Diaphragmatic Breathing to Reduce Pain & StressOpen pdf


People experiencing pain tend to hold their breath during a flare-up or breathe fast and shallow — especially when anxious. The fight-or-flight response is triggered when we are in pain or stressed. This increases our heart rate and muscle tension in our jaw, head, neck, and back. Tensing up the body further aggravates the pain itself. One way to turn off the fight-or-flight response is through diaphragmatic breathing — also called belly breathing.

Visualize a balloon expanding with the inhale, hold, and then slowly deflating with the exhale. Place one hand on your belly to feel the breath. Don’t move your chest.

Basic Diaphragmatic Breathing:

Find a comfortable position for you (lying down, reclined, or sitting).

  • Inhale = smell a flower
  • Exhale = gently blow out a candle
  • When you inhale, visualize your abdomen and pelvic area filling up with air — expanding and stretching like a balloon
  • When you exhale, visualize the abdomen and pelvic area relaxing — like a balloon deflating without air
  • Take 10 slow breaths

Advanced Diaphragmatic Breathing: (FOCUS ON A LONGER, SLOWER EXHALE)

  • Inhale normally / quietly to a count of 4
  • Hold your breath for a count of 1-2
  • Exhale slowly for longer
  • GOAL = 8 count exhale (4:8 RATIO)
  • If you cannot achieve the 4:8 ratio, any breath with a longer exhale is good (5, 6, 7 count). Or the ratio may change to a 3-count inhale: 6-count exhale
  • Repeat for a total of 5 breaths
  • Rest and breathe normally for a minute and observe how your body feels
  • Repeat another 5 breaths

Tips: Many muscles are susceptible to tension. Relaxing the muscles of the face, jaw, neck, shoulders, abdomen, hips, legs, and feet will also help.

Moment-to-Moment Relaxation:

  • Scan your muscles throughout the day.
  • If tension is noted, take a few moments to focus on your breathing and allow yourself to relax those muscles.

updated > 7.2022
reviewed by > Lisa Johnstone, PT, Mayfield Clinic, Cincinnati, Ohio

Mayfield Certified Health InfoMayfield Certified Health Info materials are written and developed by the Mayfield Clinic. We comply with the HONcode standard for trustworthy health information. This information is not intended to replace the medical advice of your health care provider.

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We strive to manage patients as conservatively as possible. Exercise and physical therapy strengthens back and stomach muscles.

The Mayfield Physical Therapy Network is a listing of preferred physical therapy providers in the region that have been oriented to Mayfield's spine treatment processes. While there are many qualified providers in the area, these providers have met our criteria for treating patients with spinal diseases and disorders.

If your back or neck pain doesn't respond to conservative treatment, surgery may be needed.


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