No one is thrilled to get the hiccups – they’re a nuisance and annoyingly disruptive. In some cases, though, hiccups can be wildly uncomfortable. So what’s the deal? Why do your hiccups hurt sometimes?
Hiccups are sudden, involuntary contractions of the diaphragm-the muscle that separates the chest cavity from the abdomen and plays a crucial role in breathing, says 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 ‘hic’ sound,” she explains.
The exact reason for hiccups is a bit of a medical mystery, but what we do know is that hiccups are linked to your nervous system, says Zachary Bittinger, MD. Some cases of hiccups are triggered by the 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 beverages, overeating, getting overly 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 doctors told PS.
Experts Featured in This Article:
Shoshana Ungerleider, MD, is an internal-medicine physician and founder of End Well Foundation.
Zachary Bittinger, MD, 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 typically harmless, so in most cases, they’re not a cause for concern. The accompanying symptoms can tell you a lot about what’s causing the discomfort, though. Read on to understand more about what’s causing your hiccups to hurt so much and when to visit a doctor.
Esophageal Irritation
Conditions like esophagitis, a disorder that causes swelling and inflammation of the esophagus, can trigger painful hiccups since the esophagus passes through the diaphragm on its way to the stomach, Dr. Ungerleider says. Trouble 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 of esophageal irritation that can lead to painful hiccups, per Dr. Ungerleider? Swallowing sharp food such as chips, popcorn, nuts, seeds, or hard taco shells.
Gastroesophageal Reflux Disease
Gastroesophageal reflux disease, also known as GERD, is a common cause of pain in the chest, and it’s usually accompanied by a burning sensation while lying down or after eating and a sour taste in your mouth. However, because GERD occurs when stomach acid repeatedly flows back into the tube connecting 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 Exercise
Believe it or not, heavy exercise can lead to overuse or strain of the diaphragm, leading to uncomfortable hiccups, Dr. Ungerleider says. If you’re a high-level athlete, Dr. Bittinger says your diaphragm may also be stronger and could spasm more powerfully, in turn, causing painful hiccups. Fortunately, rest and relaxation can ease strain and calm symptoms.
Chest or Rib Pain
Injuries, inflammation, and/or muscle strain in the chest or ribs can make the spasms from your hiccups more noticeable and painful, Dr. Ungerleider says. This may be especially common if you have a persistent cough, she 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.
Abdominal Distension
An overfull stomach (AKA abdominal distension) from overeating, gas, or constipation can stretch the diaphragm and lead to painful hiccups, Dr. Ungerleider says. It’s often accompanied by bloating, visible swelling, and occasional nausea, per the Cleveland Clinic. If your symptoms get worse, persist for more than a few days, or come with a fever, vomiting, or blood in your stool, it’s time to check in with 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 phlegm-producing cough, fever, chills, shortness of breath, and chest pain, so visit 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 fever reducers may be prescribed, per the Mayo Clinic.
Neurological Disorder
“Certain neurological disorders and conditions like stroke, multiple sclerosis, or traumatic brain injuries can disrupt the neural pathways controlling the diaphragm, leading to chronic or painful hiccups,” Dr. Ungerleider says. Treatment of a neurological disorder varies on the condition and severity, so talk with your doctor about treatment and possible medication to manage symptoms.
How to Get Rid of Hiccups
There isn’t a so-called “cure” for hiccups, but here are some simple remedies worth trying, per Dr. Bittinger and Dr. Ungerleider.
- Hold your breath: Taking a deep breath and holding it for five to 10 seconds may reset your diaphragm and squash hiccups.
- Drink water: Slowly sipping cold water can help stimulate the vagus nerve and stop painful hiccups.
- Stimulate the back of your throat: Gargling with cold water or gently swallowing may activate nerves that control hiccups to ease symptoms.
- Apply pressure: Gently press on your diaphragm or pull your knees to your chest to relax the hiccup-inducing muscle.
- Try the Valsalva maneuver: Exhaling while closing your mouth and pinching your nose stimulates the vagus nerve, potentially stopping hiccups.
The 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 more than two days, or they’re followed by difficulty breathing, swallowing, or sleeping, it’s time to see a healthcare provider, Dr. Bittinger says.
Additionally, if your symptoms worsen or are accompanied by chest pain, severe abdominal pain, fever, or unexplained weight loss, it may indicate an underlying medical issue, so Dr. Ungerleider recommends visiting your doctor for a full exam and medical workup.
Andi Breitowich is a Chicago-based freelance writer and graduate from Emory University and Northwestern University’s Medill School of Journalism. Her work has appeared in PS, Women’s Health, Cosmopolitan, and elsewhere.
