What Causes Back Pain When Coughing?

Medically Reviewed By Alana Biggers, M.D., MPH
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If you are coughing and experience back pain, the cause may not be respiratory. Instead, back pain with coughing is sometimes associated with muscle concerns like sprains, muscle stiffness, spasm, tightness, or pain. Back pain when coughing can occur in your upper back or lower back. It can feel dull, throbbing, or sharp. Being able to tell your doctor as much as you can about the type of pain you are experiencing can help them know which tests to order when diagnosing the cause.

This article looks at the possible causes of back pain when coughing and what treatments your doctor may recommend. It also looks at when to contact a doctor, how doctors diagnose the cause of back pain when coughing, and more.

What causes back pain when coughing? 

A person has their hands behind their back.
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Back pain affects around 8 out of 10 people at some point in their life. Sometimes, this pain can occur when you cough.

Coughing can strain your back and make it contract atypically. However, when coughing is not a long-term issue, the pain may be due to another concern. Where you feel the pain in your back can help determine the cause.

Upper back pain

Upper back pain can be acute (short lived) or chronic (long lasting). The pain can be a dull ache, a throbbing pain, or a sharp, sudden pain.

When you are coughing and have upper back pain, it may be due to an injury or an underlying condition. Possible causes of upper back pain include the following:

Poor posture

Extended periods of sitting with poor posture — such as when driving or hunched over a computer — can cause structural changes, and muscles become weak. Good posture will reduce this pain.

Improper lifting technique

Lifting a heavy object without considering spine alignment can cause back Injury.

To avoid upper back pain due to a lifting injury, use the proper lifting techniques. This includes standing close to the object you’re lifting and bending with your knees.

Overuse

Doing more physical activity than usual, such as working in the yard all day, can lead to muscle strains, ligament sprains, and inflammation in the upper back.

Coughing can exacerbate this pain, but resting can help you manage it.

Injury

You may experience upper back pain from an injury or accident. This may worsen when you cough.

It is important to contact your doctor if you experience an injury to your back. They will be able to run tests to assess the damage and advise you on any necessary treatments.

Underlying condition

In some cases, upper back pain when coughing is caused by an underlying condition. There are many different possible causes of upper back pain, including:

If your doctor suspects that a condition is causing your back pain, they will be able to run tests to reach an accurate diagnosis.

Learn more about conditions that can affect the upper back.

Lower back pain

The causes of lower back pain are numerous. If you are coughing and have lower back pain, there is a good chance the underlying cause is rooted in the lower back, with the pain worsening when you cough and move your back unexpectantly.

Sprains and injuries

Receiving a back sprain or injury can result in lower back pain that may worsen when you cough. This can be due to injured tendons, muscles, or ligaments.

Possible causes of injuries and sprains include:

Contact your doctor if you have experienced an injury to your back. A back injury can be serious, so it is important that they assess the extent of the damage.

Degenerative conditions

Degenerative conditions can cause lower back pain when coughing. This pain may gradually worsen over time as the condition progresses.

Degenerative conditions that may be responsible for lower back pain include:

  • intervertebral disc disease
  • spondylosis
  • rheumatoid arthritis
  • osteoarthritis
  • spondylitis

Nerve and spinal cord conditions

An issue with your nerves or your spinal cord can result in lower back pain when coughing. Conditions include:

Learn about types of spinal cord injury.

Other causes

There are many possible causes of lower back pain. Other reasons your lower back may hurt when you cough include:

If you do not know the cause of your lower back pain, it is important to contact your doctor so that they can reach an accurate diagnosis and advise on the right treatments to ease your pain.

What are the treatments for back pain when coughing?

Treatments for back pain when coughing can depend on what is causing it and whether it is acute or chronic.

Acute back pain

Acute back pain typically resolves on its own and within a few days or weeks, according to the National Institute of Neurological Disorders and Stroke (NINDS). Your doctor may suggest treating acute back pain with the following:

  • analgesics, such as acetaminophen and aspirin
  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen
  • muscle relaxants
  • topical pain relief
  • a heating pad or ice pack
  • gentle stretching

It is best to avoid vigorous exercise until your back pain goes away. It is unlikely that you will require surgery for acute back pain.

Chronic back pain

Your doctor may recommend a stepped-care approach for chronic back pain. This involves starting out with first-line treatments to see if they are effective before moving on to more advanced techniques, per the NINDS.

Pharmacological treatments for chronic back pain can include

  • analgesics and NSAIDS
  • opioid drugs 
  • anticonvulsants, which can treat sciatica
  • antidepressants 

Complementary and alternative treatments can include:

Advanced treatments your doctor may recommend for chronic back pain include:

  • implanted nerve stimulators
  • rehabilitation programs
  • surgery

The type of surgery can depend on the cause and location of your back pain. Your doctor will be able to explain which surgery they recommend in more detail and answer any questions you may have. This can help you make an informed decision about your treatment.

When should I see a doctor?

If your back hurts when you cough, it may reveal an underlying issue with your back that requires consultation with your doctor. Contact your doctor to help you understand what is causing your back pain and how best to treat it.

Learn more about when to see a doctor for back pain.

How do doctors diagnose the cause of back pain when coughing?

To assist with diagnosing the cause of your back pain when coughing, your doctor may carry out a physical examination and take a full medical history. They may then carry out tests to reach an accurate diagnosis.

Tests your doctor orders can depend on any other symptoms you have, but may include:

  • X-ray to assess for signs of arthritis or broken bones
  • MRI or CT scans for a closer look at muscles, tendons, ligaments, and blood vessels
  • blood tests to check for signs of infection
  • nerve studies to assess for nerve damage

Your doctor will be able to explain the tests to you in more detail and answer any questions you may have.

How can I prevent back pain?

The best way to avoid future back issues is to take steps to prevent injuries through activities that promote a healthy back. This can include:

  • getting regular exercise
  • maintaining a moderate weight
  • eating nutritiously for solid bone growth
  • using work surfaces at a comfortable height
  • sleeping on a firm surface
  • avoiding lifting heavy objects
  • quitting smoking, if you smoke, since smoking reduces blood flow to the lower spine

Summary

If you experience back pain when coughing, this can be a sign of an underlying condition or injury. Coughing can make an existing back concern worse because it causes your back to move suddenly and unexpectedly.

Back pain when coughing can occur in the upper back or the lower back. Possible causes include injury, overuse, degenerative conditions, and nerve conditions.

Contact your doctor if you experience back pain when coughing. They will be able to carry out tests to determine the cause and advise on the right treatments for you.

Everyone experiences coughing. Coughing repeatedly, for an extended period, or with hard effort can put a lot of stress on your body. Contact your doctor if you are coughing and developing back pain that does not resolve.

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Medical Reviewer: Alana Biggers, M.D., MPH
Last Review Date: 2022 Nov 24
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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