Lower back pain when coughing is a common and often uncomfortable sensation. While it can be a temporary annoyance linked to a simple cold, this symptom can also indicate underlying issues within the spine and surrounding structures. Understanding its origins is important for effective relief.
How Coughing Affects Your Lower Back
Coughing involves a complex biomechanical process that significantly impacts the lower back. A forceful cough triggers a sudden, involuntary contraction of the abdominal and chest muscles, including the intercostal muscles between the ribs. This muscular effort rapidly increases intra-abdominal pressure, which then exerts considerable force on the spinal discs, ligaments, and muscles in the lumbar region.
This sudden pressure surge, combined with the body’s natural tendency to flex or bend forward during a cough, can place considerable strain on the lower back. If there are pre-existing vulnerabilities, such as muscle imbalances or spinal instability, the added force can exacerbate discomfort or trigger new pain. Even without underlying issues, the repetitive strain from prolonged or severe coughing can lead to muscle fatigue and an increased risk of injury.
Underlying Reasons for the Pain
Lower back pain that worsens with coughing can stem from various underlying conditions. Identifying the specific cause is important for effective management.
Muscle Strain or Sprain
One frequent cause is a muscle strain or ligament sprain in the back. Sudden, forceful movements from coughing can overstretch or tear muscle fibers or ligaments. This injury often results in immediate pain, soreness, limited range of motion, and sometimes muscle spasms in the affected area.
Herniated (Slipped) Disc
A herniated disc occurs when the soft, gel-like center of a spinal disc pushes through a tear in its tougher outer layer. The increased intra-abdominal pressure from coughing can push the disc further outward, potentially compressing nearby spinal nerves. This compression can lead to sharp, radiating pain that intensifies with each cough.
Sciatica
Sciatica is nerve pain that radiates down the leg, originating from compression or irritation of the sciatic nerve in the lower back. A herniated disc causes this compression, and the sudden pressure from coughing can worsen the pain, sending it further down the leg. Tingling or numbness in the legs or buttocks can accompany this radiating pain.
Spinal Stenosis
Spinal stenosis involves the narrowing of the spinal canal, which can put pressure on the spinal cord and nerves. Coughing can further constrict these narrowed spaces, intensifying symptoms such as pain, numbness, or tingling in the legs or buttocks. Individuals with this condition find relief when bending forward.
Facet Joint Dysfunction
The facet joints are small joints located between the vertebrae that allow for spinal movement. Irritation or inflammation of these joints can cause localized lower back pain. The jarring motion and increased pressure from coughing can aggravate these sensitive joints, leading to increased discomfort.
Respiratory Infections
Prolonged or severe coughing fits, common with respiratory infections like bronchitis or pneumonia, can lead to muscle fatigue and strain in the back. The continuous, forceful contractions of core and back muscles during persistent coughing can result in widespread muscle soreness. This type of pain subsides once the underlying infection and cough resolve.
Poor Posture
Chronic poor posture can make the lower back more susceptible to strain during activities like coughing. When the spine is not properly aligned, the muscles and ligaments are already under increased stress, making them more vulnerable to injury from the sudden forces generated by a cough. Maintaining good posture helps distribute these forces more evenly, reducing the risk of pain.
When to Seek Medical Advice
While lower back pain from coughing is often temporary, certain symptoms warrant prompt medical attention. These “red flags” can indicate more serious underlying conditions.
You should seek immediate medical help if your pain is accompanied by:
Fever, chills, or night sweats (potential infection).
Numbness, tingling, or weakness in legs or feet (nerve involvement).
Sudden loss of bladder or bowel control (cauda equina syndrome).
Pain after a significant fall or injury, or with a history of osteoporosis (spinal fracture).
Unexplained weight loss.
Severe, constant, or worsening pain that does not improve after a few weeks of self-care.
Managing and Treating the Pain
Managing lower back pain from coughing involves home care strategies and, when needed, professional medical treatments. The approach depends on the underlying cause and severity of the pain.
Home Care and Self-Management
For immediate relief, short-term rest can be beneficial, though prolonged bed rest is not recommended. Applying ice to the affected area for 15-20 minutes during the first 48 hours can help reduce inflammation and numb sharp pain. After this initial period, switching to heat therapy, such as a heating pad or warm bath, can relax tense muscles and improve blood flow.
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce both pain and inflammation. Practicing gentle stretching exercises, such as pelvic tilts or cat-cow stretches, can ease tension in the lower back.
Maintaining good posture, even while coughing, is important; try to avoid hunching over and instead brace yourself by holding onto a stable object or hugging a pillow across your chest to redistribute force. Strengthening core muscles through gentle exercises can also provide better spinal support and stabilize the trunk during coughing.
Professional Treatments
If home care measures do not provide adequate relief, a medical professional may recommend further treatments. Physical therapy is a recommendation, involving targeted exercises, manual therapy, and techniques to strengthen core muscles and improve spinal stability. Physical therapists can also teach proper body mechanics to reduce strain during daily activities, including coughing.
Prescription medications, such as muscle relaxants to alleviate spasms or stronger pain relievers, might be prescribed for more severe pain. In some cases, a doctor may suggest injections, such as epidural steroid injections, to reduce inflammation around compressed nerves.
Surgical intervention, such as a microdiscectomy to remove part of a herniated disc or a laminectomy to widen the spinal canal, is considered only in rare instances when conservative treatments have failed and a clear structural issue requires correction.