Symptoms Arising From the Diaphragm Muscle: Function and Dysfunction

Abstract

There can be many reasons that damage the function of the diaphragm, either transiently or permanently, involving one hemilate or both muscle portions. The diaphragm is associated only with breathing, but many other functions are related to it. The patient is not always aware of the presence of diaphragmatic dysfunction, and it is not always immediate to identify non-respiratory diaphragmatic symptoms. Pseudoanginal pain, night sweats, difficulty memorizing, or muscular and visceral problems of the pelvic floor are just some of the disorders linked to reduced diaphragmatic contractility. A decline in respiratory contractile force can be the basis for further pathological conditions that can increase the rate of mortality and morbidity. The article reviews the possible symptoms that may be presented by the patient, which are not necessarily related to lung function.

Keywords: breathing; cardio rehabilitation; diaphragm; fascia; manual therapy; osteopathic; osteopathy; physiotherapy.

Figure 1. The image shows the position of the diaphragm in a healthy subject (curved white line).

The examination is done with magnetic resonance imaging in the sagittal section. The white arrows indicate the direction of the diaphragm during any inhalation (oblique, anterior, and caudal). The image is the property of Bordoni Bruno (there is the patient's consent for the use of this figure).

Figure 2. The X-ray shows in two different projections the elevation of the diaphragm bilaterally due to a bilateral lesion of the phrenic nerve in previous cardiac surgery with median sternotomy and pacemaker placement.

The red arrows indicate the elevation of the diaphragmatic domes: (A) frontal plane and (B) sagittal plane. The patient presented with exertional dyspnea post-surgery, without the need for mechanical ventilation support. The image is the property of Bordoni Bruno (there is the patient's consent for the use of this figure).