Why Does Breathing Make Everything Hurt? 
If you have a lung condition like COPD, pulmonary fibrosis, asbestosis, or berylliosis, you might be wondering why you’re dealing with pain in your neck, shoulders, low back, or even your abdomen. After all, your diagnosis is in your lungs—so why does it feel like your whole body is affected?
The answer lies in how your body adapts to restricted breathing. When your lungs aren’t working well, accessory breathing muscles pick up the slack. Over time, these muscles become tight, fatigued, and even painful. This is why your doctor or provider may request massage therapy authorization through the Department of Labor’s Energy Employees Occupational Illness Compensation Program (EEOICPA). Manual therapy helps address the very real physical consequences of chronic breathing effort.
Let’s take a closer look at why this happens.
Compensating for the Breath You Can’t Take
In a healthy body, breathing is effortless. The diaphragm and intercostal muscles expand the lungs with very little energy. But when your lung tissue is damaged or inflamed, the diaphragm has to work much harder—or may stop working well at all.
To keep air moving in and out, your body starts recruiting other muscles to help pull the rib cage up and open to pull air in. Your body recruits any muscles attached anywhere on the rib cage. These muscles include:
- Scalenes and sternocleidomastoid in the neck
- Trapezius, serratus, and paraspinals in the back
- Pectoral muscles in the chest
- Abdominals and obliques in the core
- Quadratus lumborum and spinal stabilizers in the low back
These are called accessory breathing muscles. They’re meant to assist during intense exertion—not to handle every breath, all day, every day. When they become overworked, they get sore, tight, and inflamed. They also develop trigger points that can radiate pain to other areas of the body.
Common symptoms include:
- Neck and shoulder pain
- Difficulty turning the head or raising the arms
- Rib and chest pain
- Low back stiffness
- Tingling or numbness in the arms and hands
- Fatigue in the neck and upper back from sitting upright
Cramping and Spasms in the Diaphragm and Intercostals
It’s not just the accessory muscles that suffer. The diaphragm itself can become strained and cramp from overuse. The intercostal muscles—the small muscles between the ribs—can become tender or even go into spasm from constant coughing or shallow breathing.
These spasms may feel like a side stitch, sharp rib pain, or a tight band across the back or chest and they respond well to manual therapy.
What Massage Therapy Addresses
Massage therapy for lung conditions does not treat the lung tissue directly. What it does treat are the muscular and fascial consequences of living with a chronic lung disease.
Our work focuses on:
- Reducing secondary muscle tension in the neck, shoulders, and upper back
- Releasing trigger points in the scalenes, traps, and pectorals
- Improving rib cage and diaphragm mobility
- Relieving pain and stiffness in the diaphragm and intercostals
- Decompressing nerve pathways affected by muscle tightness
- Supporting more comfortable upright posture and restful breathing
Authorization from the DOL
The Department of Labor recognizes that occupational lung diseases create more than just breathing problems. They cause physical compensation that affects the entire body.
Massage therapy is an approved treatment under EEOICPA when it addresses the effects of a covered diagnosis. That includes:
- Myofascial restriction
- Postural collapse
- Nerve compression
- Muscle hypertonicity
- Pain that interferes with daily function
We request massage therapy authorization not as a luxury, but as a medically necessary way to help you:
- Reduce pain
- Improve mobility
- Regain function in daily life
- Breathe more freely with less strain
If you’ve been experiencing full-body pain or tightness along with your lung condition, you are not imagining it. And you are not alone. We are here to help relieve the burden your body is carrying—one breath at a time.