What You Need to Know About Restrictive Lung Disease

Medically Reviewed By Luke Davis, MD
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Restrictive lung disease refers to a group of conditions affecting the lungs’ ability to expand during breathing. When the lungs cannot expand fully, total lung capacity is reduced and breathing may become difficult. Restrictive lung disease is one of two major categories of lung disease. The other is obstructive lung disease, in which the lungs cannot fully expel air due to narrow or blocked airways.

Read on to learn more about restrictive lung disease including types, symptoms, treatment, and complications.

What are the types of restrictive lung disease?

A man trying to catch his breath
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There are two main types of restrictive lung disease: intrinsic and extrinsic. Experts classify lung diseases based on their causes and the areas of the body they affect.

Intrinsic restrictive lung diseases

Intrinsic restrictive lung diseases directly affect the lung itself. Inflammation of the lung tissues can cause tissue restriction. This impairs the lung’s ability to expand and take in air.

These diseases may be caused by a group of conditions known as interstitial lung diseases. Interstitial lung diseases cause inflammation and scarring in the lung tissue and can include:

  • idiopathic pulmonary fibrosis
  • sarcoidosis
  • hypersensitivity pneumonitis
  • silicosis
  • systemic sclerosis
  • pneumonitis resulting from certain medications such as:
    • nitrofurantoin
    • phenytoin
    • methotrexate
  • pneumonitis resulting from radiation therapy

Extrinsic restrictive lung diseases

Extrinsic restrictive lung diseases affect structures outside the lungs. They result from conditions such as obesity and neuromuscular disorders.

These conditions impair lung movement by affecting the:

  • chest wall
  • muscles
  • tissues
  • connections between bones in the chest cavity

Conditions that cause extrinsic restrictive lung diseases can include:

  • obesity
  • ascites
  • conditions affecting the pleura, the membrane that surrounds the lungs
  • neuromuscular disorders such as muscular dystrophy and polio
  • kyphoscoliosis

What are the symptoms of restrictive lung disease?

The symptoms of restrictive lung disease can vary depending on the underlying cause. However, most people experience progressive dyspnea, or difficulty breathing.

People with underlying interstitial lung disease also typically experience coughing and nail clubbing. Nail clubbing is where the tissues under the nail bed swell and cause the nail to curve down.

Additional symptoms may result from the lungs’ inability to draw in air and receive oxygen. These can include symptoms such as shortness of breath and fatigue.

How do doctors diagnose restrictive lung disease?

Doctors will typically use pulmonary function tests to diagnose restrictive lung disease. These tests evaluate your respiratory function by assessing a few different factors, including:

  • Lung capacity: This measures the total volume of air present in the lungs after a complete inhalation.
  • Diffusion capacity: This assesses your lungs’ ability to diffuse oxygen and carbon monoxide. This ability can be reduced in restrictive lung disease due to damaged lung tissues.
  • Respiratory muscle pressure: This assessment measures the strength of your breathing muscles. It can be useful for determining the effects of certain disorders such as muscular dystrophy.
  • Central and upper airway obstruction: This can help doctors determine whether or not you have any obstructions in your airways. It can be useful for ruling out obstructive lung disease.

In addition, doctors may order a chest radiograph or high-resolution CT scan to evaluate the lung structures for any scarring. They may also use blood tests to detect markers of inflammation or a stethoscope to listen for crackling sounds.

What are the treatments for restrictive lung disease?

Treatment for restrictive lung disease can vary depending on the cause. For example, someone with an autoimmune condition such as systemic sclerosis may need immunosuppressant drugs to manage symptoms.

In certain cases, a doctor may prescribe steroids to help relieve inflammation. Antifibrotic drugs may also help slow down the progression of scarring.

According to experts, pulmonary rehabilitation can improve lung function and relieve symptoms of intrinsic restrictive lung disease. This typically involves breathing and physical exercises to improve respiration.

In the most severe cases of restrictive lung disease, acute loss of the lungs’ diffusing capacity may occur. In these cases, lung transplantation may be necessary.

What is the outlook for someone with restrictive lung disease?

The outlook for someone with restrictive lung disease depends on the cause.

Some underlying conditions such as pleural effusion or certain types of pneumonia typically improve with medical treatment. Others such as idiopathic pulmonary fibrosis or systemic sclerosis are more serious and have reduced survival rates.

If you have received a diagnosis for restrictive lung disease, it is essential to determine the underlying cause. This can help improve your outcome and increase life expectancy.

What are the potential complications of restrictive lung disease?

Restrictive lung disease can lead to serious complications, including:

What are the risk factors for restrictive lung disease?

According to researchers, certain factors may increase your risk for developing restrictive lung disease, including:

  • Age: Older adults experience restrictive lung disease at higher rates.
  • Obesity: People with obesity are at a higher risk of developing restrictive lung conditions.
  • Smoking: Smoking can increase your risk for conditions that may contribute to restrictive lung disease. These include conditions such as idiopathic pulmonary fibrosis.
  • Environmental hazards: Inhaling pollutants or hazardous materials can increase your risk for lung inflammation and scarring.

Other frequently asked questions

Here are some other commonly asked questions about restrictive lung disease. Dr. Luke Davis has medically reviewed the answers.

What is the difference between restrictive lung disease and obstructive lung disease?

Restrictive lung disease affects the lungs’ ability to expand fully during inhalation. Obstructive lung disease makes it more difficult for the lungs to exhale air fully.

What is the life expectancy for someone with restrictive lung disease?

The life expectancy for someone with restrictive lung disease depends on the underlying cause. For example, someone with restrictive lung disease due to idiopathic pulmonary fibrosis has a median life expectancy of 3 to 5 years after diagnosis.

Those with less severe underlying conditions may have better outcomes and longer life expectancies.


Restrictive lung disease affects your lungs’ ability to expand fully during inhalation. Symptoms can include breathing difficulties and coughing.

Doctors diagnose restrictive lung disease using pulmonary function tests, imaging, and blood tests. In some cases, a surgical or bronchoscopic lung biopsy may be necessary.

Treatment depends on the underlying cause and may involve medications, pulmonary rehabilitation, or surgery.

Contact your doctor if you are experiencing difficulty breathing or other symptoms related to restrictive lung disease.

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Medical Reviewer: Luke Davis, MD
Last Review Date: 2022 Sep 6
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