Experiencing mid-back pain when coughing is common, ranging from mild discomfort to sharp sensations. This pain often results from the sudden, forceful muscle contractions in the chest and abdomen during a cough, which stress the back. Understanding its causes is the first step in addressing the symptom.
Common Reasons for Pain
Muscle strain or overuse frequently underlies mid-back pain when coughing. The vigorous action of coughing generates rapid pressure changes within the chest and abdominal cavities, putting strain on the intercostal muscles located between the ribs and other core muscles that support the spine. Prolonged or forceful coughing, often seen during respiratory illnesses, can lead to muscle soreness or inflammation in these areas, causing discomfort that radiates to the middle back.
Another common cause involves issues with the rib joints or surrounding structures. Conditions like costochondritis, which is inflammation of the cartilage connecting the ribs to the breastbone, or minor rib subluxations (where a rib shifts slightly out of alignment) can cause pain that intensifies with the sudden movements of coughing. Ligament sprains in the thoracic spine, the middle section of your back, can also contribute to this pain. These connective tissues can be stretched or injured by the forces exerted during a strong cough.
Minor inflammation of the pleura, the thin membranes surrounding the lungs, or the airways themselves can also lead to referred pain in the mid-back when coughing. While the primary issue is in the respiratory system, the irritation can manifest as discomfort in the back due to shared nerve pathways. Spinal alignment issues, such as scoliosis or kyphosis, can also make the spine more susceptible to discomfort during coughing due to existing stress on specific spinal areas.
Potential Serious Causes
Less commonly, mid-back pain during coughing can signal more serious underlying medical conditions that warrant attention. Pleurisy, an inflammation of the pleura, causes sharp chest pain that worsens with deep breaths and coughing, and this pain can sometimes be felt in the back. Severe respiratory infections like pneumonia or bronchitis can also lead to back pain, as the inflammation in the lungs and airways increases the effort required to cough, causing prolonged muscle tension and exacerbating discomfort.
Vertebral compression fractures, particularly in older adults or individuals with osteoporosis, can cause sudden and severe back pain that is intensified by coughing. These fractures occur when one of the vertebrae in the spine collapses. A thoracic disc herniation or bulge, where the soft inner part of a spinal disc pushes out and irritates nearby nerves, can also cause sharp or radiating middle back pain that is aggravated by the pressure from coughing.
Shingles, caused by the varicella-zoster virus, can manifest as nerve pain in the back before the characteristic rash appears, and this pain may be made worse by coughing. Kidney infections or kidney stones can also refer pain to the back, sometimes accompanied by other symptoms like fever or urinary changes, and this pain might be aggravated by the body’s movements during a cough.
When to Consult a Doctor
Seeking medical attention is advisable if mid-back pain while coughing is accompanied by certain warning signs. These include the presence of fever, chills, or night sweats, which can indicate an infection. Shortness of breath, chest pain, or wheezing alongside the back pain are also concerning symptoms that warrant immediate evaluation.
Consult a doctor if you experience any of the following:
- Coughing up blood or discolored mucus.
- Severe, worsening, or persistent back pain despite home care.
- Numbness, tingling, or weakness in the arms or legs.
- Unexplained weight loss.
- A history of cancer, osteoporosis, or recent trauma.
Home Care for Relief
For mid-back pain caused by common, less serious issues, several home care strategies can offer relief. Rest is important, and avoiding activities that aggravate the pain can allow strained muscles to recover. Applying heat or cold packs to the affected area can help manage discomfort; heat can relax muscles, while cold can reduce inflammation.
Several home care strategies can offer relief:
- Use over-the-counter pain relievers, such as NSAIDs (ibuprofen or naproxen) or acetaminophen, to reduce pain and inflammation.
- Perform gentle stretching exercises, if pain allows, to improve flexibility and reduce muscle stiffness.
- Maintain good posture, especially when coughing, to minimize strain on back muscles.
- Stay hydrated and use steam inhalation to loosen mucus and soothe airways, potentially reducing coughing intensity and frequency.