How Breathwork Could Aid Your Recovery

Breathing exercises and breathwork has been a popular topic of research in Health and wellness. Some of this research has shown that it can genuinely help with musculoskeletal pain, particularly in the lower back and neck. So when your physio or osteo asks you to breathe slowly it’s not just about relaxation.

The Research Behind It

A 2023 systematic review (A review of 13 trials) focusing on people with chronic lower back pain found that breathing exercises led to significant reductions in pain scores. They also saw improvements in lumbar function and lung capacity. This was reinforced by a second review where 11 trials were researched and a similar conclusion was found demonstrating its not likely to be a one-off finding. 

Neck pain tells a similar story- a 2025 meta analysis found that breathing dysfunction is closely tied to reduced respiratory muscle strength in people with chronic neck pain and forward head posture. They concluded that breathing muscle training and diaphragmatic breathing alongside exercises and manual therapy produced better outcomes than exercises alone. 

Most interestingly a 2024 randomised pilot trial also has supporting evidence. They compared movement-control exercises vs movement-control exercises with synchronised breathing, in people with lower back pain. The people that added breathing to their movements across several measures when compared to the group that did the exact same exercises without breathwork. This suggests that how you breathe whilst completing movement is just as important as the movement itself. Most studies and data are currently being developed focussing on shoulder conditions like rotator cuff tears.

Why Might this work?

Shallow, chest dominant breathing is associated with chronic pain and an overactive stress response. Engaging your diaphragm and slowing down your breath is helpful for a few reasons: 

• Calming the nervous system: slower breather can reduce sympathetic (fight or flight) activity, which is often elevated in people with persistent pain.
• Reducing muscle guarding: when you’re tense or bracing against pain, shallow breathing reinforces that tension, whereas deeper breather interrupts it.
• Supporting core and spinal stability: the diaphragm is a key part of your deep core, so training it can improve control around the spine.

We have to acknowledge that the research is still developing, meaning most trials are small to moderate in size and mainly focus on low back and neck pain as opposed to ‘musculoskeletal pain’ in general. However, the supportive science is promising and in clinic it is typically used alongside other evidence based modalities like exercise or manual therapy.

Breathing Exercises to Try at Home

1. Diaphragmatic (belly) breathing: lie on your back with your knee bent. Place one hand on your chest and one on your belly. Breathe slowly in through your nose, letting you belly rise whilst you chest stays fairly still. Exhale slowly, letting your belly fall. Try this for 5-10 minutes once or twice a day. This is the technique used in most of the research mentioned above. 

2. Extended exhale breathing (4 seconds in, 6-8 seconds out): do this sitting or standing. Breathe in through your nose for a count of 4, then breathe out slowly through your nose or mouth for a count of 6 to 8. The longer exhale is what helps to activate your body’s calming response and ease muscle tension. You can do this daily and in moments when pain flares up. 

The Takeaway

Breathing is something you do 20,000+ times a day anyway — so it costs nothing to do it a little more mindfully. If you’re currently working with us on low back, neck, or shoulder pain, ask your clinician how to build these techniques into your specific program. And if you have any underlying respiratory conditions, do check with us first before starting structured breathing training.

Breathing is automatic, something you do over 20, 000 times a day, so it costs nothing to do it a little more mindfully. Here at Ebrook, your clinician might integrate some of these techniques into your treatment or rehabilitation programme and now you know why! As always, this post is for general information and education and not a substitute for thorough assessment and person centred rehab plan – book in with one of healthcare professional for your tailored plan.