No one likes to have hiccups – they’re bothersome and annoyingly disruptive. In some cases, however, hiccups can be very uncomfortable. So what’s the deal? Why do your hiccups sometimes hurt?
Hiccups are sudden, involuntary contractions of the diaphragm – the muscle that separates the chest cavity from the abdomen and plays a crucial role in breathesays Shoshana Ungerleider, MD. “Hiccups occur when the diaphragm spasms unexpectedly, causing a rapid intake of air, and when this air hits the vocal cords, it leads to the familiar ‘hiccup’ sound,” she explains.
The exact cause of hiccups is a bit of a mystery medical mysterybut what we do know is that hiccups are linked to your nervous system, says Zachary Bittinger, MD. Some cases of hiccups are triggered by stimulation of the phrenic or vagus nerves (the phrenic nerve controls breathing, while the vagus nerve controls heart rate, mood and digestion), which are connected to the diaphragm, but according to Dr. Ungerleider, common triggers also include drinking carbonated drinkseating too much, getting too excited or stressed, or swallowing too much air while chewing gum.
Most cases of hiccups only last a few minutes, but why do hiccups hurt so much? Here’s what the doctors told PS.
Experts featured in this article:
Shoshana UngerleiderMD, is an internal medicine physician and founder of the End Well Foundation.
Zachary BittingerMD, is a family medicine physician at The Ohio State University Wexner Medical Center.
Why do your hiccups hurt so much?
Hiccups are common, normal and usually harmless, so in most cases they are not a cause for concern. However, the accompanying symptoms can tell a lot about what is causing the discomfort. Read on to understand more about what makes your hiccups so painful and when to visit a doctor.
Irritation in the esophagus
Conditions that esophagitisa disorder that causes swelling and inflammation of the esophagus, can trigger painful hiccups as the esophagus passes through the diaphragm on its way to the stomach, says Dr. Ungerleider. Difficulty swallowing and a burning pain in the chest also accompany esophagitis, so if your symptoms become severe or last more than a few days, it’s time to see a doctor.
Another common culprit in esophageal irritation that can lead to painful hiccups, according to Dr. Ungerleider? Swallowing sharp foods such as chips, popcorn, nutsseeds or hard taco shells.
Gastroesophageal reflux disease
Gastroesophageal reflux diseasealso known as GERD, is a common cause of chest pain, and is usually accompanied by a burning sensation when lying down or after eating and a sour taste in the mouth. But because GERD occurs when stomach acid repeatedly flows back into the tube that connects your mouth and stomach, the acid can irritate the diaphragm and esophagus, making your hiccups painful, Dr. Ungerleider says. You may be able to manage symptoms with OTC antacids, but if your pain persists or interferes with daily life, it’s time to see a doctor.
Heavy training
Believe it or not, heavy exercise can lead to overuse or straining of the diaphragm, leading to uncomfortable hiccups, says Dr. Ungerleider. If you’re a high-level athlete, says Dr. Bittinger that your diaphragm may also be stronger and may spasm more forcefully, in turn causing painful hiccups. Fortunately, rest and relaxation can relieve stress and calm symptoms.
Chest or rib pain
Injury, inflammation, and/or muscle tension in the chest or ribs can make the spasms from your hiccups more noticeable and painful, says Dr. Ungerleider. This can be especially common if you have one persistent coughshe adds. If your cough lasts more than a few days or you have difficulty breathing or chest pain that worsens with activity, see a doctor ASAP.
Distended abdomen
An overfull stomach (AKA distended abdomen) from overeating, gas, or constipation can stretch the diaphragm and lead to painful hiccups, says Dr. Ungerleider. It is often accompanied by bloating, visible swelling and occasional nausea, according to the Cleveland Clinic. If your symptoms get worse, persist for more than a few days, or come with fever, vomiting, or blood in the stool, it’s time to see a doctor.
Lung infection
In more serious cases, pneumonia and other lung infections such as bronchitis or cystic fibrosis can inflame the tissues around the diaphragm and lungs, causing painful hiccups, Dr. Ungerleider says. Other symptoms include a mucus-producing cough, fever, chills, shortness of breath, and chest pain, so see a healthcare provider if you’ve been diagnosed with or suspect you have a more serious lung infection. Depending on the case, cough medicine, antibiotics and/or antipyretics may be prescribed, according to Mayo Clinic.
Neurological disorder
“Certain neurological disorders and conditions such as stroke, multiple sclerosisor traumatic brain injuries can disrupt the nerve pathways that control the diaphragm, leading to chronic or painful hiccups,” says Dr. Ungerleider. Treatment for a neurological disorder varies by condition and severity, so talk to your doctor about treatment and possible medication to manage symptoms.
How to get rid of hiccups
There’s no so-called “cure” for hiccups, but here are some simple remedies worth trying, according to Dr. Bittinger and Dr. Ungerleider.
- Hold your breath: Taking a deep breath and holding it for five to 10 seconds can reset your diaphragm and squash hiccups.
- Drink water: Sipping cold water slowly can help stimulate the vagus nerve and stop painful hiccups.
- Stimulate the back of the throat: Gargling with cold water or gently swallowing can activate nerves that control hiccups to relieve symptoms.
- Apply pressure: Gently press on your diaphragm or pull your knees toward your chest to relax the hiccup-inducing muscle.
- Try the Valsalva maneuver: Exhale while closing your mouth and pinching the nose stimulates the vagus nerve, which can stop hiccups.
Bottom line
Painful hiccups can be an uncomfortable experience, but they’re not automatically a red flag. Most cases subside within a few minutes to an hour, but if your painful hiccups persist for more than two days, or if they’re followed by difficulty breathing, swallowing or sleeping, it’s time to see a health care provider, Dr. Bittinger says.
In addition, if your symptoms worsen or are accompanied by chest pain, severe abdominal pain, feveror unexplained weight loss, it could indicate an underlying medical problem, so Dr. Ungerleider recommends seeing your doctor for a full exam and medical evaluation.
Andi Breitowich is a Chicago-based freelance writer and graduate of Emory University and Northwestern University’s Medill School of Journalism. Her work has appeared in PS, Women’s Health, Cosmopolitan and elsewhere.
