What are symptoms of Phrenic nerve damage?

Hi Stradivarius,

Injuries to the phrenic nerve can occur in a number of ways, including injections of medicine in the neck prior to shoulder surgery or to treat pain, chiropractic adjustments of the neck, or neck, chest or vascular surgery. In addition, scar tissue can form in the neck and compress the nerve.

 Patients are often misdiagnosed because the symptoms are similar to those of pneumonia or asthma. Phrenic nerve injury is usually diagnosed by conducting a physical exam, asking the patient about previous medical treatments that may have affected the neck or chest, and considering whether the patient has severe shortness of breath and is unable to perform simple day-to-day activities.

Hi you two,

You actually wrote all the symptoms of phrenic nerve damage in your question, Stradivarius. Shortness of breath, having trouble even climbing the stairs, when even the easiest things to do now seem to be hard.

As Health n Joy wrote, since the symptoms of phrenic nerve damage aren't some regular symptoms which could be noticed by doing tests or so, the doctor is just going to talk to you and ask you question about your daily activities and how you react to them in order to conclude whether or not do you have a phrenic nerve damage. He will focus on your severe shortness of breath.

Hi everyone,

I know some things regarding the phrenic nerve damage so I think that I can help you out.

The phrenic nerve controls function of the diaphragm muscle - the primary muscle involved in breathing.  It tells the diaphragm when to contract, allowing the chest cavity to expand and triggering the inhalation of air into the lungs. That's why your doctor will always ask you about your shortness of breath in order to diagnose you with phrenic nerve damage.

There are actually two different tests that can help conclude that you got phrenic nerve damage. I can't tell you much about them because I don't know.

Hello everyone. I need to tell you that I never have heard of the phrenic nerve until my friend told me about it. I can say that this is funny because it is very important part of your body, of our bodies and we all should know more about it. Well, this nerve send signals to our diaphragm from your brain. When this diaphragm moves, this pulls or pushes air into your lungs and your phrenic nerve helps to keep your body breathing automatically.

Some symptoms that can show that the nerve is irritated or damaged are pretty odd. For example, you can feel the pain in the tip of the shoulder. If the nerve is damaged you can have trouble breathing.

Hey everyone.

A lot of people don’t know the importance of phrenic nerve. And it is bad when it is damaged. Luckily, no one from my friends and family never had any problems with it, but I have heard a couple of cases.

About the symptoms – well, I am not that sure but I have heard that there are a lot of symptoms, for example from being asymptomatic or respiratory influence.

According to the symptoms, your doctor can be able to determine the proper treatment for phrenic nerve damage.

Also, you should learn to know what is the difference when the nerve is irritated and when nerve is damaged.

Hey guys. Phrenic nerve damage can be caused by spinal cord injury and depending on which vertebrae are damaged, nerve impulses can be disrupted. It is like injury happens above the third vertebrae. If this injury happens in the lower part of the spine – in that case breathing is not usually impacted. Phrenic nerve damage can also happen during the neck injury. It also can happen during the heart surgery. So the first symptom is when you are breathing hard. Also, you can have problems with the hiccups and the hiccups can be triggered by phrenic nerve irritation. This can result in a small intake of the air.

I realize the posts here are nearly a year old, but I felt compelled to contribute for anyone who happens to stumble upon it in the future. Nearly a year ago, my husband began complaining of difficulty taking a deep breath, feeling pressure in the diaphragm area on the right side, particularly after eating. He began getting fuller, faster, and having some episodes of vomiting after eating large meals. He became easily winded with physical activity and things such as climbing stairs and bending over to tie his boots. Upon first seeing his primary medical doctor, he had an x-ray and was diagnosed with bronchitis and treated as such, two times. His cough improved after 2-3 months, but the other symptoms did not improve, rather, they gradually worsened. Upon returning to the doctor, another x-ray was obtained, which the doctor said was a suboptimal image, but that she could see quite a bit of stool in the colon, and sent him home with a prescription laxative, and set him up for upper and lower endoscopies, as well as a pulmonary functions test. The surgeon who performed the endoscopies also ordered a hydascan to rule out gall bladder issues. The PFT showed decreased lung functions. The following week, while working out of state, (my husband is a 48 year old heavy equipment mechanic for a bridge construction company, who was in excellent health prior to this), ended up in an ER due to feeling as though he had had the wind knocked out him for no reason. CT scan was done and revealed he had a paralyzed diaphragm on the right side with 2 of the 3 lobes in his right lung collapsed. That led to a quick referral to a pulmonologist, which resulted in a year long process of other tests and specialty referrals. He had a bronchoscopy, 2 SNIFF tests, full blood panel workup to rule autoimmune and other issues, a stress test (he was out of wind after only 3 minutes on the treadmill, but interestingly, his oxygen saturation levels stayed at 98%. He also had to have a heart catheterization to rule out any blockages of his arteries, which came back perfect. He has 56% lung function currently. After all other possible issues were ruled out, a phrenic nerve conduction study was done and concluded that in fact, the phrenic nerve on his right side was indeed, dead. There is no function in the right diaphragm. We have worked with 3 different pulmonologists who all have told us much the same; there are 3 options. 1) Diaphragmatic Plication- tack that diaphragm down so that it doesn't cause so much pressure, but that is not a fix to the problem, and it would eliminate any other treatment options down the road. 2) Put in a Diaphragm Pacer, similar to a pace maker for the heart. The problem being with that, is that he still has one side functioning, so with a pacer, they likely would not work in sync, and thus would cause a permanent disrupted breathing pattern. 3) Learn to live with it. That option is just not an easy one to swallow! However, I had done quite a bit of research on my own, and learned that there is a 4th option! Since day one after the CT scan showed hemi-diaphragmatic paralysis (one sided), everything I have searched related to that, has resulted in phrenic nerve damage. That led me to a Dr. Kauffman from New Jersey who also practices at UCLA with another doctor, and is performing phrenic nerve surgery on patients with phrenic nerve damage. He is currently the only doctor in the world who does this surgery, and has a fairly high success rate, though that is improved if done within the first 8-12 months of symptomatology first presenting. All of the above testing has to be done first to make a positive diagnosis that it is truly phrenic nerve damage, but we are finally at that point. When I brought this 4th option up to my husband's pulmonologist, he had never heard of it, but was willing to call Dr. Kauffman and discuss it with him. After doing so, he was actually very excited about this cutting edge treatment option, and equally excited that there is a 4th option to offer his future patients potentially. He is currently working on contacting Dr. Kauffman again to arrange a video conference with my husband and myself, to see if my husband is a good candidate for the surgery. We do yet know the financials of how it will all work, whether insurance will help pay, what the recovery time will be, or any of those details as of yet, but at least we have a hope at this point that we did not have prior. Even if my husband never regains 100% lung function, we would consider 75-80% a huge improvement over the current 56% he has now. Our story is long, but I want to encourage anybody who is going through what we have, to be your own advocate when it comes to your healthcare! If you don't feel like your doctor is getting to the bottom of your issues... insist they do more testing or refer you on to somebody else. Because phrenic nerve damage is relatively rare, it is not going to be the first thing most doctors consider, know that!

it is a sniff test, a pulmonary function test and an emg. I am in the process of having these tests set up to do.

I had a fall down an elevator shaft head first several years ago and fractured my C4 spine. About a year later I was diagnosed with an elevated right Diaphragm.

You are so right, I have been doing research on my own because the Doctors have been telling me different diagnosis. I fell down an elevator shaft several years ago and fractured my C4 in my neck. I have had breathing issues ever since. I have been going in and out of Afib, my asthma has come back, out of breath, told I have an elevated right Diaphragm, have to think about breathing, etc. I have finally convinced my Doctor to give me a sniff test and others. I have researched on my own and found out that the Phrenic nerve goes through the C4 area where I was injured. I am hoping they can figure this out and something can be done to help my situation. I have heard about this Doctor Kaufman at UCLA but I have to have several tests before I can even be seen by Him.

Thank you for a very fine explanation of the process! Im not sure this is what I am having...but, I am an RN and I understood everything! Thanks for taking the time!

Thank you for your information. I have phrenic nerve damage from a heart ablasion. I have trouble breathing and going up stairs. I also have a lot of indigestion and burping and chest discomfort. I was told this damage is rare and it could take 18 month's to correct itself. I have another chest x Ray next week.

Hi,
I've been living with right sided, diaphragmatic paralysis since '02. Phrenic nerve was damaged during surgery. The creepy surgeon knew, but didn't tell me (he saw the elevated r hemidiaphragm right after surgery on an xray). I found out later on my own... oh joy. A sniff test and emg/ncs both confirmed Dx. I'd like to know more about your sxs of burping, chest discomfort, indigestion, etc. I have that too, but always atributed it to something else I suffer with. Maybe I'll go consult Mathew Kaufman M.D. here in L.A. who surgically repairs phrenic nerves. Although, I'm older and it may be too late to do squat. Thx, Jan.

I have a phrenic nerve injury that I am treating with acupuncture, reflexology, and touch for health and body management. Mine is a result of a motor vehicle accident in which I received a whiplash injury and closed skull injury. I can do my own work since I am a touch for health practitioner.