back pain when coughing - what causes it and sciatica when coughing

Lower Back Pain when Coughing: Causes & How to Stop It

Lower back pain when coughing can be an alarming symptom, especially if you don’t know the reason for the sudden increase in pain. Worsening back pain when coughing is very common and there are a few clear reasons for this symptom that we will discuss – however, we’re also going to give you some uncommon advice on how to avoid this problem too!

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What Causes Lower Back Pain When Coughing?

Lots of people with back pain and sciatica will know what “the fear” is like – the feeling of dread that comes over them when they feel that tickle in the back of their throat meaning that a cough is coming soon.

People with back pain and sciatica fear coughs because of the often excruciating back and leg pain associated with each cough. Some of my clients tell me that they’d rather choke than cough again!

But why is coughing such an ordeal for some people with back pain and sciatica but not others?

The answer to this question lies in the root cause of that person’s back problem. There are two main problems that aggravate sciatica and lower back pain when coughing.

You can see a good summary in my video below, which also applies to sneezing:

Which Problems Cause Lower Back Pain When Coughing?

1) Back Muscle Spasms:

When someone is suffering from a muscle spasm in their back, coughing is likely to aggravate this problem significantly.

This is because the muscles in our back tense up as we cough, causing the already spasmodic spinal muscles to contract even further.

You can see a great 5 minute stretching programme for back pain and sciatica by clicking here.

A simple back muscle spasm is unlikely to cause sciatica on its own, however, so if your main problem is the sciatic pain in your leg when you cough, see the second likely cause below.

2) Disc Bulges:

Disc bulges are by far the biggest culprit of worsening back pain when coughing and may also lead to the sensation of electricity down your leg that every sciatica sufferer is so familiar with.

The reason disc bulges cause worsening back pain when coughing as well as sciatica is due to the physics that occur within your abdomen when you cough.

In order to generate a cough, your breathing system builds up pressure within your thorax in the lungs. This will have a knock-on effect in the abdomen, which also experiences an increase in pressure. As your spinal discs are also in this region, they will have increased pressure exerted on them too.

When the spinal discs are put under pressure, the inner material within the damaged disc will push towards the tears in the periphery of that disc. This will cause the disc to “bulge” more than it was before, often pressing on a nerve root and causing terrible sciatic nerve pain.

Here, you can see three disc bulges of different severity.

When you cough and force the air out of your chest, this sudden change in pressure makes the disc bulge momentarily even worse, leading to the dreaded pain many of my clients tell me about.

What’s even worse for people with disc bulges is that they will get the pain from their back muscle spasm AS WELL as the disc pain! Not a good combination.

So, Is There a Way to Prevent Lower Back Pain When Coughing?

Although we can’t fully prevent back pain when coughing, there are ways we can hopefully reduce the symptoms associated with coughing while still allowing proper clearance of the throat.

The following technique is one I learned when I was training as a physio. We had to learn how to treat respiratory patients with lung failure who needed to clear their throat but didn’t have the physical strength to cough. Although the technique was designed for people with COPD and asthma, it is perfect for sciatica sufferers who can’t cough due to pain.

It turns out there is a way to replace coughing with a technique that researchers feel is even more effective than a cough for clearing the throat. This technique is called the “huff”.

The huff avoids the large build-up of abdominal pressure that aggravates disc bulges and muscle spasms. It’s quite simple but takes some practice.

You can try it by following the steps below:

  1. When you feel a tickle in the back of your throat or as if you might need to cough, try to suppress the cough first.
  2. Take three normal breaths to prepare yourself.
  3. Take a deep breath and hold your breath for a moment as your lungs are almost full.
  4. With your lungs still full, open your mouth slightly and sharply exhale about 30% of the breath in your lungs as fast as you can.
  5. You may feel your throat start to clear with small, non-painful reflexive coughs.
  6. Repeat the process until you feel your throat is clear and you no longer need to cough.

I have found a video that details this process that you can watch below to make more sense of the instructions above.


I hope this post has shed some light on why lower back pain when coughing can occur. The technique above is certainly worth trying and is not a common practice so if you find it helpful, please feel free to share it with anyone you know with back pain and sciatica if they are complaining about a winter cold making their symptoms worse!

Did you try the technique? What did you think of it?

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The information on Overcome Sciatica should never be used as a substitute for medical advice from a doctor. Never put into action any tips or techniques from Overcome Sciatica without checking with your doctor first. Please see full terms of use here.

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