Experiencing upper back pain when coughing is common. While often temporary, it can signal an underlying issue. Understanding the mechanics behind this pain and recognizing when to seek medical advice can help.
Understanding How Coughing Affects Your Back
Coughing is a complex reflex involving a forceful expulsion of air, placing significant strain on the body. This action requires the coordinated contraction of several muscle groups, including the diaphragm, intercostal muscles between the ribs, and abdominal muscles. As these muscles contract suddenly and powerfully, they create increased pressure within the chest and abdomen.
This pressure and muscular contractions exert considerable force on the thoracic spine, the middle section of your back. The sudden movement and pressure can strain the muscles and ligaments supporting the spine and rib cage. This mechanical stress can irritate tissues, leading to pain in the upper back region.
Common Causes of Upper Back Pain When Coughing
Upper back pain when coughing can stem from various sources, from muscle strain to respiratory or spinal conditions. Musculoskeletal issues, such as muscle strain or tension, are frequent culprits. Forceful or repetitive coughing can overwork back muscles, leading to micro-tears or inflammation. Poor posture can exacerbate this, placing uneven pressure on the spine and worsening existing discomfort.
Another musculoskeletal cause involves the ribs. Costochondritis, inflammation of the cartilage connecting ribs to the breastbone, can cause pain that radiates to the back and intensifies with coughing. Rib subluxation, a minor misalignment of a rib joint, can also lead to sharp back pain aggravated by deep breaths or coughs.
Respiratory conditions also cause upper back pain with coughing, as the lungs are in the back of the chest cavity. Infections like bronchitis or pneumonia cause inflammation in the lungs and airways, leading to persistent coughing. The inflammation and recurring cough strain surrounding muscles and tissues, causing upper back pain. Pleurisy, an inflammation of the lining around the lungs, can cause sharp chest pain also felt in the back, especially when breathing deeply or coughing.
Less commonly, spinal issues can be the source of pain. A herniated or bulging disc in the thoracic spine, though less frequent than in the lower back, can cause pain worsened by increased intradiscal pressure during a cough. This occurs when the soft inner part of a spinal disc pushes through its outer layer, potentially pressing on nerves. Vertebral compression fractures, particularly in older adults or individuals with osteoporosis, can also cause severe back pain that intensifies with coughing due to sudden compression on weakened bone.
Nerve compression in the thoracic region can also lead to upper back pain when coughing. A pinched nerve can be irritated or compressed by the mechanical force of coughing, causing radiating pain between the shoulder blades or along nerve pathways. Spinal stenosis, a narrowing of the spinal canal, can also induce nerve compression, with coughing further intensifying the pain.
When to Seek Medical Attention
While many instances of upper back pain from coughing resolve on their own, certain symptoms warrant medical attention. Persistent or worsening pain that does not improve with rest or home remedies should prompt a doctor’s visit. This is true if the pain is severe or sharp and intensifies over time.
Accompanying symptoms such as fever, unexplained weight loss, or night sweats could indicate an infection or other systemic issues. Shortness of breath, chest pain, or coughing up blood point to lung conditions, heart problems, or other health concerns. Numbness, tingling, or weakness in the arms or legs, or any changes in bowel or bladder function, suggest potential nerve involvement or spinal cord compression that needs immediate attention. If the pain began after a fall, injury, or traumatic event, a medical professional should assess for fractures or other injuries.
Relief Strategies and Home Care
For mild to moderate upper back pain associated with coughing, several home care strategies provide relief. Resting and modifying activities to avoid strenuous movements can reduce strain on affected muscles. Over-the-counter pain relievers, such as non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen, can help manage pain and reduce inflammation.
Applying heat or cold therapy to the painful area is beneficial. A heating pad can relax tense muscles and improve blood flow, while an ice pack can reduce inflammation and numb the pain. Gentle stretching exercises for the upper back and chest can alleviate muscle tension and improve flexibility. Maintaining good posture, even when coughing, can prevent additional strain on the spine and surrounding muscles.
Staying well-hydrated helps thin mucus, making coughs more productive and less harsh. Throat lozenges or a spoonful of honey can soothe an irritated throat, reducing cough intensity and frequency. For persistent coughs, discussing cough suppression techniques with a healthcare professional can minimize mechanical stress on the back.