Did you know that a single sneeze can generate a force of up to 100 miles per hour?
No wonder our bodies can react in unexpected ways.
That momentary jolt of can catch us off guard and cause some pretty strong back pain. Especially in cases where there's an existing problem.
In this article, we'll uncover the mysteries behind these painful sneezes and explore effective ways that I’ve used in my clinical practice to fix it.
So, sit up straight (spine supported, of course) and get ready to discover why your back seems to protest every time you unleash a mighty sneeze.
The Causes of Back Pain While Sneezing
You're not alone if you've found that back pain while sneezing can be quite alarming. One second you're fine. The next you're wondering how something as simple as a sneeze could trigger so much pain.
Our content director, Mark, once sneezed his way into seven straight days of back pain while rehabilitating a mild case of scoliosis. So the team here knows that the problem is serious.
Here are common causes plus what happens inside your body when this happens to you.
Why Does Sneezing Hurt Your Back Ribs?
Pain and discomfort associated with sneezing often affects the lower ribs. Here's why it happens:
Diaphragm contraction
The diaphragm, a dome-shaped muscle beneath the lungs, contracts forcefully during a sneeze. This contraction helps expel air from the lungs, creating that strong burst of air.
That forceful contraction of the diaphragm puts stress on the surrounding muscles and structures. Lower ribs included.
Rib movement:
When you sneeze, the rapid and forceful contraction of the diaphragm causes a sudden upward movement of the rib cage [1].
This movement puts strain on the muscles and ligaments that connect the ribs to the spine. If these structures are already weakened or injured, it can cause pain.
Poor posture
When sneezing, if you've got poor posture, the misalignment of the spine and ribs can make sneeze pain worse.
The additional strain placed on the muscles attached to the ribs during a sneeze can intensify discomfort, especially if you're not positioned straight. That's another good reason to maintain proper posture at your desk.
Can Coughing Cause Back Pain?
Yes, coughing can cause back pain in certain circumstances too. When you cough forcefully or repeatedly, it can put a strain on your muscles, ligaments, and spinal structures, which can lead to back pain. These health conditions include the following.
Respiratory infections
Coughing is a common symptom of respiratory infections such as bronchitis or pneumonia. These conditions can cause inflammation in the airways and lungs, and the resulting coughing can lead to back pain due to the strain on the muscles and tissues in the back.
Vertebral fractures
In rare cases, severe coughing can cause or worsen vertebral fractures, especially if you've got weakened bones (osteoporosis). These fractures can cause significant back pain during coughing or other movements.
Scoliosis
Scoliosis, is a condition characterised by an abnormal curvature of the spine, and coughing could make it worse. The curvature can put additional stress on the spinal structures, making them more susceptible to pain.
Costochondritis
Costochondritis is the inflammation of the cartilage that connects the ribs to the breastbone (sternum). Coughing can exacerbate costochondritis pain, resulting in back pain as well.
Obesity
Excess weight can put added stress on the spine and its supporting structures. When combined with the forceful motion of coughing, this can result in back pain too.
What Happens In Your Body During Sneezing-induced Back Pain
When you get back pain while sneezing, several processes occur in your body:
Nerve irritation
The movement of the ribs and the subsequent strain on the surrounding muscles can irritate nerves in the affected area [2]. This nerve irritation sends pain signals to the brain and pain follows.
Ligament and joint stress
The sudden movement and increased pressure can strain the ligaments and joints connecting the ribs to the spine [1]. This strain can cause inflammation and discomfort, contributing to the pain experienced during a sneeze.
Muscle strain
The intercostal muscles are found between your ribs. They play a role in expanding and contracting the chest during breathing. When you sneeze, these muscles contract forcefully to expel air. If the intercostal muscles are weak or overworked, sneezing can strain them and cause pain in the back.
Spinal disc pressure
Sneezing can also increase pressure on the spinal discs in the back. The forceful contraction of the muscles during a sneeze can temporarily increase pressure within the spinal column.
If there’s an underlying issue with the spinal discs, such as degeneration or herniation, the increased pressure during a sneeze can make the pain worse.
The Science Behind Sneezing And Its Connection With Back Pain
Have you ever wondered what exactly happens when you sneeze? It's a fascinating reflex that serves a crucial purpose for our bodies.
A sneeze is a sudden, forceful expulsion of air through the mouth and nose that typically includes a distinctive sound [1]. Irritants or stimuli in the nasal passages cause sneezing, which is a natural and involuntary response [2]. It’s our body's way of clearing the airways and removing potentially harmful particles.
How and Why Sneezing Happens
A five-step process is used to explain the phenomenon of sneezing.
- Irritation Detection: Specialised nerve endings in the nasal lining detect irritants such as dust, allergens, or viruses [3].
- Brain Signaling: When an irritant is detected, the nerves send signals to the brain's sneezing center, located in the medulla oblongata at the base of the brain [4].
- Preparatory Phase: The brain initiates a series of actions, including closing the eyes, taking a deep breath, and tensing certain muscles, to prepare for the sneeze [3].
- Forceful Release: The diaphragm contracts forcefully, pushing air out of the lungs, while the muscles of the chest, throat, and face rapidly contract to propel the air out [1].
- Expulsion of Irritants: The rapid release of air helps expel irritants from the nasal passages, providing relief and maintaining a healthy respiratory system.
The Connection To The Back
The diaphragm, a crucial muscle responsible for breathing, plays a central role in the sneezing process [5].
It contracts forcefully during a sneeze, generating the necessary pressure for the sudden expulsion of air. As the diaphragm contracts, it creates a domino effect within the body.
The forceful contraction can transmit stress to the surrounding muscles, ligaments, and structures, including the back area [2]. Specifically, sneezing-related back pain is often associated with the lower ribs and the muscles and ligaments that connect them to the spine [1].
How To Safely Sneeze And Minimise Back Pain
Fortunately, there are effective steps that I advise my patients to reduce the risk of triggering back pain during a sneeze. Especially if you’ve got a pre-existing back condition.
Maintain Good Posture
- Stand or sit with proper posture, keeping your spine aligned and shoulders relaxed.
- Avoid slouching or hunching over, as this can put unnecessary strain on your back [3].
Support Your Back
- Use a supportive chair with good lumbar support to maintain proper spinal alignment.
- Place a small pillow or cushion behind your lower back when sitting for extended periods to provide extra support [6].
Engage in Core Strengthening Exercises
- Strengthening your core muscles can help provide stability and support to your back, reducing the risk of pain during sneezing.
- Speak with a physiotherapist to learn safe and appropriate exercises for your back condition [1]. Especially if you have a pre-existing back problem.
Practice Controlled Breathing
- Take slow, deep breaths before and during a sneeze to help control the force and impact on your back [3].
- Avoid holding your breath or forcefully exhaling during a sneeze, as this can increase the pressure on your spine [2].
Be Mindful of Body Mechanics
- When you feel a sneeze coming on, brace yourself by gently hugging your abdomen and engaging your core muscles [4].
- This can help stabilise your spine and minimise the impact of the sneeze on your back.
Use Supportive Techniques
- Support your upper body by leaning against a wall or holding onto a sturdy object when you anticipate a sneeze [6].
- By providing external support, you can reduce the strain on your back during that sudden 100mph air explosion.
Seek Professional Advice
- If you’ve got a chronic or persistent back issue, consult with a healthcare professional or physiotherapist for personalised guidance and exercises [5].
- They can provide specific strategies and techniques tailored to your condition.
Remember, it's important to listen to your body and adapt these suggestions based on your individual needs and limitations.
If you continue to experience significant back pain while sneezing or if the pain worsens, consult a healthcare professional for further evaluation and appropriate management.
Treating Back Pain While Sneezing: Options and Approaches
Sneezing-related back pain can be frustrating, but the good news is that there are a number of treatment options available to reduce discomfort and encourage healing.
From natural remedies to pharmaceutical interventions and physical therapies, let's explore the different avenues you can explore for managing sneezing-induced back pain.
Natural Remedies and Self-Care
Hot and Cold Therapy
- When you experience sneezing-induced back pain, applying a hot compress or heating pad to the affected area for 15-20 minutes at a time can help relax muscles and improve blood flow [1].
- Alternatively, apply a cold pack wrapped in a thin towel to the painful area for 10-15 minutes. Cold therapy can help reduce inflammation and numb the area [2].
Rest and Gentle Movement
- Take short periods of rest to give your back a break and prevent further strain. Avoid prolonged bed rest, as it can lead to muscle stiffness and weakened muscles [3].
- Engage in gentle movement and light back stretching exercises to promote blood circulation and improve flexibility [4].
Pharmaceutical Interventions
- Over-the-Counter Pain Relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help manage pain and reduce inflammation.
- Prescription Medications: In some cases, stronger pain medications or muscle relaxants may be prescribed by a healthcare professional to provide temporary relief [1]. I shared more about painkillers and back pain here.
Physical Therapies
- Physiotherapy: A physiotherapist can provide a personalised treatment plan, including exercises, stretches, and manual therapies to address the underlying causes of back pain [3].
- Chiropractic Care: Chiropractors use manual adjustments and manipulations to restore proper spinal alignment and relieve pain [7].
- Massage Therapy: Massage techniques can help relax tense muscles, improve circulation, and promote healing in the affected area [4].
Other Modalities
- Acupuncture: This traditional Chinese medicine practice involves the insertion of thin needles into specific points to promote pain relief and balance the body's energy flow [7].
- TENS (Transcutaneous Electrical Nerve Stimulation): This therapy involves the use of low-voltage electrical currents to relieve pain by stimulating the nerves [2].
In some cases, a combination of treatments may be recommended to address sneezing-induced back pain effectively.
Red Flags For Back Pain & When To Speak With A Doctor
In my clinical experience, back pain during sneezing is often a temporary and benign issue. That means speaking to a doctor for your occasional sneezing-induced back pain is usually not required.
That said, there are certain circumstances where it's important to seek medical attention. If you have any of the following, it's recommended to consult with a healthcare professional to rule out more serious underlying conditions. I covered these more in my article about red flags associated with back pain.
Severe or Debilitating Pain
If your sneezing-induced back pain is severe and significantly impacts your daily activities, it's essential to speak with a doctor [1]. Intense, persistent pain may be a sign of a more serious issue that requires medical evaluation.
Persistent or Chronic Pain
If the back pain starting with an episode of sneezing persists for more than a few weeks, despite self-care measures and rest, consult with a healthcare professional [3]. Chronic pain could indicate an underlying condition that needs proper diagnosis and management.
Radiating Pain or Numbness
If the pain radiates down one or both of your legs, or is accompanied by numbness, tingling, or weakness, it may be nerve compression or a herniated disc [4]. Seek medical attention promptly to assess the condition and prevent further complications.
Bladder or Bowel Dysfunction
If you get difficulty controlling your bladder or bowel movements along with sneezing-induced back pain, it could be a sign of cauda equina syndrome, a rare but serious condition requiring immediate medical attention [4].
History of Trauma or Injury
If you’ve got a history of significant trauma or injury, such as a fall or car accident, it's important to consult with a healthcare professional [7]. They can evaluate any potential structural damage or spinal injuries that may need intervention.
Fever or Infection Symptoms
If you’ve got a history of fever or chills or notice signs of infection, such as redness, warmth, or swelling in the back area, it may also indicate an underlying infection that needs medical evaluation [1].
Progressive Worsening of Symptoms
If your back pain due to sneezing continues to worsen over time or is accompanied by unexplained weight loss, speak with a doctor [6].
Expert’s Advise On Back Pain Due To Sneezing
As an expert who treats back pain every day, I understand the concerns and discomfort that come with back pain due to sneezing. Here's the bottom line on what I advise my patients on this issue:
- Take it seriously: While sneezing-induced back pain is often harmless and resolves independently, paying attention to any persistent or severe pain is essential. Don't ignore it or dismiss it as a minor inconvenience, as it could be a sign of an underlying condition that requires medical attention.
- Seek professional evaluation: If your back pain while sneezing is persistent, severe, or accompanied by other concerning symptoms, it's crucial to see a doctor. They can conduct a thorough evaluation, diagnose the underlying cause, and provide appropriate tailored treatment options.
- Follow a comprehensive treatment plan: Depending on the cause of your sneezing-induced back pain, a comprehensive treatment plan may include a combination of therapies such as physical therapy, medication, and lifestyle modifications.
- Focus on prevention: Taking proactive measures to prevent back pain episodes during sneezing is key. This may involve practicing good posture, maintaining a healthy weight, staying active with regular exercise, and using proper lifting techniques.
Remember, the advice provided here is general, and individual cases will vary. It's always best to consult with a qualified healthcare professional who can provide personalised guidance and treatment based on your specific needs and circumstances.
Good luck.
References:
1. Healthline. What Causes Back Pain When You Sneeze? https://www.healthline.com/health/back-pain/back-pain-when-sneezing
2. Health Match. Lower Back Pain When Sneezing: What You Need To Know. https://healthmatch.io/lower-back-pain/lower-back-pain-when-sneezing#what-could-be-causing-lower-back-pain-when-you-sneeze
3. Elevate 360 Physiotherapy. Back Pain When Sneezing- Why & What to Do? https://elevatephysio.com.sg/back-pain-when-sneezing-why-what-to-do/
4. Alliance Physical Therapy Partners. Back hurts when you sneeze? Here's why and what to do about it. https://www.allianceptp.com/back-hurts-when-you-sneeze-heres-why-and-what-do-about-it
5. Dr. House. Back Pain When Sneezing: Causes and Treatment. https://drhouse.com/back-pain-when-sneezing/
6. One Body. Say Goodbye To Lower Back Pain From Sneezing. https://onebodyldn.com/physiotherapy/lower-back-pain-sneezing/
7. The Mayfair Clinic. What Causes Back Pain While Coughing or Sneezing? https://themayfairclinic.com/what-causes-back-pain-while-coughing-or-sneezing/