Breathing evaluation and retraining as an adjunct to manual therapy

Area of Science:

• Physiology
• Manual Therapy
• Pain Management

Background:

• Back and neck pain are prevalent, often treated with manual therapy.
• A link exists between breathing difficulties and back pain.
• Trunk muscles serve dual roles in posture and respiration, suggesting functional interdependence.

Purpose of the Study:

• To investigate the relationship between breathing dysfunction and persistent back/neck pain.
• To evaluate the efficacy of breathing retraining in patients unresponsive to conventional manual therapy.

Main Methods:

• A case series of 29 outpatients with neck or back pain was analyzed.
• Patients with plateaued manual therapy outcomes were screened for breathing dysfunction using capnography to measure End Tidal CO₂ (ETCO₂).
• Breathing retraining was implemented as an intervention.

Main Results:

• All patients identified with low ETCO₂ (indicating breathing dysfunction) experienced improvements.
• Breathing retraining led to enhanced ETCO₂, reduced pain, and improved function.
• 93% of patients achieved clinically significant improvements in pain or function.

Conclusions:

• Low ETCO₂ is a potential indicator of breathing dysfunction in patients with chronic back and neck pain.
• Screening for breathing dysfunction via capnography may enhance manual therapy outcomes.
• Breathing retraining offers a viable adjunct treatment for patients with persistent pain unresponsive to standard care.