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Coughing makes back problems worse!

SteveCSSteveC Posts: 64
edited 06/11/2012 - 7:50 AM in Back Surgery and Neck Surgery
Hi Guys,

This is not so much a request for help or answers (but maybe someone has some thoughts) as a rant. I had L5/S1 disc/lami on the left side in 2009. A bulge on the left was noted but not corrected.

I started to get some other issues last year which appeared to be SI joint, MRI showed same bulge, same disc appearance, no nerve impingement etc., I recently had an RFA on my R SI joint. It didn't really help, or maybe it did and just uncovered a different pain source.

Shortly afterwards the RFA, I developed a *nasty*, hacking deep, cough bad enough that I would "scream" as my body convulsed (my GP gave me some high potency cough suprressant with codeine I think - it helped, but not enough). The pain would extend down my leg to my knee. A physiatrist my pain doc referred me to, said my bulge was not insignificant, but she felt the problem was the disc and said I should try to work with a spine PT. She also suggested a round of epidurals to calm things down.

Today I had my first epidural, it certainley helped, they always did for about 3 weeks. What has made me concerned is my pain doc asked if I had gone to get a consult from my N-surgeon and said he felt they were both "very conservative" (I agree) but the pressure build up on coughing can cause general nastiness in joints which had some degeneration (mine) and which had not been fused.

So now I have gone from pre-cough of annoying with a 2-4 pain range to, this hurts 2-6 (but typically 4-6) with me willingly taking tramadol. Now my conservative pain doc is asking if I have gone to get a surgical consult.

I've observed a fusion in the OR and it ain't pretty. It seems the odds of a positive outcome of a fusion is 60:40 rather than the 90:10 of a disc/lami. I'm not at the point where I want to play those odds, but at the same time, I am in discomfort to active pain most of the time now.



  • Steve,

    If it helps, you're not alone. When I have coughing fits (my C6 vertebra is cracked - causing movement), I get headaches and backaches at times that puts me in bed for days!

    My thoracic fusses the most with coughing though. I guess it makes sense since the majority of the cough forces are in the chest. Hopefully you will be feeling better soon.

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Uggh...coughing and sneezing are things I dread.
    I suspect coughing is worse because it's more continual. I think there are things you can do (position wise) when you cough to lessen the impact to your spine. I recall reading on this b/c I worried that it would cause me to herniate more at L5/S1.

    I'm with you though...I love my conservative Neurosurgeon because I've met far too many patients that lead me to believe that success on a lumbar fusion has a far different definition than success of discectomy/laminectomy. Still worth a consult just to check in to be sure.

    Cheers indeed.
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  • A sneeze is what caused my annular tear, thus leading to the herniation and everything else that followed!!
  • Amazing how something so simple can cause such issues! I found the "safest" (least pain) for me to cough was on the floor in "childs pose". Still hurt, but my body couldn't thrash around.

    I am grateful that my cough has subsided and my epidurals yesterday helped a LOT. I am no longer in active pain (which I class as 6 up), still uncomfortable, but more like a 2/3...a definite improvement.

    Thanks guys and good luck with your fusion recovery Traci.
  • From what I've read, coughing can temporarily aggravate back pain associated with nerve impingement, b/c any type of straining - coughing, sneezing, defecation, etc. - increases cerebrospinal fluid (the thin layer of fluid surrounding the brain and spinal nerves) pressure, which in turn irritates the affected nerve tissue more. Eeyowch!!
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