Diaphragm paralysis: What it is, diagnosis, prevention and treatment

In this week's Moves in Medicine, Temple Health doctors look at an uncommon, but very serious condition call diaphragm paralysis. It can easily be repaired, if it is diagnosed in the first place.

Whether you're running a race or working at your desk, the diaphragm keeps us breathing.

The dome-shaped muscle just below the lungs and heart contracts continually as we breathe in and out. When one or both sides becomes paralyzed, it's harder to breathe.

"It's something that's overlooked as a source of shortness of breath," said Dr. Matthew Gordon of Temple Health.

Gordon says diseases like multiple sclerosis or ALS, injuries to the neck, can damage the nerve which runs from the neck to the abdomen, controlling the diaphragm.

"If you've ever had any kind of surgery in the chest, heart surgery, lung surgery that's a potential source of diaphragm paralysis," he said.

In addition to shortness of breath, a person's sleep can also be affected.

"Sleep disordered breathing becomes a big problem for people with diaphragm dysfunction," he said.

Chest X-rays, often for other issues, can also reveal the problem says Dr. Roman Petrov.

"When we see one side of elevation of the diaphragm, this is a hint that might be the condition," said Dr. Petrov.

The first treatment option is exercise and weight loss, to reduce the burden on the diaphragm. Surgery comes next.

"Surgery is performed minimally invasive and through a small incision," said Dr. Petrov. "It can be approached either through the abdomen or through the chest."

That reshapes or stretches the diaphragm, giving the lungs more room to expand.

And that fix is usually permanent.

The doctors said having a team of specialists to diagnose and treat the problem proides the best chance of good results.
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