There are many reasons why people may experience back pain when sneezing. When a person sneezes, it can trigger symptoms from an existing injury, or the sneeze itself may cause an injury.

Some possible causes of back pain when sneezing include muscle strain, a herniated disk, sciatica, or a vertebral compression fracture.

This article looks at some of the injuries sneezing can cause and how sneezing can trigger pain in an existing injury. It also looks at ways of sneezing safely and offers tips for managing back pain.

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Sneezing is a reflex action and happens involuntarily, meaning people cannot control it.

Just before a person sneezes, their body goes through a series of reactions to prepare. People usually take a deep breath in, open their mouths, and close their eyes.

Inside their ribcage, their diaphragm contracts to build up the pressure needed to expel the sneeze.

By this point, not many people are paying attention to their posture, and a violent sneeze may jerk their body into unnatural movements.

These movements can injure the person’s back or overstretch muscles, leading to back pain.

There are 24 bones, called vertebrae, in a person’s spine, or backbone. The American Academy of Orthopaedic Surgeons explains that these bones protect the nerves in the spinal cord and help people stand upright, bend, and twist.

Intervertebral disks are jelly-like disks that separate the vertebrae and act as shock absorbers, protecting the spine as the person moves.

If a person damages a disk, it may bulge out of place and put pressure on the spinal nerves. Doctors describe this as having a herniated, or “slipped,” disk.

The American Association of Neurological Surgeons (AANS) adds that people can get a herniated disk from a relatively minor strain, or twisting motion, especially as people age and the bones and ligaments degenerate.

People who already have a herniated disk may experience additional discomfort when sneezing if the disk presses against the spinal cord.

Sneezing is an explosive force, and any sudden, twisting movements may cause a disk to bulge, or herniate, in people without any existing injuries.

The AANS describes muscle strain as when muscle fibers tear or overstretch. The lower back is vulnerable to strains because the muscles help support the weight of the upper body and help a person bend, twist, and move.

The AANS adds that people can get muscle strains from a sudden injury, or they can build up gradually.

Sneezing puts pressure on a person’s back and abdominal muscles, and a particularly violent sneeze may be enough to tear the fibers.

Anyone with an existing muscle strain may find that sneezing aggravates their injury, causing additional pain.

People with osteoporosis may experience a vertebral compression fracture while sneezing, as their bones are less dense than others. Bones become thinner and weaker as a person ages.

Vertebral compression fractures can happen when there is too much pressure on a person’s weakened spine. The front of the vertebra cracks and collapses, losing height.

The sciatic nerve is the largest nerve in the body and runs from a person’s lower back, through their hips, and down each leg.

If the nerve becomes inflamed, or if something is pinching against it, a person may experience a burning feeling in their buttocks or painful tingling in their legs. This is referred to as sciatica.

Many people with sciatica experience pain when sneezing, either in their lower back, buttocks, or legs. The pain is usually fleeting, but if it continues, it could be a sign of a herniated disk.

Only a few researchers have investigated the best way for a person to protect their back when sneezing.

In a small 2014 study, researchers measured the compression force on intervertebral disks, how the person’s lower back moved, and how they inclined their trunk when sneezing.

They concluded that the safest way to sneeze is for a person to stand, resting both hands on a table or similar object, and lean slightly forward. They also recommend pulling in the abdominal muscles.

Back pain can range from mild to severe. Doctors usually prefer noninvasive treatment options, but they may prescribe pain relief medication or recommend surgery in some cases.

Noninvasive treatments include:

  • using an ice pack
  • staying active, though stopping any activities that cause pain
  • using a heat pack
  • taking over-the-counter (OTC) pain medication
  • paying attention to posture
  • doing gentle, strengthening exercises that target the core muscles, such as Pilates or yoga
  • stretching

Some people also find that acupuncture relieves their pain.

Sneezing is an explosive reflex that can trigger back pain. People with existing back injuries may find that sneezing aggravates their symptoms, but sometimes, the sneeze itself is enough to cause an injury.

Injuries may include muscle strain, herniated disks, or vertebral compression fractures.

Most people can manage their back pain with OTC remedies and gentle exercise. Doctors may recommend prescription pain medications or surgery if a person’s back injury is severe.