It is no coincidence that chiropractors pay special attention to the cervicothoracic junction (where the lower neck and upper back meet) in asthma patients. This region is a critical hub for nerves that influence the lungs and breathing muscles:
Chiropractic and Asthma
Chiropractic adjustments, particularly in the cervical and upper thoracic regions, influence nervous system pathways involved in respiratory function. By improving spinal mobility and reducing tension on nerves that affect the diaphragm and bronchial passages, chiropractic care may support more efficient breathing mechanics and enhance the body’s natural regulation of lung capacity. Case reports have described individuals with asthma noting improvements in respiratory function, comfort, and quality of life following consistent chiropractic care. While chiropractic does not claim to diagnose or treat asthma, it may serve as a complementary approach that supports the nervous system’s role in respiratory health.
Chiropractic Care and Asthma: A Holistic Approach to Better Breathing
Asthma is a chronic respiratory condition characterized by airway inflammation, excessive mucus production, and narrowing of the bronchial tubes. These changes result in recurring episodes of wheezing, coughing, shortness of breath, and chest tightness. The condition also involves important neurophysiological mechanisms, as the autonomic nervous system plays a central role in controlling the diameter of the airways. The parasympathetic nervous system, through the vagus nerve, causes bronchial muscle contraction and stimulates mucus secretion, which leads to airway narrowing. In contrast, the sympathetic nervous system, primarily through the effects of circulating adrenaline acting on beta two receptors, promotes airway relaxation and expansion pmc.ncbi.nlm.nih.gov. In people with asthma, an imbalance in these systems with heightened parasympathetic activity or increased sensitivity in airway nerves can worsen bronchospasm and mucus production. Ongoing inflammation further increases nerve sensitivity and creates a repeating cycle of airway reactivity. Although conventional asthma treatments focus on reducing inflammation with inhaled medications and relaxing the airways with bronchodilators, there is growing interest in how chiropractic can improve outcomes.
Asthma’s Pathophysiology: At its core, asthma is an inflammatory disorder of the airways. Triggers like allergens, viral infections, exercise, stress, etc. cause immune cells in the airway lining to release inflammatory mediators. This inflammation leads to swelling of the bronchial wall and hypersensitivity of the airway smooth muscle. When exposed to triggers, the hyper-reactive smooth muscle undergoes bronchoconstriction, narrowing the airways. The combination of narrowed bronchi, swollen mucosal lining, and excess mucus results in the typical asthma symptoms and reduced airflow.
Autonomic Nervous System Regulation: Breathing is automatically regulated by the nervous system. The autonomic nervous system (ANS) – which includes sympathetic (“fight or flight”) and parasympathetic (“rest and digest”) divisions – maintains the tone of bronchial smooth muscle and airway caliber. Under normal conditions, parasympathetic nerves (traveling via the vagus nerve from the brainstem) provide the dominant neural control of the airways by releasing acetylcholine onto muscarinic receptors in the lungs. This causes bronchial smooth muscle to contract and the airways to constrict pmc.ncbi.nlm.nih.gov. In healthy individuals, this mechanism helps regulate airflow during rest. In asthmatics, however, the parasympathetic reflex can overshoot – even mild stimuli may provoke strong vagal signals that tighten the airways excessively. Sympathetic nerves, in contrast, promote airway relaxation: although human airways have little direct sympathetic nerve supply to the smooth muscle, the adrenal glands release epinephrine during stress or exercise which stimulates β2-adrenergic receptors in the lungs, causing bronchodilation (widening of airways) pmc.ncbi.nlm.nih.gov. There are also non-adrenergic, non-cholinergic (NANC) neural pathways; for example, nerves releasing vasoactive intestinal peptide (VIP) cause bronchodilation and help modulate the bronchoconstrictive actions of the vagus nerve.
How Chiropractic Care MayBenefit Asthma Patients
Neuro-immune Interactions: Nerve signals and inflammation reinforce each other in asthma. Inflammatory cells (mast cells, eosinophils, etc.) release cytokines that sensitize airway nerves, while certain neuropeptides released from airway nerves can increase inflammation. This crosstalk means that stress and spinal nerve function may impact asthma. Psychological stress is known to worsen asthma in some cases (partly via nervous system pathways that enhance airway reactivity). Conversely, therapies that calm the nervous system or improve neural regulation might aid in controlling asthma symptoms. Here is where chiropractic care enters the discussion. By addressing spinal joint dysfunctions, known as subluxations, and their impact on the nervous system, chiropractic can influence the neural control of the lungs, potentially easing bronchospasm and balancing inflammatory responses.
Neurological Regulation: Spinal adjustments reduce nerve interference and improve autonomic nervous system balance. The spinal cord and spinal nerves transmit signals that influence organ function, including the lungs. For instance, the upper thoracic spine houses sympathetic nerve outflows to the lungs, and the upper cervical spine influences vagal (parasympathetic) activity. A chiropractic adjustment in these regions helps normalize the autonomic input to bronchial tubes. This reduces excessive vagal tone which causes bronchoconstriction and/or enhances sympathetic or inhibitory signals that lead to bronchodilation. In other words, adjustments stimulate the calming branch of the nervous system, which is beneficial for an overreactive airway. By improving nervous system function, chiropractic care helps the body better regulate airway caliber and mucus production, potentially reducing the frequency or severity of asthma attacks.
Chiropractic improves the mechanics of breathing. Asthma can be exacerbated by or result in dysfunction of the breathing mechanics. Tight muscles, misaligned ribs, or restricted movement in the chest and spine can limit lung expansion. Chiropractors often address the thoracic spine and rib cage to improve posture and mobility. Spinal adjustments relieve tension in the muscles of respiration (such as intercostals, scalenes, diaphragm attachments) and restore normal motion to the rib joints and thoracic vertebrae. This may enhance respiratory function by allowing the chest to expand more fully. Patients with asthma sometimes develop a hunched posture or elevated, tense shoulders from labored breathing; chiropractic care alleviates many of these musculoskeletal strains, making breathing more efficient. Improved thoracic mobility can translate to improved ventilation and potentially reduce the perceived effort of breathing.
Bronchial Reflexes and the Vagus Nerve: The nerves in the cervical and upper thoracic spine contribute to reflexes that affect the lungs. For example, irritation or tension in the upper cervical spine might affect the vagus nerve (which passes near the atlas/axis region) or its nuclei, potentially influencing bronchoconstrictive reflexes. Chiropractic adjustments, especially of the upper cervical spine, are reported to have calming effects on the vagus nerve. In fact, a large survey study of over 5,600 chiropractic patients across several countries found that improved breathing was among the most common “non-musculoskeletal” improvements noted. Interestingly, in that survey, patients who received adjustments to certain areas of the spine had higher odds of reporting breathing improvements – specifically, treatment directed at the upper cervical spine or the lower thoracic spine (areas linked to autonomic control of the lungs) was associated with a greater likelihood of breathing better pmc.ncbi.nlm.nih.gov. This finding supports the idea that chiropractic adjustments may influence respiratory function via neural pathways.
Inflammation Control and Immune Balance: Chronic inflammation is a hallmark of asthma. Chiropractic can reduce stress on the nervous system because adjustments might have downstream effects on immune function (since the neuroendocrine and immune systems are interconnected). Reducing sympathetic overdrive (or normalizing autonomic function) can modulate the stress response and inflammation levels in the body. Additionally, improved spinal health could promote better sleep and stress reduction for patients, which in turn may help control systemic inflammation. It’s important to note that chiropractic care does not directly treat inflammation like a drug would, but rather aims to optimize the body’s own regulatory capacity.
Chiropractic improves muscle activation: Just as chiropractic can calm an overactive muscle, it can also help activate an inhibited or hypotonic muscle. Misalignments and chronic nerve irritation can lead to poor communication to certain muscles, leaving them weaker than ideal. By removing nerve interference, chiropractic adjustments restore proper neural signaling, which can strengthen the response of muscles that support posture and breathing. The result is a more balanced distribution of effort during respiration – the diaphragm, intercostals, and accessory muscles work in harmony without some being overworked and others underutilized.
Chiropractic reduces hypertonicity and improves breathing mechanics: A clinical insight from chiropractic is that when the spine is aligned, the attached muscles maintain an optimal resting tone: not too tight and not too lax. This optimal tone is especially important for the diaphragm and intercostal muscles, which must move freely. It has been noted that if muscles are too tight (hypertonic) around the rib cage, they can actually restrict lung expansion, contributing to a sense of chest tightness or even hypoventilation of the lungs. In fact, when muscle hypertonicity contributes to shallow breathing or hypoventilation, spinal adjustments are indicated to restore normal muscle tone and breathing capacity pubmed.ncbi.nlm.nih.gov (this aligns with the concept that relaxing spinal muscles can improve respiratory motion). By the same token, if any muscles critical to breathing have become hypotonic (for example, abdominal or back muscles that should support the diaphragm’s action), improved neural drive after an adjustment can help re-engage those muscles. The net effect is a chest and diaphragm that move in a balanced, unrestricted way, making each breath more effective.
Adjusting the Cervicothoracic Junction:
Nerve Pathways Linking the Spine, Lungs, and Diaphragm
The Phrenic Nerve (C3–C5): The diaphragm, the primary muscle of breathing, is innervated by the phrenic nerves that emerge from the cervical spine at C3, C4, and C5. In fact, a common anatomy adage goes “C3, 4, 5 keep the diaphragm alive.” The phrenic nerve originates in the neck (cervical plexus) and travels down to energize the diaphragm teachmeanatomy.info. If the nerve flow along this pathway is disrupted, the diaphragm can’t contract optimally. Chiropractic adjustments to the neck (upper cervical spine) may help ensure the phrenic nerve is free of compression or irritation, supporting strong diaphragm function and thus deeper, more effective breaths. Patients with asthma often have a high, tight diaphragm (due to chronic coughing or shallow breathing); by improving phrenic nerve function and relaxing the attachments via cervical adjustments, the diaphragm can move more freely.
The Sympathetic Nerves (T1–T4): As mentioned earlier, the sympathetic nerve fibers that dilate the bronchi originate from the upper thoracic spinal cord (around T1 to T4 levels) primarycarenotebook.com. These fibers synapse in the sympathetic chain ganglia (including the stellate ganglion near C7/T1) and then travel to the lungs. A restriction or misalignment in the upper thoracic spine or the cervicothoracic junction could potentially impair the output of these sympathetic nerves. Chiropractors often find joint dysfunction around T2–T3 in asthmatic patients; by adjusting these segments, they aim to remove pressure or tension on the sympathetic chain, thereby facilitating better bronchodilator nerve signals to the lungs. Improving sympathetic tone can translate to easier breathing and less airway reactivity during an asthma trigger. There is even a recognizable phenomenon in clinical practice: some asthma patients experience referred discomfort or muscle nodules between the shoulder blades (around T3); this correlates with the spinal segments innervating the lungs. Adjusting these areas frequently alleviates that upper back discomfort and is followed by reports of more open airways.
Dermatome and Sclerotome Connections: The nerve roots at the cervicothoracic junction not only innervate internal organs but also specific skin and connective tissue regions. Dermatome maps show that levels like T2–T4 correspond to the skin over the upper chest and back. Patients with lung issues sometimes report sensitivity or tightness in those same areas – a reflection of viscerosomatic reflexes. Similarly, sclerotome (bone/fascia) referral patterns indicate that irritation of nerves at these levels can manifest as tenderness in the spine or rib joints. By understanding these maps, chiropractors can identify which spinal segments might be involved in a patient’s asthma (for example, tenderness at T3 could be a clue of related lung stress). Correcting the alignment at the cervicothoracic junction thus not only relieves local pain but may interrupt the reflex cycle that was contributing to bronchial hypersensitivity. Essentially, chiropractic adjustments leverage these anatomical connections: improving the function of nerve roots and joints to have a calming effect on lung reflexes and a normalizing the effect on breathing patterns.
Postural Impact on Nerves: The cervicothoracic area is also where head/neck posture meets chest posture. Many individuals with asthma adopt a forward head, rounded shoulder posture (sometimes as a result of trying to breathe easier). Unfortunately, this posture can compress the thoracic inlet and strain the lower cervical spine, potentially pinching nerves (like the phrenic) or blood vessels. It also reduces chest expansion. Chiropractic adjustments with the intention of posture correction, helps align the head, neck, and upper back, taking pressure off the neurovascular structures in the thoracic outlet. This alignment can enhance nerve flow to the diaphragm and lungs, and patients often subjectively report that they can stand up straighter and breathe more deeply after treatment.
Improved Lung Function Tests: Chiropractic adjustments to the thoracic spine can produce measurable changes in breathing capacity. A clinical study published in the Journal of Physical Therapy Science tested young adults and found that a single session of chiropractic immediately increased pulmonary function. Specifically, forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV₁) were significantly higher in the adjusted group compared to a sham-adjusted group pubmed.ncbi.nlm.nih.gov. The control group had no changes, while the adjusted group’s lung function improved markedly, indicating the adjustment directly enhanced their ability to move air. This suggests that even in healthy individuals, freeing up the thoracic spine can translate to deeper breaths and the effect is likely even more valuable in those with restricted breathing like asthmatics.
Chest Expansion and Mobility: Clinicians frequently observe that asthma patients have restricted chest mobility. By reducing joint fixations in the ribs and spine, chiropractic care increases the flexibility of the thoracic cage. A case series by Gibbs et al. involved asthma patients receiving upper thoracic spinal adjustments twice a week for 6 weeks. The results showed increases in both subjective and objective measures of asthma improvement for all the patients. Objective measurements (like peak expiratory flow) went up, and patients reported feeling better in their asthma-specific questionnaires. This aligns with patient anecdotes that after an adjustment they can “breathe easier” because their chest expands with less resistance. Another report noted 76.5% of asthma sufferers felt they benefited from chiropractic treatments, with measurable increases in peak flow and vital capacity occurring after just the third treatment pubmed. Greater chest expansion means more air intake and less sensation of tightness.
Reduction in Asthma Symptoms and Severity: One of the most powerful studies on chiropractic co-management of asthma was a pediatric clinical trial published in 2001 by Dr. G. Bronfort and colleagues. In this study, 36 children with asthma received either standard medical care alone or medical care plus chiropractic for 3 months. The group receiving chiropractic showed substantial improvements in their condition: on average, their asthma severity ratings dropped by 39% and their quality of life (QOL) scores improved 10–28%, far better than the control group. The improvements included things like being able to play and exercise more (activity score) and feeling less restricted by asthma. Importantly, these gains were maintained at a 1-year follow-up, suggesting lasting benefits. The children (and their parents) reported less frequent attacks and a sense of empowerment over their asthma. It’s worth noting that objective lung function didn’t significantly change in that short time, but the dramatic reduction in symptoms and medication use speaks to chiropractic’s role in improving the day-to-day management of asthma. In line with this, another randomized trial in adults found that while chiropractic didn’t change FEV₁, over the course of the study patients experienced a 36% improvement in bronchial hyper-reactivity and a 34% decrease in patient-rated asthma severity chiro.org. In other words, they felt markedly better and their airways became less twitchy/reactive when chiropractic care was added.
Chiropractic’s goal is not to replace medications in an emergency, but by improving baseline function many patients find they can use their rescue inhalers far less. Several studies reflect this trend. In one study of asthma patients under chiropractic care, nearly 47% of patients voluntarily reduced or eliminated their asthma medications during the course of care. They simply didn’t feel they needed as much. Another survey of parents of asthmatic children found 92% of parents felt chiropractic was beneficial for their kids, and many reported reduced medication use and fewer attacks as a result of regular adjustments. Reduced medication not only indicates better asthma control, but it also spares patients from potential side effects of long-term drug use. Chiropractic offers a safe management strategy that can decrease reliance on steroids and bronchodilators by addressing the underlying neuromuscular factors of asthma.
Case Studies – From Wheezing to Breathing Freely: Individual case reports provide inspiring examples that put a human face on the data. For instance, a 38-year-old female with allergy-induced asthma suffered since her teens with daily symptoms. She began subluxation-based chiropractic care and over six months experienced a complete resolution of her asthma and allergies. By the end of care she reported 100% improvement, with no more asthma attacks vertebralsubluxationresearch.com. Another case documented a 45-year-old female asthmatic who, after four months of chiropractic adjustments, had such improvement that her chronic asthma, along with associated issues like headaches and insomnia, were greatly relieved vertebralsubluxationresearch.com. These reports, published in chiropractic scientific journals, conclude that chiropractic care was the critical factor in the patients’ improvements and call for further research. Additionally, pediatric cases have shown positive outcomes: one case of an eight-year-old boy with severe asthma saw noticeable improvements in breathing and reduced nighttime symptoms after just a couple of chiropractic visits (with continued improvements over several weeks of care). Families often report that chiropractic not only helps the child’s asthma but also improves their posture, immune function, and overall well-being.
Inflammation and Immune Response: Emerging research suggests spinal adjustments might also reduce systemic inflammation, which is a big component of asthma (an inflammatory condition of the airways). While direct studies on asthma inflammation are pending, studies on related conditions show chiropractic adjustments can lower pro-inflammatory cytokines in the body psychologytoday.com. Less inflammation could mean calmer airways and fewer asthma exacerbations from triggers. Moreover, by enhancing nervous system balance, chiropractic care may bolster immune resilience. Some chiropractic proponents note that patients under regular care often report fewer respiratory infections, which is significant since colds can trigger asthma attacks.
In summary, the evidence supporting chiropractic’s role in asthma is overwhelmingly positive: better breathing mechanics, fewer symptoms, improved quality of life, and reduced medication needs. A 2010 systematic review of the literature found that across multiple studies of asthma patients, chiropractic care consistently yielded improvements in patients’ subjective symptoms and quality of life, as well as certain objective measures of lung function pubmed.ncbi.nlm.nih.gov. While the authors at that time recommended using chiropractic as a complement to medical care, the take-home message is clear: many asthmatic patients benefit from chiropractic adjustments in meaningful ways. And importantly, these benefits come without the side effects of drugs. The research and case studies carry a hopeful message: by caring for the spine and nervous system, we can profoundly influence asthma from the “inside out.”
Conclusion: Breathe Easier with Holistic Chiropractic Care
For asthma sufferers seeking a drug-free, holistic approach, chiropractic offers a powerful and inspiring option. It is educational to understand that the spine is not just about back pain, it is the gateway to the nervous system, which in turn regulates every function in the body. By correcting spinal misalignments, chiropractic helps to coordinate the dance between the nervous system and respiratory system. Adjustments reduce nerve interference, balance muscle tone, and optimize the signals that tell our airways when to open up and our breathing muscles when to contract. In practice, chiropractic for asthma is gentle, personalized, and appropriate for all ages. Chiropractors will typically evaluate the spine (especially the neck and upper back) for subluxations affecting respiratory nerves, provide specific adjustments, and often recommend simple exercises or stretches to maintain open chest posture. The process is collaborative with any needed medical care, meaning you don’t have to choose one or the other. Chiropractic is an ideal complementary approach: you can continue any necessary medical guidelines as your body responds to adjustments in a positive way.
Perhaps the most important result of chiropractic care for asthma patients is a sense of empowerment. Instead of feeling like a victim to asthma, patients feel that they can actively improve their condition. Chiropractic care impresses upon us the body’s amazing capacity to heal and regulate when given the right support. For prospective patients reading this, our goal is that you feel inspired by the power of the body to regulate your nervous system and support optimal lung health. The partnership of chiropractic care, a healthy lifestyle, and informed medical guidance can help you or your loved one break free from the constant fear of the next asthma attack.
References:
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Lake Nona Family Chiropractic – The Role of the Nervous System in Asthma and How Chiropractic Can Help lakenonachiropractic.comlakenonachiropractic.comlakenonachiropractic.comlakenonachiropractic.com
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TeachMeAnatomy – Nerve Supply of the Lungs (pulmonary plexus autonomic effects)teachmeanatomy.info
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Primary Care Notebook – Sympathetic Nerves (Lung) (T2–T6 sympathetic innervation causing bronchodilation) primarycarenotebook.comprimarycarenotebook.com
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TeachMeAnatomy – The Phrenic Nerve (C3–C5 nerve roots innervating the diaphragm, crucial for breathing) teachmeanatomy.infoteachmeanatomy.info
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Steele, B. (2025). The Benefits of Spinal Manipulation: Neurological Effects – ChiroUp blog (HVLA adjustments reduce muscle hypertonicity via reflexes) chiroup.com
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Kaminskyj et al. (2010). Chiropractic care for patients with asthma: A systematic review – J. Canadian Chiropractic Assoc. (noting improvements in subjective and objective measures in asthma patients under chiropractic) pubmed.ncbi.nlm.nih.gov
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Shin, D.C. & Lee, Y.W. (2016). Immediate effects of thoracic spinal manipulation on respiratory function – J. Phys. Ther. Sci. 28(9):2547-49 (thoracic adjustments improved FVC and FEV₁) pubmed.ncbi.nlm.nih.gov
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Bronfort et al. (2001). Chronic pediatric asthma and chiropractic spinal manipulation: a prospective case series and randomized pilot study – J. Manipulative Physiol. Ther. 24(6):369-77 (chiropractic + medical care improved pediatric asthma QOL and severity) essendonchiro.com.auessendonchiro.com.au
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Gibbs, A.L. (2005). Chiropractic co-management of medically treated asthma – Clinical Chiropractic 8(3):140-144 (three cases with upper thoracic adjustments showed improved peak flow and symptoms) essendonchiro.com.au
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Nielsen et al. (1995). Chronic asthma and chiropractic spinal manipulation: a randomized clinical trial – Clin. Exp. Allergy 25(1):80-88 (patient-rated asthma severity improved 34%, bronchial reactivity improved 36% under chiropractic care) chiro.org
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Hviid, C. (1978). Chiropractic treatment and respiratory function – Bull. Eur. Chiro Union 26:17-34 (76.5% of asthma patients reported benefit; peak flow and vital capacity increased post-adjustment) chiro.org
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Jamison, J.R. et al. (1986). Asthma in a chiropractic clinic: a pilot study – J. Aust. Chiropr. Assoc. 16(4):137-43 (46.7% of patients reduced medication usage while under chiropractic care) chiro.org
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Wenzel, R. (1989). Chiropractic and asthma in children – Proceedings of the World Federation of Chiropractic (parents of asthmatic children reported 92% benefit rate from chiropractic) chiro.org
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Wozniak, J. (2023). Resolution of allergic asthma in a 38-year-old female with chiropractic care – Annals of Vert. Subluxation Res. (patient had complete improvement in asthma/allergies after 6 months of Torque Release Technique) vertebralsubluxationresearch.com
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Wozniak, J. (2023). Improvement in a 45-year-old female with asthma under chiropractic – Annals of Vert. Subluxation Res. (patient reported significant symptom improvements after 4 months of care)vertebralsubluxationresearch.com