Experiencing lower left back pain when coughing can be an uncomfortable sensation. This common symptom often prompts individuals to understand its origins and potential implications. While frequently linked to muscle strain, this pain can sometimes point to deeper underlying issues that warrant medical attention.
Why Coughing Worsens Back Pain
Coughing is a reflex involving coordinated muscle contractions throughout the body, including the diaphragm, abdominal muscles, and back. This action generates a sudden increase in intra-abdominal pressure, forcefully expelling air from the lungs. This pressure then transmits to the spinal column, placing temporary but significant strain on the discs and vertebrae in the lumbar region.
Muscle contractions also cause sudden movements and spinal compression. This exacerbates existing conditions by pressuring irritated nerves or compromised spinal structures. Coughing does not cause new back problems but intensifies pain from existing issues.
Potential Reasons for the Pain
Lower left back pain that worsens with coughing can stem from a variety of medical conditions, primarily involving musculoskeletal or neurological structures, but sometimes also organs like the kidneys or lungs. Musculoskeletal issues are a frequent cause, with muscle strains being among the most common.
Excessive or repetitive coughing can strain the muscles in the back, leading to localized discomfort, stiffness, or spasms. Ligament sprains, which involve stretched or torn ligaments connecting bones, can also cause pain that intensifies with the sudden pressure from a cough.
Spinal disc problems are another significant contributor to this type of pain. A herniated disc occurs when the soft inner material of a spinal disc pushes through its tougher outer layer, potentially pressing on nearby nerves. Similarly, a bulging disc can irritate nerve roots, and the increased intra-abdominal pressure from coughing can exacerbate this compression, leading to sharp, radiating pain, often down the leg (sciatica). Facet joint irritation, which affects the small joints connecting vertebrae, can also cause localized pain that may worsen with movements like coughing, especially if the joints are inflamed or arthritic.
Nerve compression, or radiculopathy, frequently results from these spinal issues. When a nerve root exiting the spinal column is pinched or inflamed, the sudden movements and pressure changes during coughing can intensify the pain, which may radiate along the nerve’s path. Spinal stenosis, a narrowing of the spinal canal, can also put pressure on nerves, and coughing can further induce this compression, increasing discomfort.
Beyond spinal issues, conditions affecting organs can present as referred pain in the lower left back and be aggravated by coughing. Kidney stones, hard deposits that form in the kidneys, can cause severe back pain that may worsen with movement or pressure, including coughing. Kidney infections (pyelonephritis) are another possibility, typically presenting with symptoms like fever, pain when urinating, and lower back pain.
Respiratory conditions, such as pleurisy (inflammation of the lung lining) or pneumonia, can also cause referred back pain that intensifies with deep breaths or coughing fits. While less common, certain conditions in females like endometriosis, or gastrointestinal issues such as diverticulitis, can sometimes cause referred lower abdominal or pelvic pain that may be exacerbated by the pressure from coughing.
When to Seek Medical Attention
Recognize “red flag” symptoms indicating a need for prompt medical evaluation. If lower left back pain is severe, persistent, or worsening despite rest, see a doctor.
Seek immediate medical attention if pain accompanies fever, chills, or unexplained weight loss, suggesting infection or other serious conditions. New or worsening numbness, tingling, or weakness in the leg or foot may signal nerve compression requiring urgent assessment. Loss of bladder or bowel control necessitates immediate medical care.
Other concerning signs include pain following a significant injury or trauma, like a fall. If back pain occurs with difficulty breathing or chest pain, it could indicate respiratory or cardiac issues. Any throbbing abdominal pain combined with back pain should also be evaluated.
Managing and Treating the Discomfort
Managing lower left back pain worsened by coughing involves self-care and professional medical treatments. Resting the back and avoiding aggravating positions provides relief. Applying ice reduces inflammation, followed by heat to relax muscles and promote blood flow. Over-the-counter pain relievers, such as NSAIDs, may reduce pain and inflammation.
Gentle stretching eases muscle tension and improves flexibility. Good posture, especially when sitting or standing, reduces back strain. When coughing, “braced coughing” (pushing hands against thighs or hugging a pillow) supports the trunk and lessens back strain. Staying well-hydrated is important, particularly if coughing is due to respiratory issues, as it helps thin mucus.
For persistent or severe pain, medical treatments may be necessary. Physical therapy is often recommended, involving exercises to strengthen core and back muscles, improve spinal support, and enhance flexibility. Manual therapy and other techniques may alleviate muscle spasms. Prescription medications, such as muscle relaxants or stronger pain relievers, might be prescribed.
In some cases, injections like epidural steroid injections (ESIs) deliver anti-inflammatory medication directly around spinal nerves to reduce inflammation and pain, particularly for herniated discs or radiculopathy. For severe disc issues or structural problems unresponsive to conservative treatments, surgical intervention, such as a discectomy, may be considered. If pain relates to kidney infections, antibiotics are the primary treatment, with hydration. Respiratory causes require specific treatment for the underlying lung condition.