Breathlessness and shortness of breath
Breathlessness or shortness of breath means that breathing is more difficult or takes more effort than usual. You may feel unable to get enough air, not being able to breathe deeply or experiencing pressure on the chest. Sometimes the breathlessness only occurs during exercise, while it can also be present in rest in other people.
Breathlessness is not a condition in itself and can have many different causes. New, severe or unexplained breathlessness must therefore be medically assessed.
Acupuncture and Chinese herbal medicine can be used for certain causes. Within Chinese medicine, the way in which the breathlessness is expressed is considered. Breathlessness with a lot of mucus, for example, requires a treatment other than shortness of breath by exertion or feeling through tension not being able to breathe deeply.
Possible Western disorders
Breathlessness and shortness of breath may include:
- asthma;
- COPD and emphysema;
- acute or chronic bronchitis;
- respiratory infections and pneumonia;
- allergic respiratory problems;
- anaemia;
- cardiovascular diseases, including heart failure;
- pleural disorders;
- anxiety, panic and hyperventilation;
- impaired physical condition.
Sudden breathlessness can also occur in acute conditions such as pulmonary embolism, pneumothorax, severe asthma attack or airway obstruction. Therefore, it is important not to approach new or rapidly increasing breathlessness solely as a TCM complaint.
Possible causes
Breathlessness and shortness of breath may occur when the airways are narrowed or inflamed, when the lungs are less able to absorb oxygen or when the heart and circulation are insufficient to meet the body's oxygen requirements. Anemia and reduced physical condition can also cause shortness of breath.
In respiratory diseases, various factors may provoke or worsen the symptoms. Examples include respiratory infections, allergens, exertion, cold air, smoke, dust, air pollution and other irritants. Stress, anxiety and a altered breathing pattern can also cause breathlessness or strengthen existing symptoms.
In chronic breathlessness, several factors sometimes play a role at the same time. Because the causes vary from relatively innocent to severe, it is important that new, unexplained or clearly increasing breathlessness is medically assessed.
Food can also play a role in some people. A food allergy can cause respiratory problems, while a full or heavily bloated abdomen may increase the feeling of breathlessness in others. Within TCM this is not automatically seen as the same mechanism.
How can acupuncture help with breathlessness and shortness of breath?
Acupuncture can be applied to certain types of breathlessness and is tailored to both the complaints and the underlying TCM diagnosis.
Within TCM, the presence of mucus, heat or cold, the relationship with exercise and fatigue and the influence of stress are considered. The way of breathing is also relevant. In some people exhaling is particularly difficult, whereas in chronic deficiency patterns there may be a feeling of insufficient deep breathing.
The treatment may include:
support breathing and reduce the feeling of shortness of breath;
- reduce cough, mucus formation and feeling full or oppressive on the chest;
- support the respiratory system in cases of respiratory infection;
- to reduce chest tension and difficulty in deep breathing when stress or emotions affect the symptoms;
- treat complaints associated with a full or heavily bloated abdomen;
- in chronic shortness of breath also treat fatigue, reduced capacity for activity and other underlying complaints.
Acupuncture is not a substitute for necessary medical treatment in severe acute breathlessness.
How can Chinese herbal medicine help with breathlessness and shortness of breath?
Chinese herbal medicine is also tailored to the underlying pattern. As a result, treatment can vary considerably between two people who are both short of breath.
For example, treatment may be directed at:
- support breathing and reduce cough and breathlessness;
- reduce mucus and support coughing when mucus formation interferes with breathing;
- treat acute respiratory complaints when an infection is part of the complaint image;
- treat dryness and irritation of the airways when low mucus and a dry cough are in the foreground;
- for chronic complaints, support TCM's Lung and digestive function when fatigue and mucus formation are combined;
- for prolonged shortness of breath, treat the underlying pattern when especially exertion, fatigue or difficulty in deep breathing stand out.
- regulating Qi when stress, tension or nutrition clearly affects breathing.
In chronic complaints, herbs can be used daily between acupuncture treatments. In conditions requiring regular medication, Chinese herbal medicine is used additionally and not as a replacement for necessary medical treatment.
How does Chinese medicine view breathlessness and shortness of breath?
Within TCM the Lung organ system plays a central role in breathing. According to this theory, the Lungs cause the spread and descent of Qi . If this movement is obstructed or if there is insufficient Lung-Qi, breathing can become more difficult.
In acute breathlessness, for example, this movement can be disturbed by Wind-Cold or Wind-Heat. Which pattern is present is determined by the way the complaints are presented at that time. Phlegm can also hinder the Lungs. Phlegm is a broader term than visible mucus within TCM, but in respiratory complaints, sputum can actually be an important characteristic.
Chronic shortness of breath also makes the Spleen and Kidneys important. According to TCM, the Spleen is involved in the formation of Qi and the processing of liquids. If this function weakens, it can be easier to create Dampness and Phlegm. According to traditional theory, the Kidneys support the ability to anchor the inhaled Qi down as it were. Therefore, deep breathing can become especially difficult with kidney deficiency.
In addition, the free movement of Qi can be disturbed by tension and emotions. When Liver-Qi stagnates, according to TCM, this can affect the movement of Lung-Qi. This may cause a feeling of chest pressure or inability to take a satisfactory deep breathing.
What is a TCM organ system?
A TCM organ system describes a group of related body functions and is wider than just the anatomical organ with the same name. Read more at TCM basics .
What is a TCM pattern?
A TCM pattern is a recognizable combination of complaints and physical characteristics that indicates which imbalance is likely to contribute to the complaints. Read more at TCM basics .
Below are only the most common patterns discussed. Other patterns are possible and multiple patterns can occur at the same time. This allows you to recognize yourself in different descriptions. Also, someone with a certain pattern does not have to have all the symptoms mentioned. The pattern is determined on the basis of the overall picture of complaints.
Most common TCM patterns
Wind-Cold obstructs the Lungs
Brief explanation
In this pattern, the breathlessness occurs acutely, for example during a cold or after exposure to cold air. According to TCM, Wind-Cold temporarily hinders the spread and descent of Lung-Qi. If all mucus is present, Cold can also move and strengthen the breathlessness.
Common symptoms
- sudden onset of breathlessness;
- cough and chest pressure;
- complaints provoked by cold air or weather change;
- chills or clear crookedness;
- little or no sweating;
- runny nose or nasal congestion;
- clear and aqueous nasal fluid;
- white, clear or aqueous mucus;
- stiff neck and muscle pain;
- sometimes clearly audible mucus in the chest.
Examples of Western disorders
This pattern can be recognised in respiratory infections and in asthma or bronchial symptoms induced by cold or acute infection.
Wind-Heat obstructs the Lungs
Brief explanation
According to TCM, Wind-Heat can also disrupt the normal movement of Lung-Qi. The image is warmer than with Wind-Cold and is more often accompanied by sore throats, thirst and yellow or thicker mucus.
Common symptoms
- acute shortness of breath;
- rapid or difficult breathing;
- cough;
- chest pressure or feeling full;
- fever or feeling warm;
- low chills;
- dry or painful throat;
- thirst;
- yellow or green nasal fluid;
- little mucus or yellow, sticky and difficult to cough up mucus.
Examples of Western disorders
This pattern can be recognised in acute respiratory infections, bronchitis and respiratory complaints where an infection provokes or worsens asthmatic symptoms.
Heat in the Lungs
Brief explanation
At Heat in the Lungs, the thermal image is deeper than at Wind-Heat according to TCM. This can occur when an acute infection pulls in further, but the source also describes prolonged exposure to smoke and other heating or irritating influences as a possible factor. Dryness can be clearly present.
Common symptoms
- breathlessness and rapid, difficult breathing;
- dry, hard cough;
- low mucus or sticky yellow/green mucus;
- heat, pressure or chest pain;
- fever or feeling overly warm;
- red or warm face;
- dry mouth and throat;
- strong thirst, often for cold drinks;
- constipation;
- Little and dark urine.
Examples of Western disorders
This pattern can be recognised in acute bronchitis, lung infections and other respiratory problems with obvious heat and dryness symptoms.
Phlegm-Dampness in the Lungs
Brief explanation
At Phlegm-Dampness, a build-up of moisture and mucus, according to TCM, hinders the movement of Lung-Qi. The Spleen often plays a role here, because it is responsible for part of the handling and transport of liquids. The image is usually more chronic and is characterized by much mucus, heaviness and fatigue.
Common symptoms
- shortness of breath with productive cough;
- a lot of white, clear or thick mucus;
- audible mucus or a roaring sound on the chest;
- chest pressure or feeling heavy;
- symptoms that may be worse at night, morning or after dinner;
- fatigue and sluggishness;
- feeling heavy in the body;
- sleepiness or feeling blurred in the head;
- low appetite;
- bloated abdomen;
- nausea;
- loose stools sometimes.
Examples of Western disorders
This pattern can be recognised in chronic bronchitis, COPD, emphysema and asthma with high mucus formation.
Phlegm-Heat in the Lungs
Brief explanation
Phlegm-Heat combines mucus accumulation and a clear thermal image. The mucus is usually thicker and harder to cough up than Phlegm-Dampness and can be yellow or green. This pattern can occur acutely, but according to TCM also result from long-term Phlegm-Dampness that gradually develops Heat.
Common symptoms
- breathlessness and rude or rapid breathing;
- productive cough;
- thick yellow or green mucus;
- mucus that is difficult to cough up;
- pressure, tightness or warmth on the chest;
- thirst;
- dry mouth;
- bitter taste;
- red throat or sore throat;
- irritability or restlessness;
- uncommon fever;
- complaints often worse at night and early in the morning.
Examples of Western disorders
This pattern can be recognised in acute or chronic bronchitis, bronchiectasia, lung infections and asthma where thick coloured mucus and heat phenomena are present.
Food stagnation
Brief explanation
The relationship between nutrition and breathing is more important within TCM than at first glance may seem. Food stagnation does not process enough food and maintains a strong feeling of fullness and pressure in the upper abdomen. According to TCM, this can hinder the normal falling movement of Stomach and Lung-Qi. Food stagnation can also contribute to the formation of Dampness, Phlegm and Heat.
Common symptoms
- breathlessness or chest pressure after eating;
- complaints after eating too much or certain foods;
- strong bloating or full-bloating in the abdomen;
- the feeling that a full belly interferes with breathing;
- many belching;
- flatulence;
- bad breath;
- acid rebuffing or heartburn;
- irregular or difficult stools;
- sometimes clear mucus formation.
Examples of Western disorders
A similar sign of complaints may occur in reflux, functional gastrointestinal symptoms and situations where a highly swollen or full abdomen makes breathing uncomfortable. In addition, nutrition can provoke respiratory problems in some people; the underlying cause should be assessed separately.
Liver-Qi disturbs the Lungs
Brief explanation
With this pattern, tension and emotions strongly affect the breathing. Liver-Qi, according to TCM, should move freely through the body. When this movement stagnates, the normal descending movement of Lung-Qi can also be hindered.
Characteristic is not always severe breathlessness, but the feeling that you are unable to breathe deeply or can't get a completely satisfactory breathing.
Common symptoms
- feeling unable to breathe deeply;
- regular need to sigh deeply;
- pressure, tension or tightness on the chest;
- symptoms that are clearly increased in the event of stress or emotional stress;
- little or no mucus;
- feeling of chunk or throat obstruction;
- irritability;
- tense or bloated abdomen;
- variable digestive symptoms.
Examples of Western disorders
This pattern can be recognised in stress-related respiratory problems, hyperventilation, anxiety or panic symptoms and in asthma where stress is a clear triggering factor.
Lung- and Spleen-Qi-deficiency
Brief explanation
In this pattern, according to TCM, there is insufficient Qi to support breathing vigorously. In addition, the Spleen does not provide sufficient support for the Lungs and is less capable of handling liquids. As a result, fatigue, shortness of breath and mucus formation can occur together.
Common symptoms
- chronic or recurrent shortness of breath;
- complaints are clearly worse in case of exercise;
- fast out of breath;
- fatigue;
- low cough;
- soft or weak voice;
- easy sweating;
- easy colds;
- pale radiating pain;
- low appetite;
- bloating;
- any thin or watery mucus;
- loose stools sometimes.
Examples of Western disorders
This pattern can be recognised in chronic respiratory diseases such as asthma, chronic bronchitis, COPD or emphysema, especially when fatigue and reduced capacity for activity are clearly present.
Lung- and Kidney-deficiency
Brief explanation
According to TCM, the Kidneys support the Lungs when bringing down and, as it were, holding on to the inhaled Qi. When this function weakens, it becomes more difficult to breathe. This pattern is especially seen in long-term respiratory complaints.
The image can go more towards Yin-deficiency or Yang-deficiency. In Yin-deficiency, dryness and relative heat are at the forefront; in Yang-deficiency, coldness, fatigue and fluid processing.
Common symptoms
- chronic shortness of breath;
- especially difficulty in deep breathing;
- symptoms are much worse with effort;
- sometimes also breathlessness at rest;
- fatigue and exhaustion;
- weakness or pain of lower back and legs.
In addition, Yin deficiency may include:
- dry mouth and throat;
- low mucus;
- dry cough;
- feeling of warmth;
- redness of the face;
- night sweats;
- complaints that are worse at night.
In addition, Yang deficiency may occur:
- strong crucibility;
- cold hands and feet;
- thin, clear or aqueous mucus;
- spontaneous sweating;
- pee more frequently or urinate at night;
- fluid retention;
- dizziness.
Examples of Western disorders
This pattern can be recognized in long-term conditions such as COPD, emphysema and chronic asthma. Severe breathlessness with fluid accumulation may also occur in heart or lung disease and requires conventional medical assessment.
When to contact your doctor?
Breathlessness can be a symptom of a serious condition. Therefore, let new, unexplained or clearly increasing shortness of breath be medically assessed.
Seek immediate medical attention in case of severe or sudden breathlessness, especially when accompanied by chest pain or pressure, blue or grey discoloration of lips or skin, drowsiness or confusion, coughing up blood, fainting or having difficulty breathing.
Breathlessness also needs medical assessment if it occurs at rest, wakes you at night, worsens rapidly, is accompanied by fever and clear signs of illness, or occurs with new fluid retention in the legs or ankles.
Acupuncture and Chinese herbal medicine are used in such situations only after necessary regular diagnostics and treatment have taken place.
Outlook
The course of breathlessness and shortness of breath depends on the cause, duration and severity of the symptoms. In case of temporary respiratory infection the symptoms may decrease within a few days or weeks. In chronic conditions such as asthma, COPD, heart failure or a long-term TCM emptying pattern, a longer treatment pathway may be required.
The underlying TCM-pattern also plays a role. Complaints from a temporary external pattern, such as Wind-Cold or Wind-Heat, can be different than breathlessness by Phlegm, Qi-stagnation or a shortage of Lung-, Spleen- or Kidney-Qi.
In the initial phase, one treatment per week is common. For acute symptoms, treatment can be temporarily much more frequent than for chronic shortness of breath. Depending on severity and pattern, this can be multiple times a week and even daily in some acute TCM-treatment protocols. In case of severe acute breathlessness, necessary regular medical treatment always takes precedence.
For chronic complaints, once a week as the usual initial directive remains fine.
Contact
Do you suffer from breathlessness or shortness of breath and do you want to know if acupuncture or Chinese herbal medicine can mean anything for your complaints? Please feel free to contact us to discuss your situation or make an appointment.