Case 18: Post-Traumatic Breathing Dysfunction Presenting as Persistent Back Pain

A patient presented with unusual, persistent back pain following a severe motor vehicle accident six months earlier. During the accident, glass penetrated the skull, causing critically raised intracranial pressure and requiring temporary removal of part of the skull. Recovery involved months of relearning memory, speech, movement, and eating.

Post-trauma back pain resolved by addressing rib, diaphragm, and breathing dysfunction rather than treating the pain site alone.

Despite neurological recovery, the patient reported ongoing “strange” back pain that had no clear explanation. During assessment, breathing patterns were notably unstable, and PPG readings showed significant variability.

Closer examination revealed abnormal high-frequency vibration at the left 10th and 11th ribs during exhalation. Auscultation confirmed high-frequency breath sounds from the left lung on expiration. Functional assessment suggested residual injury to the left lung–rib interface, impaired diaphragm pressure regulation, and intermittent intercostal muscle spasm.

Notably, prior echocardiography and MRI had not identified these issues.

After targeted treatment focusing on breathing mechanics, rib mobility, and neuromuscular regulation, breathing became continuous and stable. The abnormal vibrations and breath sounds resolved, and the unexplained back pain reduced significantly.

Although symptoms improved, the patient was advised to seek further specialist review to rule out any remaining underlying risk. This case highlights how trauma-related breathing dysfunction can persist undetected and present as non-specific musculoskeletal pain long after the initial injury.

Clinical Practice: Heal Young Massage

Evidence-based remedial massage and movement rehabilitation services.