Why does my back hurt when I sneeze or cough?

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Written By Dr. Marcus Yu Bin Pai

MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

Why I have back and neck pain when I cough or sneeze?

The reasons for this pain can include the violent motion of coughing or sneezing, which causes a quick, short, and sharp contraction of the muscles. If there are existing injuries, coughing or sneezing can irritate those injuries further.

Additionally, sneezing can increase pressure in the abdomen, potentially putting more pressure on injured discs in the back. This increased pressure can cause a shooting pain down the legs or in the back. To avoid worsening the pain, try to keep yourself upright when sneezing and avoid throwing yourself forwards.

If you’re experiencing issues due to sneezing or coughing, it’s crucial to seek expert advice rather than trying to manage the pain on your own. If the pain has been going on for more than a couple of weeks, it’s essential to consult a professional to help address the problem and provide appropriate treatment.

Low Back Pain

Low back pain can be triggered or exacerbated by coughing, and if you’ve ever experienced this, you’re not alone.

In this article, we’ll explore why coughing can cause low back pain and how to prevent or minimize its effects on your spine.

Different Types of Low Back Pain

degenerative disc disorder

Not all low back pain is the same, and it can be triggered by different factors. There are three primary categories of low back pain:

  1. Flexion dysfunction: This type of low back pain is caused by flexion movements, such as maintaining a flexed posture, repeated flexion over time, or lifting heavy objects with a flexed spine.
  2. Extension dysfunction: The opposite of flexion dysfunction, extension dysfunction occurs when movements or positions involving spine extension (e.g., standing, walking, squatting with an extended spine) exacerbate or cause low back pain.
  3. Compression dysfunction: This type of low back pain is caused by compression forces acting on the spine, even without any added weight. Gravity compresses the spine, and if this pressure irritates your back, you have compression dysfunction.

How Coughing Affects Your Spine:

Coughing typically causes a subtle spinal flexion movement, as the abdominals engage and act as flexors of the spine. People with flexion dysfunction are more likely to experience low back pain when coughing, as their pain is triggered by flexion movements.

For those with extension dysfunction, coughing-induced flexion might actually relieve some pressure from the irritated spinal tissue.

However, those with compression dysfunction could experience increased pain when coughing due to the strong contraction of torso muscles causing more compression on the spine.

Tips to Prevent Low Back Pain When Coughing

Depending on the type of low back pain you have, there are different strategies to prevent coughing from causing or exacerbating your pain:

  1. Flexion dysfunction: Maintain a tall posture with a slight extension and cough from this position. If you’re sitting down, place a hand behind your back to support the extension, lean back, and then cough.
  2. Compression dysfunction: Create length in your spine by placing your hands on your hips, pushing up, and allowing your shoulders to shrug. Cough from this position, which will minimize or eliminate the compression on irritated spinal tissues.

Identifying the Root Cause of Your Low Back Pain

chronic pain spine flare up

If you’re unsure about the root cause of your low back pain, consider taking an assessment designed to help identify whether you have flexion, extension, or compression dysfunction.

This assessment consists of a series of tests and questions to help you determine the movements that irritate your spine and how to avoid them. By addressing the root cause, you can work towards healing your spine and preventing future irritation.


Coughing can irritate the spine and cause low back pain, especially for those with flexion or compression dysfunction.

By understanding the type of low back pain you have and employing strategies to minimize the impact of coughing on your spine, you can work towards preventing or alleviating low back pain caused by coughing.

Remember that seeking professional advice from a healthcare provider is essential for proper diagnosis and treatment.

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MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

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