Lower Back Pain When Coughing: What You Need To Know

Lower back pain (LBP) is a common problem that coughing can make worse. If you are experiencing lower back pain and are struggling to cope, read on for some tips on easing the discomfort. We will discuss the causes of your back pain when coughing, treatment options, and when to see a doctor.

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What could be causing lower back pain when you cough?

There are several potential causes of lower back pain when coughing. They include:

Strain or injury to the muscles, ligaments, or tendons in your back

The lower back is particularly vulnerable to stress because it supports part of the upper body's weight. Coughing can put excess pressure on the muscles and other tissues in your lower back, causing them to become inflamed and painful. A sudden, hard cough such as a hacking spell can strain the muscles and ligaments of your back.

A spinal disc herniation

A spinal disc herniation is a condition in which one of the discs between the vertebrae of your spine becomes compressed and starts to bulge out. This can cause inflammation and pain in the surrounding tissues, and it may also cause numbness, tingling, and muscle weakness. The pain from a herniated disc may worsen whenever you cough.

Acute infectious rhinitis

Acute infectious rhinitis is inflammation inside your nose caused by allergies. It causes cold-like symptoms and may result in lower back pain and discomfort. When you have an infection like a cold, your body triggers mucus production and a coughing reflex. If you strain your back when coughing, the resulting inflammation and pain could add to your cold symptoms.

Pregnancy-related lower back pain

Pregnancy can cause several aches and pains, including lower back pain. This is because your body stores most of its extra weight in front in the weeks and months leading up to labor, which can cause the muscles and ligaments in your lower back to stretch and weaken. Hormones to prepare your body for labor can also cause instability in the lower back and pelvis, resulting in pain. Coughing can add to this strain, making your back pain worse.

Spinal stenosis

Spinal stenosis is a condition that results from the narrowing of the spinal canal. This can cause pressure and discomfort in the spinal cord and surrounding tissues. Coughing can add to this pressure, leading to pain in your back.

Intercostal neuralgia

Intercostal neuralgia is nerve pain that affects the muscles between the ribs. The condition can occur when a rib slips out of place and presses against a spinal nerve. Coughing may intensify this pressure, worsening your back pain.

Sacroiliac joint irritation

The sacroiliac joint is a small, weight-bearing joint located at the bottom of the spine. It helps connect the pelvic bone and the spine. If it becomes irritated, often from strenuous or repetitive activities, it can cause pain in the lower back. Coughing can worsen the inflammation and increase your discomfort.


Costochondritis is an inflammation of the cartilage that joins your ribs to your sternum (breastbone). The inflammation usually comes after a strenuous activity such as exercise and causes pain in the chest wall and rib cage and tenderness upon pressing on the affected area.  Coughing can aggravate the pain associated with costochondritis.

What are the treatment options for lower back pain when coughing?

If you have lower back pain only when you cough, the problem is likely to resolve on its own in a few days or weeks. You can also find relief with these options:

  1. Non-medical therapies: These therapies can be tried before any medications. 

  2. Heat packs can help during acute flares.

  3. Continuing regular exercise can help prevent further back pain and improve symptoms. Lower-back-friendly exercises include Tai Chi, swimming, and Pilates.

  4. Massage.

1. Medication

Over-the-counter pain relievers

Over-the-counter pain relievers, such as ibuprofen (Advil) or acetaminophen (Tylenol), can help relieve the inflammation and discomfort associated with lower back pain. Be sure to follow the dosing instructions on the bottle carefully.

Prescribed pain relievers

If over-the-counter pain relievers fail to provide relief, your doctor may prescribe stronger medication. They include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, or opioid painkillers, such as oxycodone or hydrocodone.

Muscle relaxants

Muscle relaxants can help relieve tension in the muscles and ligaments that support your back, which could be contributing to your pain.


Antidepressants, such as amitriptyline (Elavil) or duloxetine (Cymbalta), can help to relieve chronic pain.

Corticosteroid injections

Corticosteroid injections are medications injected directly into the areas where you feel pain. Your doctor may give you one injection or multiple injections over time. They can help relieve lower back pain quickly, but they do not work for everyone, and the effects only last a short time (a few months at most). As with any injection, there can be complications, including bleeding or infection, and your doctor will discuss these with you.

Topical creams and patches

Creams and patches that contain the medication lidocaine or capsaicin cream can provide relief. They block pain signals to help ease discomfort.

2. Physical Therapy

Physical therapy can help relieve lower back pain by strengthening your abdominal and back muscles. You'll likely need to take time off work for this treatment option, but it may bring long-term relief. The types of physical therapy that are effective include:

Chiropractic manipulation

Chiropractic manipulation is a hands-on treatment that uses pressure and gentle movement to help align your spine. It is very common for chiropractors to treat lower back pain.


Acupuncture involves using fine needles to stimulate specific points along your body's energy pathways or meridians. This can help to improve blood flow and circulation in the area, and it may also reduce muscle spasms and stiffness.

TENS unit

A TENS (transcutaneous electrical nerve stimulation) is a small device that sends mild electrical currents through electrodes placed on your skin. This can help to relax tense muscles and reduce pain.

3. Surgery

Surgery is usually the last resort if you have chronic lower back pain that has not responded to other treatments. There are a few different types of surgery that can be used to treat lower back pain:


Laminectomy is a surgery that removes the lamina, or roof, of the vertebrae in your spine. This can help to relieve pressure on the spinal cord or nerves.

Spinal fusion

Spinal fusion is a surgery that joins two or more vertebrae together with metal screws, rods, or plates. This can help to reduce pain and correct alignment problems in the spine.


A discectomy is a surgery that removes part of a herniated disc to relieve pressure on the spinal cord or nerves.

Artificial disc replacement

Artificial disc replacement surgery is a minimally invasive surgery where the outer part of one of your vertebrae is replaced with an artificial disc. This can help to relieve pressure on the spinal cord or nerves.

When should you see a doctor if you are experiencing lower back pain when coughing?

Make a point to visit a doctor if you have lower back pain accompanied by the following symptoms:

  • Numbness or weakness in your lower body

  • A fever over 100 degrees Fahrenheit, accompanied by coughing and lower back pains

  • Pain that radiates down your legs

  • Troubles with urination or bowel movements

  • Weight loss

The lowdown

Lower back pain is a common condition that can be caused by issues such as muscle strains, ligament damage, and spinal stenosis. The good news is that several treatment options can help to provide relief. However, consult your doctor first before trying any treatment option on yourself. If your lower back pain doesn't subside within a few days, see your doctor for further evaluation.

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