To most people, hiccups are nothing more than a passing nuisance or an embarrassing “hic” at an inopportune time. But hiccups that last for more than 48 hours can be uncomfortable and a sign of another medical problem.

Hiccups are a sudden contraction of the diaphragm, the muscle at the base of the lungs that helps us breathe. These spasms are believed to occur when the phrenic or vagus nerves that are responsible for signals between the brain and the diaphragm become irritated. When you hiccup, your diaphragm contracts and the glottis (top of the windpipe) closes, which causes the “hic” sound.

Here are some natural ways to ease frequent hiccups…

Self-massage. Massage the front part of the neck and the chest area right below the collarbone for five minutes when you get the hiccups. This can help reduce irritation of the phrenic nerve.

Consider taking Nux vomica. This homeopathic remedy is known to stop the rapid contraction of the diaphragm, especially when hiccups are accompanied by belching after a large meal. Take two 30C pellets every 15 minutes for up to six doses.

See a chiropractor if you frequently get the hiccups. A chiropractor can adjust the neck at the C3 to C5 positions on the spine (the third to fifth vertebrae down from the head) or massage the neck in this area. This is the origin of the phrenic nerve, which feeds nerve impulses to the diaphragm. The adjustment or massage may calm the nerve and prevent hiccups.

Getting to the root of the problem. If you still have persistent hiccups after having tried the remedies above, see a doctor. Hiccups often occur at night in people who have sleep apnea, a disorder in which sleep is interrupted because breathing stops. Hiccups also can be caused by nerve damage from a sore throat or gastroesophageal reflux that affects the nerves of the diaphragm. Damage to the central nervous system, either from a stroke, a tumor or traumatic brain injury, also can cause hiccups. A doctor can help you determine and treat the root cause.