Research Suggests an Association Between Breathing Patterns and Fibromylagia
Research reveals a connection between breathing patterns, thoracic mobility, and Fibromyalgia symptoms
Introduction: When Breathing Becomes Part of the Pain Problem
As a Physiotherapist who has worked extensively with fibromyalgia patients, I've long observed what research may now confirm: how we breathe matters in chronic pain conditions. A recent study published in The Journal of Pain provides compelling evidence that breathing dysfunction isn't just a side effect of Fibromyalgia—it may be actively contributing to your symptoms.
For those living with Fibromyalgia's widespread pain, fatigue, and cognitive challenges, the discovery that something as fundamental as breathing might be working against you can feel overwhelming. But here's the hopeful perspective: unlike many aspects of Fibromyalgia, your breathing pattern is something we can actively assess and control. This article will break down the key findings from this interesting research and translate them into practical strategies you can apply today to potentially reduce your symptoms and improve your quality of life.
Learn more about what Fibromyalgia is here.
Understanding the Study: How Breathing Patterns Differ in Fibromyalgia
Research Design and Methodology
This case-control study compared 38 women with Fibromyalgia against 44 age-matched healthy controls using rigorous measurement techniques:
- Respiratory rate was measured discreetly using a portable intensive care monitor to ensure natural breathing patterns
- Tidal volume (amount of air per breath) was assessed through spirometry
- Thoracic mobility was evaluated by measuring chest expansion at the axilla and xiphoid process levels
- Pain sensitivity was measured via pressure pain thresholds over paraspinal muscles
- Perceived stress was assessed using the validated Perceived Stress Scale-10
This comprehensive approach allowed researchers to capture both the physiological and psychological aspects of breathing in fibromyalgia.
Key Findings: The Fibromyalgia Breathing Profile
The results revealed a distinct breathing pattern in the Fibromyalgia group compared to healthy controls:
| Parameter | Fibromyalgia Group | Control Group | P-value |
|---|---|---|---|
| Minute ventilation | 7.3 ± 1.6 liters/min | 6.6 ± 1.4 liters/min | 0.032 |
| Respiratory rate | 14.8 ± 2.3 breaths/min | 11.8 ± 1.9 breaths/min | 0.001 |
| Tidal volume | 0.49 ± 0.1 liters | 0.56 ± 0.1 liters | 0.001 |
| Chest expansion (axilla) | 3.9 ± 1.4 cm | 6.2 ± 1.7 cm | 0.001 |
| Chest expansion (xiphoid) | 4.7 ± 1.6 cm | 7.4 ± 1.7 cm | 0.001 |
The research identified what we often consider to be a "stress breathing pattern": faster, shallower breaths with significantly reduced chest expansion. This pattern represents a 25% higher respiratory rate and 12.5% lower tidal volume compared to healthy controls.
Perhaps most intriguingly, when researchers adjusted for perceived stress, the difference in minute ventilation between groups disappeared, suggesting that stress plays a crucial role in driving these breathing changes. However, differences in respiratory rate and tidal volume remained significant even after this adjustment, indicating both psychological and physiological factors are at work.
Clinical Implications: What This Means for Your Fibromyalgia Management
The Stress-Breathing-Pain Cycle
The study findings illuminate a vicious cycle that many Fibromyalgia patients experience:
- Stress and anxiety increase respiratory drive
- Faster, shallower breathing develops as a pattern
- Reduced thoracic mobility results from muscle tension and stiffness
- Altered blood gas levels may occur (specifically decreased carbon dioxide)
- Increased pain sensitivity can be exacerbated by a stress-breathing pattern dysfunction
- Stress increases further in response to heightened pain
This cycle may explain why many Fibromyalgia patients report feeling constantly "winded" or unable to take a satisfying deep breath. The good news is that this cycle can be interrupted at multiple points, particularly through breathing retraining.
Practical Assessment: Is Your Breathing Contributing to Your Symptoms?
Based on this research, here are some simple ways to assess if your breathing pattern might be amplifying your fibromyalgia symptoms:
- Check your breathing rate: Count how many breaths you take in one minute while at rest (ideal is 10-14; Fibromyalgia patients averaged nearly 15)
- Assess chest mobility: Place your hands on your lower ribs and notice how much movement you feel with each breath
- Monitor for symptoms: Note if you frequently sigh, yawn, or feel breathless despite normal lung function
- Observe breathing pattern: Notice if your shoulders rise significantly with inhalation (indicating upper chest breathing)
These simple assessments can help identify whether breathing retraining should be a component of your fibromyalgia management plan.
Translating Research Into Practice: Actionable Strategies for Patients
Breathing Retraining Techniques
Based on the study findings, here are evidence-informed breathing techniques that target the specific deficits identified in Fibromyalgia:
1. Diaphragmatic Breathing
- Lie on your back with knees bent
- Place one hand on your chest, the other on your abdomen
- Breathe in slowly through your nose, allowing your abdomen to rise while keeping your chest relatively still
- Exhale slowly through pursed lips
- Practice for 5-10 minutes daily
2. Thoracic Mobility Exercises
- Rib Cage Stretch: Sit tall and reach one arm overhead, bending sideways while focusing on expanding the lower ribs
- Seated Rotation: Sit upright and gently rotate your torso, holding for 15-30 seconds on each side
- Foam Roller Chest Opener: Place a foam roller lengthwise along your spine and allow your arms to fall open to the sides
3. Paced Breathing
- Use a breathing app or metronome to gradually slow your respiratory rate
- Aim for a rhythm of inhalation (3-4 seconds), pause (1-2 seconds), exhalation (4-6 seconds)
- Practice during low-stress moments to establish the pattern before applying it during pain flares
Integrating Breathing Awareness Into Daily Life
Beyond formal exercises, cultivating breathing awareness throughout your day can yield significant benefits:
- Set regular reminders to check in with your breathing pattern
- Use mealtimes as cues to take three conscious diaphragmatic breaths
- Pair breathing exercises with existing medication schedules
- Incorporate gentle movement practices like tai chi or yoga that emphasise breath-body connection
Limitations and Future Research Directions
While this study provides valuable insights, it's important to acknowledge its limitations:
- The cross-sectional design can't determine whether altered breathing causes worsened fibromyalgia or vice versa
- The relatively small population size may mask subgroup differences
- Recruitment of controls exclusively from healthcare workers may introduce selection bias
- Measurements of respiratory rate and tidal volume were taken sequentially rather than simultaneously
Future research should explore whether breathing retraining directly improves pain levels and function in Fibromyalgia, and investigate potential subtypes of Fibromyalgia based on breathing patterns.
Conclusion: Breathing as an Accessible Therapeutic Tool
This research may demonstrate that breathing pattern disturbances are a significant, measurable component of Fibromyalgia. The identified pattern—faster, shallower breathing with reduced thoracic mobility—offers us a concrete therapeutic target that is modifiable, measurable, and accessible regardless of current pain levels.
As the authors note, "Including the respiratory system in the evaluation and treatment may optimise the effects of rehabilitation." From my clinical experience, I've found that breathing work often serves as an ideal entry point for Fibromyalgia management—it's something patients can practice regardless of their current pain levels, provides a sense of agency, and offers tangible biofeedback.
If you take away one message from this research, let it be this: Your breathing pattern is not just a response to your pain; it may be actively influencing it. With conscious attention and practice, you may have the opportunity to transform your breathing from part of the problem to part of the solution.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Consult with a qualified healthcare provider, such as a physiotherapist or physician, before starting any new exercise or breathing program, particularly if you have respiratory conditions or other health concerns.
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