There is no cure for asthma, but treatment and a written asthma action plan can help you manage it. The National Heart, Lung, and Blood Institute (NHLBI) says so plainly. (NHLBI, Asthma) For moderate to severe asthma, treatment usually has four parts that work together: medicines prescribed by your doctor, avoiding your triggers, a written action plan, and follow-up visits where the plan is adjusted until your symptoms are controlled. Breathing rehab sits next to those parts, not in place of them. This page explains each part using NHLBI, MedlinePlus and the American Lung Association, and it is clear about where Bloom Medical Group does and does not fit.
How is asthma treated?
The American Lung Association says that a variety of medicines can help control asthma, and that regular healthcare and an action plan are important parts of treatment. (American Lung Association, Asthma Treatment) MedlinePlus describes the same pattern: you work with your health care provider to create a treatment plan, which includes strategies to avoid triggers, quick-relief medicines and control medicines. (MedlinePlus, Asthma)
NHLBI adds that your healthcare provider may adjust your treatment until your asthma symptoms are controlled. (NHLBI, Asthma Treatment and Action Plan) That adjusting is the reason follow-up visits matter. A plan that worked last year may not fit this year.
Medicines are prescribed and changed only by your own doctor. Bloom does not prescribe asthma medicine. The next section explains what doctors commonly use, so you can ask better questions at your visit.
What medicines do doctors use for moderate to severe asthma?
Quick-relief (reliever) medicines
NHLBI says quick-relief medicines, or relievers, help prevent or ease symptoms during an asthma attack. (NHLBI) MedlinePlus advises carrying your inhaler with you at all times. (MedlinePlus, Asthma) It also says to tell your provider if you are using quick-relief medicines twice a week or more. (MedlinePlus, Asthma) Needing a reliever that often is worth a conversation, because it may mean your asthma is not well controlled.
Long-term control (controller) medicines
Control medicines work differently. The American Lung Association says they reduce the swelling and inflammation in your airways and prevent symptoms, and that you need to take them every day, even when you feel well. (American Lung Association, Understand Your Asthma Medication) Many are inhaled corticosteroids. The same page notes that corticosteroid pills are usually used for short periods in special circumstances, such as when symptoms are getting worse.
The American Lung Association also describes long-acting bronchodilators, which it says should not be used for quick relief and are only recommended when combined with an anti-inflammatory asthma medicine. (American Lung Association) If you are not sure which of your inhalers is a reliever and which is a controller, ask your prescriber or pharmacist to label them for you.
Add-on treatments when asthma is hard to control
When standard treatment does not control asthma, doctors have other options. The American Lung Association lists anticholinergics, which are typically used together with an inhaled corticosteroid, and biologics, which it describes as add-on medicines for moderate to severe asthma that is not well controlled with standard therapy and are given by shot or IV in a doctor’s office. (American Lung Association) NHLBI says biologics, such as benralizumab, may help with asthma that is difficult to control. (NHLBI)
MedlinePlus notes that for some adults with uncontrolled severe asthma, a provider may suggest bronchial thermoplasty, a procedure that uses heat to reduce airway muscle tightening, and that it carries risks to discuss with a provider. (MedlinePlus, Asthma) Whether any of these fit you is a decision for you and your doctor.
What goes in an asthma action plan?
NHLBI describes an asthma action plan as a written treatment plan that covers five things. (NHLBI)
- How to identify allergens or triggers to avoid.
- How to know if you are having an asthma attack and what to do.
- Which medicines to take and when to take them.
- When to call your provider or go to the emergency room.
- Whom to contact in an emergency.
MedlinePlus adds that a plan should explain how to recognize when your asthma is getting worse, what to do and when to contact your provider. (MedlinePlus, Asthma) If you do not have a written plan, or yours is missing any of the five items, ask for one at your next visit. See also our guide to what to do when you feel short of breath.
How do you cut down on asthma triggers?
MedlinePlus defines an asthma trigger as something that can set off or worsen your asthma symptoms. (MedlinePlus, Asthma) It groups them this way:
- Allergic triggers, such as dust mites, mold, pets, pollen and pest waste.
- Nonallergic triggers, such as cold air, certain medicines, household chemicals, infections like colds and the flu, outdoor air pollution and tobacco smoke.
- Work-related triggers (occupational asthma), from chemicals or dusts at work, and exercise.
MedlinePlus also says triggers may be different for each person and can change over time. That is why your action plan has a place to list yours. The American Lung Association says managing asthma includes reducing triggers, keeping track of your symptoms and managing stress. (American Lung Association) MedlinePlus lists steps such as allergy-proof bedding covers, low indoor humidity and unscented cleaning products, and says eliminating tobacco smoke from the home is the single most important thing a family can do to help someone with asthma. (MedlinePlus)
Tracking your breathing with a peak flow meter
MedlinePlus describes a peak flow meter as a simple device that measures how quickly you can move air out of your lungs. It says peak flow values of 50% to 80% of your best results are a sign of a moderate asthma attack, and numbers below 50% are a sign of a severe attack. (MedlinePlus, Asthma) Ask your doctor whether a peak flow meter belongs in your plan and what your personal best number is.
When should you get emergency help for an asthma attack?
NHLBI says to use your reliever inhaler as soon as you start to have symptoms, and to follow your asthma action plan to know what to do and when to call 911. It says to call 911 if your medicines are not relieving your symptoms during an asthma attack or if breathing is still very hard, and to go to the emergency room if symptoms do not go away soon after taking your at-home medicines. (NHLBI, Asthma Attack)
MedlinePlus says to go to the emergency room or call emergency medical services right away if you have extreme difficulty breathing, a bluish color to the lips and face, or breathing that temporarily stops. (MedlinePlus, Asthma) Do not wait for a rehab session or an appointment when you are in that situation.
Where does breathing rehab fit in asthma care?
Rehab is not a medicine, and it does not replace one. The American Thoracic Society describes pulmonary rehab as a treatment program of individualized exercise, education and support, and lists asthma among the conditions it can help. (American Thoracic Society, Pulmonary Rehabilitation) In practice it is where many people learn the pieces that a short doctor visit rarely has time for: how to pace activity, how to breathe during exertion, and how to use their plan.
The research on one core part of rehab, exercise, is reassuring for people with stable asthma. A Cochrane review of physical training for asthma included 21 studies with 772 participants. Physical training improved maximum oxygen uptake by a mean of 4.92 mL/kg/min (95% confidence interval 3.98 to 5.87; 8 studies, 267 participants). There was no significant change in lung function measures such as FEV1, and four of the five studies that measured health-related quality of life reported a statistically and clinically significant improvement. The reviewers found training was well tolerated, with no adverse effects reported. They concluded that people with stable asthma should be encouraged to take part in regular exercise training, without fear of symptom exacerbation. (Carson KV, et al. Cochrane Database Syst Rev. 2013, CD001116)
Read that carefully. It studied exercise training in people whose asthma was stable, not whole rehab programs, and it did not find that exercise raises lung function numbers. It supports staying active as part of care. It does not show that rehab controls asthma. For how rehab applies when asthma is moderate to severe, see pulmonary rehab for severe asthma and the benefits of pulmonary rehab.
Bloom Medical Group provides one-on-one virtual pulmonary rehab, live by video, with sessions run by licensed respiratory therapists and clinical exercise physiologists, billed to commercial insurance. It is built for adults with COPD, moderate to severe asthma, ILD or long COVID. Bloom does not prescribe or change asthma medicines. Your own doctor stays in charge of those, and rehab works alongside the plan your doctor gives you. You will need a referral from the doctor treating your lung condition, and our pages explain how to get a referral and whether insurance covers pulmonary rehab.
A skill to try: check your action plan against the five points
You can do this in five minutes with your plan in hand. Our companion video walks through it.
- Find your written plan. If you do not have one, make a note to ask your doctor for one.
- Check that it lists your triggers and how to avoid them.
- Check that it says how to tell you are having an asthma attack and what to do.
- Check that it names each medicine, when to take it, and which is your reliever.
- Check that it says when to call your provider or go to the emergency room, and who to contact in an emergency.
Bring any gaps to your next visit. Keep a copy where you can find it fast, and make sure the people you live with know where it is.
Frequently asked questions
Treatment usually combines medicines prescribed by your doctor, avoiding triggers, and a written asthma action plan. NHLBI says your provider may adjust treatment until your symptoms are controlled. The American Lung Association lists add-on options such as anticholinergics and biologics for asthma that is not well controlled with standard therapy.
NHLBI says quick-relief medicines, or relievers, help prevent or ease symptoms during an asthma attack, while controller medicines are taken daily to help prevent attacks and control symptoms. The American Lung Association says you need to take control medicines every day, even when you feel well.
NHLBI says there is no cure for asthma, but treatment and an asthma action plan can help you manage the condition.
NHLBI describes it as a written treatment plan that covers how to identify triggers, how to know if you are having an attack and what to do, which medicines to take and when, when to call your provider or go to the emergency room, and whom to contact in an emergency.
The American Thoracic Society lists asthma among the conditions pulmonary rehab can help. A Cochrane review of 21 studies found that physical training improved fitness in people with stable asthma and was well tolerated, with no change in lung function measures. Rehab works alongside your medicines and does not replace them.
No. Your own doctor prescribes and adjusts your medicines. Bloom provides one-on-one virtual pulmonary rehab, live by video, with licensed respiratory therapists and clinical exercise physiologists, billed to commercial insurance. You can call 1-866-972-8228 to check your plan.
NHLBI says to call 911 if your medicines are not relieving your symptoms during an asthma attack or if breathing is still very hard. MedlinePlus says to get emergency help right away for extreme difficulty breathing, a bluish color to the lips and face, or breathing that temporarily stops.
Next step
Not sure whether rehab fits you? Take our free 2 minute lung health assessment.
Ready to find out if you qualify? Call Bloom Medical Group at 1-866-972-8228 or fill in the see if you qualify form. One-on-one virtual pulmonary rehab with licensed respiratory therapists and clinical exercise physiologists, billed to commercial insurance.
This article is for education only and is not medical advice. Talk with your doctor about what is right for you.
Sources
- NHLBI. Asthma
- NHLBI. Asthma Treatment and Action Plan
- NHLBI. Asthma Attack
- MedlinePlus. Asthma (medical encyclopedia)
- MedlinePlus. Asthma (health topic)
- American Lung Association. Asthma Treatment
- American Lung Association. Understand Your Asthma Medication
- Carson KV, et al. Physical training for asthma. Cochrane Database Syst Rev. 2013, CD001116
- American Thoracic Society. Pulmonary Rehabilitation (patient resource)
