Diaphragm Pain

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anderkling

Distinguished member
Joined
Dec 1, 2014
Messages
273
Reason
PALS
Diagnosis
01/2015
Country
CA
State
B.C.
City
Surrey
For the past several weeks, I have been experiencing increasing soreness and pain in my diaphragm. It feels like a belt around me is getting tighter and tighter. I was just introduced today to the BiPap, and was on it for some time, but it did nothing to relieve me of this pain, which is worse than ever. The pain is worse during the day. Thoughts or suggestions are highly appreciated. Thank-you.
- Charlene
 
Was the pain worse on BiPAP or just no better?
What are you doing when it's bad -- are you in a wheelchair? Recliner? You might not have enough back/arm support, esp. if your stomach is getting bigger than it was. If it is pressure from your middle, that would explain why lying down at night helps.
Are you sure the pain is in your diaphragm specifically? That would be unusual. Does it hurt more when you breathe in? Out? If you are doing neither?
 
Thank you Laurie for helping. The pain on the BiPap was no better. I'm in a wheelchair. The pain gets worse over the course of the day to the point that I can't manage without strong painkillers. I thought it must be the diaphragm, but maybe it's not. It hurts more when I breathe in, but often it's not related to breathing in or out, it seems. The skin in that area (below the breasts across the middle) is sensitive to touch. I'm not sure about back and arm support. My arms are not strong, but they are the strongest part of my body now. I use them all the time for support. I'm noticing core strength waning. Could it be related to that, and if so, what can be done?
Grateful for suggestions,
Charlene
 
Charlene,

Assuming you're in a power chair, I would change the tilt angle (starting at least 10 degrees) every few minutes and see if that helps, and likewise the foot height (more angle than tilt). If you're up to taking a selfie in your chair, we could offer other suggestions for positioning.

Are you in a default or upgraded back/seat cushion? The ones that come w/ power chairs are generally suboptimal. If it feels like a car seat, it's not redistributing pressure as it should.

Since you are using your arms a lot, it is possible that you injured/inflamed the muscle there doing so since it (the muscle just under the breast bone) is normally not strong skeletally anyway but your core will try to engage when you try to bear more weight on your arms than they normally handle. Have you tried your favorite NSAID (naproxen, ibuprofen), dosing it regularly (not missing doses) for a few days?

Also it seems counterintuitive but you could try a flexible heating pad in the small of your back. And massage, of course. You can get someone to come to you, at home, if getting out is a challenge right now. If you have home health benefits, you could ask your clinic about writing for a PT to come and assess you since you may need a better range of motion regimen to avoid what you are experiencing. And how are you transferring right now?

I'm sorry you are in pain!
--Laurie
 
Laurie, I appreciate your thorough advice looking at this from various angles. (Have had company, so haven't had a chance to answer back.) I have been changing the tilt angle more frequently, and this helps. I have just a default back cushion, but will ask my OT to request one with back support. Weakening core muscles is a growing concern. Massage seems to help. I do take NSAIDs, and yes, they help some. The palliative care nurse comes to see me once a week, and suggests I not hesitate to take narcotics (percocet) prescribed to me if the pain is not alleviated in other ways. I've always been cautious. As far as transferring goes, I'm still pivoting on one foot with support from my DH, but this will not be possible very soon. My OT has ordered me a new transfer board with a handle for balance. I'm relieved to read that it's unlikely the pain is in my diaphragm. Next week I have an in home consult with a palliative care doctor who will hopefully give some guidance on a number of issues. Again, thanks.
Charlene
 
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