DO YOU SUFFER BACK OR NECK PAIN WHEN COUGHING OR SNEEZING. HERE IS WHAT COULD BE CAUSING THE PROBLEM.

When you cough or sneeze there is a sudden rise in your intra-spinal, or intra-thecal pressure. This increases the stress on already inflamed or impinged structures thus exacerbating the pain.

The same spinal pressure effect created when you cough or sneeze can be replicated clinically by performing the Valsalva manouvre. This can be done by bearing down hard as if going to the toilet or blowing out while holding your mouth and nose shut. Pain anywhere in the spine, especially when accompanied by shooting pain into the arms or legs, constitutes a positive sign for a focal inflammation or a space occupying lesion.

Usually a focal pain will indicate something as innocuous as a blocked or inflamed spinal facet joint (known as facet syndrome).
Nerve pain extending into the arms or legs would indicate a slightly more progressed spinal pathology- this is most often indicative of a prolapsed intervertebral disc (bulging disc) pinching a nerve. It may however also indicate a far more serious scenario such as a space occupying lesion pinching a nerve (spinal cysts, abscesses etc.) – these lesions are serious, but are also thankfully extremely rare.

Whether the cause of a positive Valsalva sign is innocuous or serious it needs to be further investigated. Always start more conservatively by visiting your Chiropractor to treat any spinal dysfunction and to rule out more serious pathology. Your Chiropractor will be the first to refer you to the appropriate specialist in the presence of any ‘red flags’ – this is however most times thankfully avoidable.

ALTHOUGH IT IS NOT THE SOLUTION – Relief from the actual pain experienced when coughing or sneezing can achieved by :

A) For cervical pain: Shrug the shoulders up completely and extend (hollow) the neck backwards slightly thereby increasing the cervical lordosis. This position braces the neck and cervical structures.
B) For thoracic pain: Shrug the shoulders backwards completely creating a pigeon chest effect while again extending (hollowing) the neck and lower back backwards. This position will brace the thoracic spine.
C) For lumbar pain: Shrug the shoulders back completely and extend (hollow) the thoracic and lumbar spine. Bend the knees placing both hands on the thighs deflecting all the pressure to the thighs. This position braces the lumbar spine and deflects the pressure to the thighs.

DO NOT EVER FLEX (ROUND) YOUR CERVICAL, THORACIC OR LUMBAR SPINE WHILE COUGHING OR SNEEZING IN THE PRESENCE OF A SPINAL INJURY. YOU WILL AGGRAVATE THE INJURY!

Don’t ignore the signs your body gives you. Pain is your body’s alarm system telling you that something is wrong… get it seen to! Written by DR. E Greyling