Coughing causing back pain? Learn how to find relief

Winter weather often impacts our health, and this time of year means that many of us will catch a cough and feel under the weather for a few weeks. Coughing can be caused by many things, from the common cold and flu to COVID-19 and even seasonal allergies. As well as a scratchy throat and runny nose, there can be other uncomfortable side effects to a persistent cough, including back pain.

Coughing isn't much different from other physical activities like bending or lifting when it comes to affecting your lower back. When you cough, your body engages your core muscles—muscles in the center of your body that support posture, balance and movement. This can sometimes irritate muscles in your back and lead to discomfort and pain. The pressure created during coughing can make existing back conditions worse, especially if you’re already living with muscle strain, spinal disc issues or spinal instability.

How to manage back pain while you have a cough

A cough is your body's natural way of responding when you have a sore throat or an irritation. It's a reflex that keeps your airways clear so you can breathe properly. If you’re experiencing back pain because of coughing, there are ways to manage the discomfort at home.

• Taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen can reduce pain and inflammation.
• Hugging a pillow when you cough can help redistribute the force to your spine, which can be beneficial and temporarily relieve any back pain.
• Massaging the impacted areas of your back, using an ice pack, stretching or taking a hot bath or shower can also help temporarily ease the pain.
• Maintaining good posture while sitting or standing, wearing shock-absorbing shoes and sleeping on your back can also reduce some back strain as you recover from what is causing your cough.
• Strengthening your core muscles, including with the help of physical rehabilitation, can help mitigate back pain and prevent future muscle strains or injuries.

When to speak to a doctor about coughing and back pain

If you’re facing both back pain and a nagging cough, the key is to get to the root of the coughing problem. Coughs typically get better on their own, but if you are experiencing a persistent cough for more than three weeks, you should book an appointment with your primary care physician. Typically, once you recover from your cough, your back pain should also go away.

If your cough has caused any strain or worsened existing back pain, you may be referred to an orthopedic specialist.

“If persistent coughing is aggravating lower back conditions, the best treatment is to address the causes of the coughing,” said Ioannis Avramis, MD, an orthopedic spine surgeon on the medical staff at Baylor University Medical Center, part of Baylor Scott & White Health.

If your coughing has damaged your spine, your health team will consider conservative treatments.

"Typically, for diagnoses such as lumbar muscular strain, lumbar disc herniation and lumbar disc degeneration, the initial treatment is usually a mixture of anti-inflammatory medications and muscle relaxers, as well as core-strengthening physical therapy,” said Dr. Avramis.

If your back pain persists and these initial methods are not relieving any discomfort, your health care provider may consider more advanced methods.

“The next tier of treatments is advanced imaging, typically through an MRI, and pain management injections such as an epidural steroid injection or facet injection. Ultimately, if these treatments do not provide lasting improvement, surgical treatment is then considered,” said Dr. Avramis.

If your back pain is causing you to lose sleep or you experience numbness, tingling or incontinence, it’s important to see a spine specialist for care.

Unsure if you should see a spine specialist? Rate your pain through our 10-question assessment. Take the quiz.