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Asthma

Wheezing, coughing, chest tightness and shortness of breath when the airways swell and narrow — a long-term lung condition in children and adults that can be well controlled with the right plan.

Signs of a severe asthma attack — call 911 right away if you or the person you’re with (MedlinePlus):

  • has trouble walking or talking because it is so hard to breathe, or is hunching over;
  • has lips or fingernails that look blue or gray;
  • has skin at the chest or neck pulling (sucking) inward with each breath; or
  • is confused or less responsive than usual (MedlinePlus).

Also call 911 if the quick-relief (rescue) inhaler isn’t helping or breathing is still very hard after treatment (NHLBI). In a young child, call 911 if they seem drowsy, confused or troubled, have a blue tint to the skin or lips, or have a fast heartbeat (NHLBI). Make sure teachers, babysitters and other caregivers know these signs too (MedlinePlus).

Never stop or change a controller (daily) medicine without talking with your clinician (CDC) — controllers are meant to be taken even when you feel fine (MedlinePlus). No herb, supplement, adjustment or other complementary approach can treat an asthma attack or replace prescribed asthma treatment (NCCIH).

What is asthma?

Asthma is a long-term condition of the airways, the tubes that carry air in and out of the lungs. The airways can become inflamed and narrowed, which makes it harder to breathe (NHLBI). During an attack the lining of the airways swells, the muscles around them tighten, and mucus can build up (MedlinePlus, CDC). Common symptoms are wheezing (a whistling sound when you breathe out), coughing — especially at night or early in the morning — shortness of breath and chest tightness (NHLBI). Many people with asthma also have allergies such as hay fever or eczema, though some don’t (MedlinePlus); see our Allergies guide.

How common is it?

Asthma is one of the most common long-term diseases of childhood, and adults can have it too (CDC). In 2023 about 27.8 million people in the U.S. — about 8.4% — had asthma, including about 4.8 million children, and 3,624 people died from it (CDC).

What sets it off

Triggers differ from person to person (CDC). Common ones include tobacco smoke, dust mites, mold, pet dander, cockroaches and other pests, pollen, air pollution and wildfire smoke, colds, flu and other respiratory infections, strong chemicals or fragrances, cold air, exercise, and strong emotions (CDC, NHLBI). Some medicines, including aspirin and other NSAIDs, can trigger symptoms, and some people develop asthma from dusts or other substances at work (MedlinePlus).

How it’s diagnosed

Diagnosis starts with your symptoms and history. The main breathing test is spirometry, which measures how much air you can blow out and how fast, often before and after a quick-acting airway-opening medicine. Other tests can include peak-flow readings, “challenge” tests that check how sensitive your airways are, allergy tests, and a breath test for nitric oxide (FeNO) that can point to airway inflammation (NHLBI). Asthma is harder to diagnose in young children, who often can’t do spirometry; providers may rely on symptoms and sometimes try a few months of asthma medicine to see whether it helps (NHLBI, CDC).

Your asthma action plan

There is no cure, but asthma can be managed (NHLBI). Ask your provider to make a written asthma action plan with you. It lists your triggers and how to avoid them, which medicines to take and when, how to recognize and respond to an attack, and when to call your provider or go to the emergency room (NHLBI, MedlinePlus).

Two kinds of medicine

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) A written asthma action plan, daily controller medicine (usually an inhaled corticosteroid) plus a quick-relief inhaler, good inhaler technique, trigger control, recommended vaccines, and biologics or allergy shots for some people. Generic albuterol inhaler about $19–$31 with a discount card (about $100 average retail). Some makers cap many brand inhalers at $35 a month for eligible patients; Medicare Part D out-of-pocket costs are capped at $2,100 in 2026. Spirometry: cost estimate being researched. No cure, but treatment and an action plan help manage it. Controllers work gradually and must be taken even when you feel well.
Chiropractic Spinal manipulation has been tried for asthma, mainly in children. About $50–$200 a visit without insurance ($15–$75 with); first evaluations about $100–$250. Well-designed trials found it worked no better than a sham (fake) treatment, and reviews find no evidence that it helps asthma. Not a substitute for inhalers.
Acupuncture Needle treatments added to usual asthma care. About $125–$230 for a first visit and $90–$185 for follow-ups; community clinics about $50–$90. Limited, inconclusive evidence: one review found symptom improvement but no better lung function; a Cochrane review found no clear benefit over sham acupuncture. Never a replacement for asthma medicine.
Herbal medicine Various herbal formulas and supplements (such as vitamin D, omega-3s and probiotics) have been studied. Cost estimate being researched. No herbal product has been proven to help asthma. Some herbs, such as ephedra, are dangerous, and herbs can interact with asthma medicines. Never use them instead of inhalers.
Massage therapy Gentle massage, sometimes given at home by a parent at bedtime, alongside usual asthma care. About $60–$120 for 45–60 minutes with a private therapist, or $50–$90 at clinics, gyms and spas. A few small studies in children report better lung function and less anxiety, but the research is low quality and unconfirmed. Use for comfort, not as treatment.
MBHA Wellness Coach Cutting triggers at home, a smoke-free home and quitting support, wildfire-smoke plans, staying active, weight, breathing exercises, vaccine reminders, inhaler technique and school asthma plans. Cost estimate being researched. Quitline coaching at 1-800-QUIT-NOW is free. Supports — never replaces — medical care. Trigger control, quitting smoking and good inhaler habits help medicines work; breathing exercises may improve quality of life.

Approach 1 of 6

Conventional medicine (AMA)

Asthma care is built around a written action plan, the right mix of medicines, and avoiding triggers (NHLBI). U.S. care follows the federal asthma guidelines from the National Asthma Education and Prevention Program, last updated in December 2020 with 19 recommendations on six topics (NHLBI).

1. Medicines — by type, not dose

2. Inhaler technique

Medicine only works if it reaches your lungs, so learn how to use your inhaler correctly (NHLBI). The CDC has short videos, in English and Spanish, on using a metered-dose inhaler with and without a spacer (CDC). Bring your inhaler to appointments and ask your provider or pharmacist to watch you use it.

3. Controlling triggers at home

The 2020 guidelines recommend using one or more methods to cut exposure to indoor triggers (NHLBI), with a combination of steps for the specific things you’re sensitive to — mattress and pillow covers alone aren’t enough (NHLBI 2020 guide). See MBHA Wellness Coach below for practical steps.

4. Vaccines

5. Other treatments for some people

  • Allergy shots (subcutaneous immunotherapy) can help some people with allergic asthma (NHLBI); the 2020 update conditionally supports them as an add-on to standard medicine for people aged 5 and older whose asthma is controlled (NHLBI 2020 guide).
  • FeNO breath testing can help guide treatment or confirm a diagnosis in some people when it is unclear (NHLBI).
  • Bronchial thermoplasty, a procedure that uses heat to thin the airway muscle, may be considered for some adults with serious asthma when other treatments aren’t working, but it carries risks such as worsening asthma and lung infections (NHLBI); the 2020 update made a conditional recommendation against it (NHLBI 2020 guide).
  • Pregnancy: keeping asthma under control helps protect both parent and baby; talk to your provider before changing any medicine (NHLBI).

What it costs

  • Quick-relief inhalers: a generic albuterol inhaler was listed at about $19–$31 with a discount card, against an average retail price of about $100 (price listing: SingleCare); prices change.
  • $35 inhaler caps: in 2024 Boehringer Ingelheim and AstraZeneca capped what eligible patients pay for many of their inhalers at $35 a month, and GSK announced a similar cap (American Lung Association). Uninsured patients, or those whose pharmacy doesn’t take part, can sign up for a savings card on the maker’s website. People with Medicare or Medicaid can’t use these caps (American Lung Association, NBC News), though AstraZeneca’s AZ&Me program may help some Medicare patients (American Lung Association). Check the maker’s current terms for your inhaler.
  • Medicare Part D: once your out-of-pocket costs for covered drugs reach $2,100 in 2026, you pay nothing more for covered Part D drugs that year; “Extra Help” can lower costs for people with limited income (Medicare.gov).
  • Other help: talk with your care team about cost; each drug company offers patient assistance programs, and the American Lung Association’s Lung HelpLine (1-800-LUNGUSA) can help you find options (American Lung Association).
  • Spirometry and biologics: cost estimate being researched.

How well it works — what to expect

There is no cure, but treatment and an action plan help most people manage asthma (NHLBI). Controllers improve symptoms gradually (American Academy of Pediatrics) and need to be taken even when you feel OK (MedlinePlus). Waking at night with symptoms, or needing your reliever more than usual, are signs your plan needs a review (NHLBI).

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Some chiropractors have offered spinal manipulation for asthma, but the best research does not show that it helps. If you choose chiropractic care for another reason, keep using your asthma medicines exactly as prescribed.

What the research says

  • The key trial: in a 1998 study, 91 children with mild or moderate asthma who still had symptoms on usual medical care were randomly given either real or simulated (sham) chiropractic manipulation for four months. Both groups improved slightly, with no difference between them; the authors concluded that adding spinal manipulation provided no benefit (trial, New England Journal of Medicine).
  • Cochrane review: neither of the two chiropractic trials it found showed any difference between spinal manipulation and a sham procedure, and the reviewers concluded there is insufficient evidence to support manual therapies for asthma (Cochrane review, 2005).
  • A 2021 review by an international group of researchers, many from chiropractic colleges and universities, found no evidence that spinal manipulation helps non-musculoskeletal conditions, including childhood asthma (systematic review, Chiropractic & Manual Therapies). The NIH likewise notes that the only high-quality study did not show a benefit (NCCIH).

Safety

Temporary pain, stiffness or headache are common after spinal manipulation; serious side effects are rare (NCCIH).

What it costs

About $50–$200 a visit without insurance ($15–$75 with), and about $100–$250 for a first evaluation (MedicalCostInfo).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Acupuncture has a long history of use for asthma in China (Cochrane review), but the research is limited and the results are mixed. It is not a treatment for an asthma attack.

What the research says

In short: some people may feel better, but there is no good evidence that acupuncture improves how well the lungs work. Use it only alongside your prescribed treatment.

Safety

Acupuncture is generally safe with an experienced practitioner using sterile needles. Moxibustion can cause allergic reactions, burns and infections, and herbal patches can cause skin redness and itching (NCCIH).

What it costs

Private sessions run about $125–$230 for a first visit and $90–$185 for follow-ups; community clinics about $50–$90 a visit (The Pricer). Medicare covers acupuncture only for chronic low-back pain (The Pricer).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

Many herbs and supplements are sold for breathing problems, but none has been proven to help asthma. The NIH is clear: don’t substitute other approaches for the treatment your provider has prescribed, and talk with them before trying any supplement, because some can interact with asthma medicines (NCCIH).

Herbal medicines

  • A review of 26 studies of various herbal preparations found too little evidence to recommend any of them, and a review of 18 studies of East Asian traditional medicines couldn’t reach conclusions (NCCIH).
  • Herbs can have serious side effects and can interact with asthma medicines (NCCIH).

Ephedra (ma huang) is dangerous. It has been used traditionally for coughing, wheezing and congestion, but it has been linked to high blood pressure, heart attack, seizure, stroke and psychosis, even at relatively low doses. The FDA banned dietary supplements containing ephedrine alkaloids in 2004 (NCCIH).

Other supplements

  • Vitamin D: a 2023 Cochrane review found that supplements did not reduce the number of people having asthma attacks (NCCIH).
  • Omega-3 fatty acids: results are inconclusive; omega-3s may interact with blood thinners such as warfarin (NCCIH).
  • Probiotics: no clear effect on preventing asthma; in children with asthma the evidence is low quality and doesn’t show better control (NCCIH).
  • Vitamin C, selenium and soy isoflavones haven’t shown a clear benefit (NCCIH).
  • Homeopathy: the FDA has warned consumers not to rely on over-the-counter homeopathic asthma products, which haven’t been evaluated for safety or effectiveness (NCCIH).

Supplements must never replace your inhalers. Before you try any herb or supplement, talk with your clinician or pharmacist — especially for a child, during pregnancy, or if you take other medicines (NCCIH). We don’t list doses here.

Approach 5 of 6

Massage therapy

Massage may help some people with asthma relax, and a few small studies in children are encouraging — but the evidence is weak, and massage is never a substitute for asthma medicine.

What the research says

  • A 1998 study of 32 children had parents give either massage or relaxation therapy for 20 minutes at bedtime for 30 days. Younger children (ages 4–8) who had massage had less anxiety and better peak flow and other lung-function measures; in older children only one lung measure improved (study, Journal of Pediatrics).
  • A Cochrane review found only one small trial comparing massage with relaxation; it reported better lung function, but it was poorly reported and its results have not been confirmed (Cochrane review, 2005).
  • A 2011 trial of 60 children in Egypt found that nightly parent-given massage for 5 weeks, added to standard asthma treatment, improved some lung-function measures; the study was not blinded, and the authors called for larger trials (trial, J Altern Complement Med).
  • A 2017 review of 14 studies with 1,299 children, mostly of traditional Chinese massage, reported better lung function, but the studies had a high risk of bias (meta-analysis, Evid Based Complement Alternat Med).

Safety tips

  • The risk of harm from massage appears low; rare serious problems have mostly involved vigorous techniques such as deep-tissue massage (NCCIH).
  • Tell your therapist you have asthma and ask for fragrance-free oils and lotions — fragrances and certain chemicals can be asthma triggers (CDC). Keep your quick-relief inhaler with you.
  • Don’t use massage to put off seeing a provider about a health problem (NCCIH).

What it costs

About $60–$120 for 45–60 minutes with a private therapist, or $50–$90 at clinics, gyms and spas (CostHelper). Home massage from a parent, as in the studies above, costs nothing.

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

An MBHA Wellness Coach can help you turn your asthma action plan into everyday habits — fewer triggers at home, cleaner air, staying active, and being ready when symptoms flare.

Cutting triggers at home

  • Dust mites: wash bedding in hot water weekly, use dust-proof covers on pillows and mattresses, and vacuum weekly, ideally with a HEPA filter (EPA).
  • Mold: fix leaks promptly, clean mold off hard surfaces, and keep indoor humidity around 30–50% (EPA, CDC).
  • Pets: if a pet triggers symptoms, at least keep it out of the bedroom and off furniture, and consider a HEPA air cleaner (EPA). Trimming a pet’s fur won’t help (CDC).
  • Pests: store food in sealed containers, clean up crumbs and spills, and seal cracks; avoid sprays and foggers, which can themselves trigger attacks (CDC).
  • Gas stoves and wood smoke: vent fuel-burning appliances outdoors, use an exhaust fan over a gas stove, and keep wood stoves and chimneys inspected (EPA).
  • Cleaning products: keep the person with asthma out of the room and apply cleaner to a cloth instead of spraying it into the air (CDC).

A smoke-free home — and quitting

Secondhand smoke can trigger attacks and make them worse, so keep smoke out of your home and car (EPA). Vaping and secondhand vapor may also worsen symptoms (NHLBI). Quitting may improve lung function, reduce symptoms and improve treatment results for people with asthma (CDC). Call 1-800-QUIT-NOW for a free quit coach, who can also help you get quit-smoking medicines (CDC).

Wildfire smoke and air quality

Staying active

Don’t give up exercise because it can bring on symptoms — talk with your provider about the right activity level and medicines that help you stay active (NHLBI). For exercise-induced symptoms, a provider may suggest using your reliever before exercise; warming up and regular training can also help (NHLBI). Yoga, usually added to regular care, may bring small improvements in quality of life and symptoms (NCCIH).

Weight

Overweight or obesity can make asthma harder to manage, and even a small weight loss can help symptoms (NHLBI). A coach can help you set realistic food and activity goals.

Breathing exercises

Techniques such as the Buteyko method, the Papworth method, yoga breathing and diaphragmatic breathing have been studied. In adults, a 2020 Cochrane review of 22 studies with 2,880 people found they may improve quality of life and hyperventilation symptoms, but the effect on asthma symptoms was inconclusive and the evidence ranged from moderate to very low certainty (Cochrane review, 2020). For children there is not enough evidence to draw conclusions (Cochrane review, 2016). No harmful effects were reported (NCCIH). Breathing exercises are an add-on for comfort — never a replacement for your inhaler during symptoms.

Staying well

Asthma at school

Give a copy of your child’s asthma action plan to school staff and other caregivers (NHLBI), and make sure they know the emergency signs and when to call 911 (MedlinePlus). Watch for signs that a child’s asthma isn’t well controlled, such as more coughing at night, eating less, or being more tired or irritable (NHLBI).

Member stories

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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