Your back moves most when your upper body moves, including when you cough. As you cough, you may notice your shoulders hunch up and your body lean forward. Since coughing affects the position of your body, you might feel pain when you cough.

The forward motion that can be caused by coughing moves the lower back as well. Pain in the lower back can spread into your hips and legs. The pain is likely a sign of a problem with your lower back.

Sometimes back pain can actually be caused by chronic coughing. The act of coughing can put a strain on the back and make it contract more than normal. However, when coughing isn’t chronic, the pain is most often due to an issue with your back.

Lower back pain can have many causes. Some of the most common causes include:

  • Herniated disk. Disks are the cushions between the bones in your spine. A herniated disk (or ruptured or slipped disk) occurs when the softer part of the disk pushes out to the harder part.
  • Muscle strain. A strain can affect a muscle or a tendon. In the back, the muscle or tendon can get pulled, torn, or twisted.
  • Muscle sprain. A sprain affects the ligaments that connect bones at a joint. With a sprain, the ligaments get stretched or torn.
  • Muscle spasm. Spasms and cramps happen when a muscle can’t relax after contracting. The spasms can last seconds to over 15 minutes at a time. Sometimes you can see the muscle twitch. The muscle can also be extra hard or look different than normal.

Try to keep a natural arch in your back when you cough, instead of hunching forward. Keeping your shoulders down (think them as moving away from your ears) can also help your back relax during a cough.

If you put your hand down on a surface like a table or counter when you cough, this helps the back not to compress.

There are many reasons why you might have lower back pain when you cough. Some are easy to fix, while others might need medical attention. Here are some common causes of back pain and tips for finding relief:

Bad mattress

If your mattress is over a five to seven years old, it maybe be time to replace it. Try a firmer or softer mattress, whichever your back prefers. A sign of an old mattress is sagging in the middle or where you sleep.

Feeling stressed

Stress, whether physical or emotional, often causes bodily stress. If the stress is caused by the coughing itself, try to relax instead of trying to fight the cough. For emotional stress, you can reduce your stress levels with breathing exercises, journaling, and other forms of self-care.

Sitting a lot

Many jobs require sitting for long periods of time. When you sit, you may find yourself slightly hunched toward your computer screen or other point of reference. Ideally, before your back feels sore, get up and move around. Even standing can help, as well as having an ergonomic chair and work setup.

When you sit, keep your back against your chair. Your arms should be at a 75 to 90 degree angle when you’re sitting at a desk. Your feet should be flat on the floor. Use a foot rest if your feet can’t reach the floor.

Uncomfortable shoes

Your feet support your legs, which support your back. Wearing uncomfortable shoes can put a strain on your back. When you look for shoes, choose ones that have proper arches and support, and make sure they fit properly. Walk around the store to see how they feel. Check the soles for cushion.

Muscle overuse

Overuse injuries can happen when you exercise too much too quickly, or if you exercise improperly. To avoid overuse, ramp up your physical activity slowly and make sure to use proper techniques and gear.

Poor posture

When you walk, look straight ahead and keep your head balanced above your spine. Don’t droop your shoulders. And step from heel to toe. Certain exercises may help you improve your posture as well.

Muscle spasm

Before you do any physical activity, be sure to warm up and stretch. Drink plenty of fluids and avoid exercising in extra hot temperatures. Otherwise, you may experience a muscle spasm that could cause your back to hurt when moving later on, including when coughing.

Occupational injury

Some jobs require a lot of lifting, bending, pulling, and pushing. If this is true for you, make sure you get properly trained on how to perform these functions in a way that supports your body. Also consider if you can adjust your work station to ease or avoid strain on your back.

Previous back injury

If you have suffered a back injury in the past, you may be more likely to get another injury. Work with your doctor to keep your back extra healthy. This may include special exercises and knowledge of warning signs.

Other treatments

Other treatments for back pain when coughing include TENS therapy, physical therapy, massage, acupuncture, prescription medications, and back braces and belts.

If your back pain doesn’t get better within two weeks, see your doctor.

You should also see your doctor if you experience the following with your back pain:

  • constant pain that’s worse at night
  • fever
  • loss of bladder or bowel control
  • numbness, weakness, or tingling in one leg or both
  • pain following a trauma, such as a fall
  • throbbing pain in your abdomen
  • unexplained weight loss

You should also see your doctor if you’re experiencing chronic coughs. Understanding and treating the cause of your coughs can go a long way to reduce discomfort and improve your overall health.

If your back hurts when you cough, there’s likely an issue with your back that needs to be resolved. The position the body is in when coughing can make your back symptoms worse. Work with your doctor to figure out why your back is hurting. Also see a doctor if you have a chronic cough.