Why Does Sciatica Hurt When I Cough or Sneeze? | Kearny Mesa, CA
A patient may be sitting comfortably with only mild lower back or leg pain, cough once, and suddenly feel a sharp pain shoot through the buttock and down the leg.
Sneezing can do the same thing.
Sometimes the pain is mainly in the lower back. Sometimes it shoots into the thigh or calf. For someone with more significant sciatica, the pain may travel all the way into the foot.
When this happens repeatedly, it can be a useful clue.
Dr. Cassidy James Boelk, DC has spent more than 22 years working with patients with lumbar disc injuries, lower back pain and sciatica and has performed more than 100,000 spinal decompression treatments. One question that comes up during an evaluation is whether coughing, sneezing or straining changes the patient's symptoms.
It certainly doesn't diagnose a herniated disc by itself. But when a cough or sneeze consistently reproduces the same pain someone already feels along the path of the sciatic nerve, it is worth looking at more closely.
Eight Months of Back Pain and Sciatica
Joshua T., a firefighter, had been dealing with constant lower back pain and sciatica for more than eight months.
He described his experience this way:
“Dr. Boelk has been a lifesaver.
I suffered from constant low back pain and sciatica for more than eight months. Pain medications didn't help, and I was headed toward multiple injections in hopes of finding relief.
After beginning treatment with Dr. Boelk, everything changed.
Today, my pain is completely gone.
As a firefighter who depends on his body every day to help others, being pain-free has made a tremendous difference in both my career and quality of life.
The results I experienced were absolutely worth it, and I highly recommend looking into what Dr. Boelk and his team can do for you.”
— Joshua T., San Diego, CA
Start With a No-Charge Consultation
If coughing or sneezing keeps triggering sharp lower back pain or sends pain down your leg, patients from Kearny Mesa can begin with a No-Charge, No-Obligation Consultation with Dr. Cassidy James Boelk, DC.
The first step isn't assuming that you need treatment.
It's understanding the problem.
Where does the pain start? How far does it travel? Is it only painful when you cough or sneeze, or are you dealing with symptoms throughout the day? Is there numbness or tingling? Has the leg or foot become weaker?
Dr. Boelk will also want to know what happens when you sit, drive, bend, stand and walk.
Those details can be surprisingly important.
Someone who cannot tolerate sitting but feels considerably better walking presents differently from someone who sits comfortably but develops leg pain or numbness after several minutes of standing.
Previous treatment matters as well. If you have already tried physical therapy, chiropractic care, medication, injections or other treatment, bring that history with you.
If you've had a lumbar MRI, bring the actual images and the radiology report. Dr. Boelk prefers to review the images himself and compare them with your symptoms.
If you haven't had an MRI, you can still schedule the consultation.
After reviewing the history and available imaging, Dr. Boelk can discuss whether further examination or imaging may be appropriate and whether Non-Surgical Spinal Decompression appears to be an option.
There is no obligation to begin treatment, and not everyone who comes into the office is accepted for decompression.
Dr. Boelk personally performs these consultations and reviews the available imaging. Because the consultations require his time and are offered at no charge and with no obligation, only a limited number of new-patient consultation appointments are available during the clinic schedule.
Call 619-298-0800 to ask about the next available No-Charge Consultation.
Why Can a Cough or Sneeze Cause a Sudden Increase in Pain?
A sneeze lasts only a moment, but it creates a rapid change in pressure through the trunk.
The abdominal and trunk muscles contract, and pressure can temporarily increase within the abdomen and spinal canal.
Most people never think twice about it.
When the lower back or a lumbar nerve is already irritated, however, that sudden pressure change may reproduce the pain.
For someone with sciatica, the sensation may follow the same path as their regular symptoms: lower back, buttock, thigh, calf and sometimes into the foot.
The cough or sneeze usually isn't creating the original problem.
It is revealing how sensitive the area already is.
Does This Mean You Have a Herniated Disc?
No.
This is an important distinction.
Pain that increases with coughing, sneezing or straining can occur with lumbar disc and nerve-root problems, but the symptom by itself does not tell Dr. Boelk that someone has a herniated disc.
There needs to be more information.
Where does the pain travel?
What movements make it worse?
Is there numbness?
Which part of the foot is affected?
Has strength changed?
What happens when the person sits or walks?
And if an MRI is available, does the finding actually correspond with the symptoms?
Those pieces need to make sense together.
What If Sneezing Hurts Your Lower Back but Not Your Leg?
Not everybody with this problem has sciatica.
Some patients experience a sudden, localized pain in the lower back when they cough or sneeze but have no pain traveling into the leg.
That is still worth mentioning during an evaluation.
There are several possible sources of lower back pain, and a disc is only one of them.
Someone with isolated lower back pain shouldn't assume they have a herniated disc because sneezing hurts.
On the other hand, if the problem is happening repeatedly, is becoming more intense or is beginning to interfere with sitting, standing, walking, bending or sleeping, simply assuming it is a pulled muscle may not be the best approach either.
The MRI Report Doesn't Tell the Whole Story
Patients sometimes come into the office very focused on a particular sentence in their MRI report.
“L4-L5 disc protrusion.”
“L5-S1 disc herniation.”
“Severe foraminal narrowing.”
Those findings may be important, but the report has to be put into context.
A patient can have abnormalities at several levels. Dr. Boelk wants to know which finding, if any, actually corresponds with what the patient is experiencing.
That is one reason he asks patients to bring the actual MRI images whenever possible.
If the pain runs down a particular part of the leg, there is numbness in a particular area of the foot, certain movements reproduce it, coughing or sneezing aggravates it and the MRI shows a finding capable of affecting the corresponding nerve, the overall picture becomes much more useful than any one sentence in the report.
The goal isn't to treat the MRI.
It's to understand the patient.
Do You Need to Change the Way You Cough or Sneeze?
There isn't a special sneezing technique that fixes a lumbar disc problem.
But if you have already noticed that coughing or sneezing while bent forward or twisted is considerably more painful, it makes sense not to put yourself in that position unnecessarily.
Try to stay reasonably upright and supported when possible.
You also don't need to aggressively brace every muscle in your body because you feel a sneeze coming.
More importantly, don't spend weeks trying to perfect the way you sneeze while ignoring the fact that an ordinary bodily function repeatedly sends severe pain down your leg.
At that point, finding out why the nerve is so sensitive is more useful.
Pay Attention to More Than Pain
Pain tends to get all the attention because it is difficult to ignore.
But Dr. Boelk also wants to know what is happening with sensation and strength.
Is part of your calf or foot numb?
Are certain toes tingling?
Does one leg feel weaker?
Can you walk on your heels and toes normally?
Are you starting to catch the front of your foot while walking?
Those changes matter.
A patient can sometimes report that the pain is decreasing while the foot is becoming increasingly numb. That isn't necessarily the improvement it first appears to be.
Should You Stretch Sciatica?
It depends on what the stretch does.
This is particularly important when the back of the thigh feels extremely tight.
People naturally assume the hamstring needs to be stretched.
But an irritated nerve can also produce a tight, pulling sensation through the back of the leg.
If a gentle hamstring stretch feels good and doesn't increase the leg symptoms, that's one thing.
If stretching produces burning, tingling or pain that travels farther toward the calf or foot, don't assume the answer is to stretch harder.
Listen to what happens afterward.
When Back Pain or Sciatica Needs More Immediate Attention
Most episodes of lower back pain and sciatica do not require emergency care.
Progressive neurological symptoms deserve more attention.
If one leg or foot is becoming noticeably weaker, you are beginning to catch your toes when you walk, or lifting the front of the foot is becoming more difficult, get the condition evaluated.
Rapidly progressing weakness, new bowel or bladder dysfunction, difficulty urinating, or numbness involving the groin or saddle area requires prompt medical attention rather than waiting for a routine spinal decompression consultation.
Who May Be a Candidate for Non-Surgical Spinal Decompression?
Dr. Boelk evaluates patients with lumbar disc bulges and herniations, degenerative disc disease, disc-related lower back pain and sciatica, foraminal narrowing and selected cases of spinal stenosis.
When the history, symptoms and imaging indicate an appropriate disc or degenerative condition, Non-Surgical Spinal Decompression may be considered.
But an abnormal MRI alone doesn't make someone a candidate.
Dr. Boelk considers the patient's symptoms, neurological findings, spinal stability, bone health, previous surgery and overall medical history.
The Spinal Decompression & Chiropractic Center of San Diego uses the DRX9000 exclusively. When a patient is accepted for treatment, factors including the spinal level involved, positioning, angle, starting force, body size, tolerance and response are considered.
There are also conditions where decompression may not be appropriate, including an unhealed fracture, significant osteoporosis, unstable spondylolisthesis, abdominal aortic aneurysm, pregnancy for lumbar decompression, certain malignancies and other medical or structural concerns.
Previous spinal surgery also needs careful consideration, particularly when fusion or metal hardware is present at the level that would need treatment.
Sometimes the Answer Is No
Jeff J. traveled from Tucson, Arizona to have his back evaluated by Dr. Boelk.
He ultimately did not become a spinal decompression patient.
He wrote:
“I found this terrific practice on social media. I followed up and did my own research so I decided to pay them a visit. The place is clean, well organized and run by a very efficient receptionist. I met with the doctor and after a honest and forthright conversation, we both determined that surgery was my only option to correct my back issues. I will return as a customer when the time is right.”
— Jeff J., Tucson, AZ
That's an important part of the process.
If Dr. Boelk doesn't believe spinal decompression is appropriate for a particular patient, the goal isn't to find a reason to treat anyway.
Sometimes another approach makes more sense.
Patients Also Come From Outside San Diego
Some patients travel from outside San Diego County, other states and even outside the United States to be evaluated for spinal decompression.
For someone considering traveling for care, it is especially important to determine candidacy before making extensive plans.
If you already have a lumbar MRI, have the actual images and report available. Information about previous treatment can also be helpful.
Whether someone lives five minutes from the office in Kearny Mesa or several hours away, the criteria don't change.
The condition still needs to be appropriate for the treatment.
About Dr. Cassidy James Boelk, DC
Dr. Cassidy James Boelk, DC has more than 22 years of experience with Non-Surgical Spinal Decompression and has performed more than 100,000 spinal decompression treatments.
He is a Certified Spinal Decompression Doctor and Certified Pain-Free Performance Specialist (PPSC), Founder of the Non-Surgical Spinal Decompression Training Academy, Founding Member of the American Spinal Decompression Society, Member of the International Disc Education Association and a California X-Ray Radiation Supervisor & Operator.
Dr. Boelk also trains other doctors in spinal decompression protocols and techniques.
His experience with spinal injuries is personal as well. He suffered an L5 compression fracture at age 16 and later experienced disc injuries and sciatica himself.
Lower Back Pain and Sciatica Help Near Kearny Mesa
If coughing or sneezing occasionally makes your lower back ache, that symptom alone doesn't tell you what is wrong.
But if it repeatedly causes sharp back pain or sends pain shooting through your buttock and down your leg, pay attention to it.
And if the problem is occurring along with persistent numbness, tingling or weakness, it may be time to find out what is irritating the nerve.
Patients in Kearny Mesa and surrounding San Diego communities can begin with a No-Charge, No-Obligation Consultation with Dr. Cassidy James Boelk, DC.
Bring your MRI images and report if you already have them. If you don't have an MRI, you can still schedule the consultation.
If Dr. Boelk believes you may be a candidate for Non-Surgical Spinal Decompression, he can explain why and discuss what treatment would involve. If he doesn't believe decompression is appropriate, he'll tell you.
Because Dr. Boelk personally performs these consultations and reviews available imaging, only a limited number of No-Charge Consultation appointments are available during the weekly clinic schedule.
Call 619-298-0800 to ask about the next available appointment.
The Spinal Decompression & Chiropractic Center of San Diego
5095 Murphy Canyon Road, Suite 300
San Diego, CA 92123
619-298-0800
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