Medical News Today: Diaphragm spasms and flutters: What to know

Diaphragm spasms are involuntary contractions of the band of muscle that divides the upper abdomen and chest. They may feel like a twitch or flutter and can occur with or without pain.

Diaphragm spasms can have a range of causes. In most cases, they do not pose a serious health risk, but they can still cause discomfort.

It is also possible for a diaphragm spasm to indicate an underlying health condition. This article will discuss the symptoms, causes, and treatments for diaphragm spasms.

What is a diaphragm spasm or flutter?

Man holding chest in pain due to diaphragm spasm
A diaphragm spasm or flutter may cause a temporary feeling of tightness in the chest.

A diaphragm spasm is a sudden, involuntary contraction that often causes a fluttering feeling in the chest. It is also common to experience a temporary tightness in the chest or difficulty breathing during the spasm.

The diaphragm is a muscle that acts as a partition between the upper abdomen and the chest. It plays a crucial role in the respiratory system by helping a person breathe.

The diaphragm contracts when a person breathes in, allowing the rib cage to expand so that oxygen can flow into the lungs. When they breathe out, it relaxes again to help push carbon dioxide out of the lungs.


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Other symptoms

Depending on the cause of the diaphragm spasm, other symptoms may accompany it. These can include:

  • shortness of breath
  • tightness in the chest
  • hiccups
  • pain in the chest, abdomen, or back
  • indigestion
  • nausea
  • vomiting
  • difficulty swallowing
  • diaphragm paralysis
  • a persistent cough

These symptoms can range from mild to severe, depending on the underlying cause.

Causes

Diagram of the diaphragm
The diaphragm divides the upper abdomen and chest.

There are several potential causes of a diaphragm spasm. The most common of these is a sudden blow to the abdomen or chest. Strikes to the chest are particularly frequent in contact sports such as rugby or boxing.

Although the symptoms can be uncomfortable, they will usually pass within a few minutes.

Other possible causes include:

Exercise

Exercise can cause cramps or stitches in the abdomen. These may occur when people fail to warm up properly or over-exert themselves. In some cases, the additional pressure from a stitch can trigger a diaphragm spasm.

Hiatal hernia

A hiatal hernia is a condition in which a part of the stomach moves up into the chest. Hiatal hernias occur when age, injury, or recent surgery weakens the muscle tissue in the diaphragm.

When a hiatal hernia occurs, part of the stomach pushes through an enlarged hiatal opening in the diaphragm. This can trigger a diaphragm spasm.

A hernia can be mild or serious, and its severity will determine any additional symptoms. The most severe cases require immediate medical attention as they can injure the stomach, cause bleeding, or interfere with breathing.

Temporary paralysis

A sudden blow to the abdomen can temporarily paralyze the diaphragm. This can lead to significant difficulties in breathing. A person will often panic or feel anxious if they cannot breathe, which can worsen symptoms.

The paralysis will quickly pass, however, and the individual should be able to breathe again.

Phrenic nerve irritation

The phrenic nerve controls the movement of the diaphragm muscle. Irritation or injury to this nerve, or any inflammation, can trigger spasms in the diaphragm in addition to causing hiccups and breathing difficulties.

A variety of factors can irritate the phrenic nerve, including:

  • swallowing and breathing air in at the same time
  • eating spicy foods
  • overeating
  • physical trauma
  • surgical complications
  • cancer
  • non-cancerous growths
  • neurological disorders
  • autoimmune conditions
  • infection

Diaphragmatic flutter

Diaphragmatic flutter is a rare condition that causes frequent spasms or fluttering of the diaphragm. Doctors are unsure why it occurs.

Episodes of spasms can come on suddenly and last for minutes or even hours, significantly affecting a person’s quality of life. Pain can be present in the chest, the middle of the abdomen, or the back, making it difficult to diagnose. There is no standard treatment for diaphragmatic flutter, as there is a lack of understanding around the condition.


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Diagnosis

ct scanner may be used for adenopathy
If a doctor suspects an underlying condition, they may order a CT scan.

It is possible to mistake the symptoms of diaphragm spasms as those of a gastrointestinal or heart problem, as they are similar. In most cases, symptoms will subside after a few minutes without the need for diagnosis by a doctor.

However, if a person has frequent diaphragm spasms without an apparent cause, they should seek medical advice.

If the doctor suspects that an underlying medical condition is causing the spasms, they may use an X-ray, blood test, CT scan, MRI, endoscopy, or manometry to help with the diagnosis.

Treatment

Treatments for diaphragm spasms vary according to the underlying cause. Diaphragm spasms resulting from a sudden blow may cause discomfort, but symptoms should subside within a few minutes, making treatment unnecessary. It is essential to rest and concentrate on maintaining a regular breathing pattern while symptoms persist.

The following causes will require different treatments:

Exercise

Most diaphragm spasms that result from exercise will also go away without treatment. In cases where the spasms are persistent, it can help to stretch or put pressure on the surrounding muscles.

For example, gently pushing into the affected muscle using the fingers can help to relieve discomfort. Holding one hand over the head can also help, as it stretches the chest muscles.

Hiatal hernia

Doctors treat hiatal hernias in different ways, depending on their severity. In cases where symptoms are minimal, it can help to eat smaller, more frequent meals, or to take medication for gastroesophageal reflux disease (GERD).

Surgery may be necessary in more severe cases, especially if the hernia causes complications.

Phrenic nerve irritation

Treating the cause of the phrenic nerve irritation is the best way to restore a regular breathing pattern. The cause will determine the treatment plan.


Outlook

The majority of diaphragm spasms are temporary and will go away within a few minutes. Specific body stretches, medications, and lifestyle changes can help to manage persistent symptoms.

If diaphragm spasms occur due to a health condition that requires medical attention, such as a hiatal hernia, phrenic nerve irritation, or diaphragmatic flutter, a doctor will help make a treatment plan for the individual.

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