5 Reasons You Feel Lower Back Pain When Breathing

5 Reasons You Feel Lower Back Pain When Breathing

Your lower spine is made up of a series of interconnected joints that house the sciatic nerve roots as they branch out to innervate your lower body. When your spine or pelvis is out of alignment, or when nerve roots become entrapped, even breathing can cause mild to moderate back pain. If you feel pain in your lower back when breathing deeply, there are certain things you can do to improve your alignment, release your sciatic nerve and alleviate pain.

Following are five reasons you feel pain in your back when breathing, and what you can do about it.

1. You have a herniated disc

Because your spine is always in motion and load-bearing, the bones in your vertebra sometimes rub against the discs that separate them, causing them to become irritated and inflamed. A swollen (herniated) disc can bulge out between your vertebrae and put pressure on the nerve roots, causing pain.

When you breathe, the entire apparatus of your ribcage and spine goes into motion, increasing pressure on intervertebral discs and nerves. Icing your low back with a bag of frozen peas throughout the day can dramatically reduce inflammation, numb pain receptors and relieve pressure on your nerve roots. If pain persists, seek help from a chiropractor or physical therapist.

You have a herniated disc

2. Your sciatic nerve is entrapped

Your sciatic nerve is the longest and widest nerve in your body. Its nerve roots branch out from your lumbar vertebrae and converge as they travel from your low back, across your buttocks and down the backs of your legs, all the way to your feet.

The sciatic nerve can become entrapped anywhere along its pathway where it glides among other structures in your body. An entrapped nerve can be extremely painful, and deep breathing, coughing or sneezing can increase pressure at the point of entrapment. A physical therapist can teach you nerve flossing exercises that release the sciatic nerve and restore unrestricted gliding.

Your sciatic nerve is entrapped

3. You have myofascial trigger points in your low back

Trigger points are tight knots of muscle or fascia fibers that can cause pain and restrict movement. They often arise after intense activity like lifting heavy boxes or furniture, or after intense sports or exercise. Spinal movement as you breathe can make the pain more noticeable.

Trigger points can sometimes be felt as nodules just below the skin’s surface, and superficial trigger points can be successfully treated with myofascial massage. Deep trigger points occur in deep muscle tissue and cannot be palpated from the surface. Dry needling by a trained professional is an effective way to release deep trigger points, especially when done under ultrasound guidance, to ensure accurate targeting.

You have myofascial trigger points in your low back

4. Your pelvis is out of alignment

Being sedentary and sitting for long hours on end can cause the muscles that support your lumbopelvic region to become imbalanced, causing your lumbar vertebra to compress their intervertebral discs. Becoming physically active and working with a physical therapist can restore balanced muscle tension to your low back and pelvis, and relieve pressure on lumbar discs and nerve roots.

Your pelvis is out of alignment

5. You have degenerative disc disease

Sometimes the discs between your vertebrae can begin to deteriorate, reducing their shock absorbing ability and narrowing the distance between your vertebrae. That can cause the bones of the spine to rub against the nerve roots and irritate them, causing pain as the vertebrae move when you breathe. Regenerative therapies like focused shockwave therapy (ESWT) and electromagnetic transduction therapy (EMTT) can help to relieve pain and inflammation and slow and reverse the degenerative process.

You have degenerative disc disease

The Best Low Back Pain Treatment Options

Chronic low back pain is not normal, and you should never let it go untreated. Taking pain medications can mask the symptoms, but drugs do not get to the underlying cause of your problem, and they can be addictive and damage your liver.

Chiropractic care and physical therapy are your best bets for successful low back pain treatment. When combined, they can help you eliminate back pain for good. Look for a practitioner who uses advanced treatment methods like regenerative shockwave therapy and ultrasound guided dry needling.

For the best low back pain treatment in NYC without drugs or surgery, contact NYDNRehab in Manhattan.

About the Author

Dr. Lev Kalika is clinical director of NYDNRehab, located in Manhattan. Lev Kalika is the author of multiple medical publications and research, and an international expert in the field of rehabilitative sonography, ultrasound guided dry needling and sports medicine Dr. Kalika works with athletes, runners, dancers and mainstream clients to relieve pain, rehabilitate injuries, enhance performance and minimize the risk of injuries. His clinic features some of the most technologically advanced equipment in the world, rarely found in a private clinic.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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