increases in preparation for a fight or flight response. Conversely, when we are in a parasympathetic state, the muscles are able to relax. Yet another win for breathing and low back pain. 

Speaking of muscles, there is a muscle that almost always gets irritated in low back pain; the QL (Quadratus Lumborum). This is a muscle that aligns the sides of your lumbar spine, and attaches to the pelvis, and the 12th rib. Because of this attachment to the rib, it has a role in creating a stable support for the diaphragm to move. If the diaphragm is not moving because of chest first breathing, the QL can stiffen and get irritated. 

One final way that breathing can help is through tissue pH. It’s been known for a while that tissue acidosis, (low pH) can cause trigger points and deep muscle pain. You can quickly alter your blood pH through breathing. As 02 rises you become more alkaline, as CO2 rises, you become more acidic. To leverage this, all you have to do is exhale longer than you inhale. I recommend aiming for 6 breaths per minute so each cycle is 10 seconds. So if you inhale for 4 and exhale for 6, you’re covered. In just a few minutes, you become slightly more alkalinic. You may get lightheaded, that’s from being in a mild phase of respiratory alkalosis.