Is a Paralyzed Diaphragm Causing Your Shortness of Breath?

What is a Paralyzed Diaphragm?

The diaphragm is a crucial muscle that plays a key role in breathing. It functions as the primary muscle responsible for drawing air into the lungs. When this muscle loses its ability to contract properly, it can become paralyzed, resulting in a paralyzed diaphragm.

“Various factors can cause the diaphragm muscle to become paralyzed,” explains Dr. Matthew Kaufman, a physician with The Institute for Advanced Reconstruction. “Phrenic nerve damage is the cause of diaphragm paralysis which is due to trauma, certain neurological disorders, or complications.”

What makes a paralyzed diaphragm problematic is that when it is paralyzed, its reduced or absent movement can impair lung function, leading to difficulty breathing, especially during physical activity or while lying down. This may manifest as chronic shortness of breath, fatigue, or even recurrent respiratory infections. 

Understanding Diaphragmatic Dysfunction

Diaphragmatic dysfunction can cover everything from snoring and frequent hiccups to difficulty breathing and respiratory distress. According to the National Institutes of Health, it can be problematic for clinicians to identify and, as such, is oftentimes underdiagnosed. 

“As one of our Distinguished Centers at The Institute for Advanced Reconstruction, we are on a mission to change that,” shares Dr. Kaufman. “By using advanced diagnostic tools and pioneering techniques, we are finding life-changing solutions for this condition that is so often misdiagnosed.”

Symptoms of a Paralyzed Diaphragm

Like any condition, recognizing symptoms early is paramount for getting the proper treatment and an ideal outcome. A paralyzed diaphragm can produce a range of symptoms, often depending on whether one or both sides of the diaphragm are affected. The most common symptoms include:  

• Fatigue and Weakness: Reduced oxygen intake can lead to tiredness and a general lack of energy as the body struggles to supply muscles and organs with adequate oxygen.  
• Frequent Respiratory Infections: A paralyzed diaphragm can lead to incomplete lung expansion, making it harder to clear secretions and increasing the risk of infections like pneumonia or bronchitis.  
• Hiccups or Changes in Voice: Irritation of the phrenic nerve or associated structures may cause persistent hiccups or subtle changes in voice quality due to altered respiratory mechanics.  
• Shortness of Breath with Exertion or in Certain Positions (i.e. Bending Over): Difficulty breathing is the hallmark symptom, particularly noticeable during physical exertion or when lying flat (orthopnea). This occurs because the diaphragm cannot properly contract to expand the lungs.  
• Sleep Disturbances: Many people experience difficulty sleeping, especially when lying on their back, as breathing becomes more labored in this position. Sleep apnea may also develop in some cases.  

Initially, symptoms may be mild and noticeable only during strenuous activity. However, as the condition progresses or if both sides of the diaphragm are affected, even basic activities like walking or speaking for extended periods may cause shortness of breath.

Is a Paralyzed Diaphragm Serious? Causes of Diaphragm Paralysis

Essentially, diaphragm paralysis occurs when the muscle becomes unable to function properly due to issues with the phrenic nerve, which controls the diaphragm. A comprehensive evaluation is necessary to determine the best treatment for diaphragm paralysis.

These are the most common underlying causes of diaphragm paralysis:

• Phrenic Nerve Injury: The phrenic nerve runs from the neck to the diaphragm, and any damage along its path can impair its function. This can happen due to:
  • Trauma (e.g., accidents or injuries to the neck or chest)
  • Surgical complications (e.g., heart, lung, or neck surgeries)
• Neurological Disorders: Conditions like multiple sclerosis or Guillain-Barré syndrome can also damage the phrenic nerve or the nervous system pathways controlling it.
• Spinal Cord Disorders. The phrenic nerve originates in the spinal cord at the C3-C5 vertebrae. Damage to this area from trauma, tumors, or degenerative diseases can lead to diaphragm paralysis.

Paralyzed Diaphragm Treatment Options

Surgery is the most common treatment for correcting a paralyzed diaphragm. These treatment approaches aim to improve respiratory function, alleviate symptoms, and enhance quality of life. 

• Diaphragmatic Pacemaker Implantation: A diaphragmatic pacemaker is a device implanted to stimulate the diaphragm with electrical impulses, mimicking natural breathing.  
• Diaphragm Plication: This procedure involves folding and suturing the paralyzed diaphragm to stabilize it in a flatter, lower position. By preventing the diaphragm from interfering with lung expansion, it improves the space available for the lungs to inflate.  
• Phrenic Nerve Reconstruction: This surgery repairs or reconstructs the damaged phrenic nerve, which controls the diaphragm. Techniques may include decompression, nerve grafting, and nerve transfers.
• Thoracic Surgery to Address Underlying Issues: In cases where diaphragm paralysis is caused by an underlying issue, such as a tumor, thoracic surgery may be performed to remove the compressing mass or repair structural damage.  

For less severe cases of diaphragm paralysis or as a complement to surgical interventions, non-surgical methods can help alleviate symptoms, improve breathing function, and enhance quality of life. These approaches commonly include:

• Inhaled medications (like bronchodilators or steroids)
• Lifestyle modifications
• Non-invasive ventilation support (like CPAP or BiPAP)
• Physical therapy
• Pulmonary rehabilitation

Improve Your Breathing: Request Your Appointment Now

Few things are as disruptive to daily life as constantly feeling shortness of breath. Addressing any symptoms of a paralyzed diaphragm is essential, not only for improving breathing but also for preventing complications and enhancing overall quality of life. 

“I’ve had many patients come in that are utterly dispirited by their inability to breathe properly,” shares Dr. Kaufman, “but with the proper treatment from the right experts, they’ve been able to get their lives back.”

If you often feel short of breath, request an appointment with our experts at The Institute today. Whether through advanced surgical procedures or non-surgical interventions, The Institute is dedicated to helping patients breathe easier and live fuller lives.