Why sneezes cause back pain

I remember several years ago I was watching Sports Center and the anchor reported that Sammy Sosa was not going to play that day due to back pain caused by a sneeze. It was reported in a way that made light of the subject, and I even got a good chuckle out of it. You may have laughed as well if this had never happened to you, but whether they make the headlines or not, sneezes often result in back or neck pain. As a chiropractor, I see this frequently and my patients are often embarrassed when they tell me how it happened. I believe sneezing is risky for two reasons:

1. When you sneeze you often turn your head in order to aim it away from people near you and to cover it with your arm or hand. Sneezing causes a very violent contraction of the diaphragm and many of the muscles that support the neck and spine. When creating such a violent contraction with your neck twisted, it is easy to see how a muscle could be pulled or even a joint in the spine sprained as the tissues are put under such intense stress.

2. Sneezing causes a rapid rise in intra-abdominal pressure. The pressure builds as all the air taken in during the “ahh” part of the sneeze gets restricted momentarily before the “choo” part. Raising intra-abdominal pressure also causes an increase in intra-thecal pressure, or the pressure inside the spinal canal, as well as the pressure inside the intervertebral discs, the soft cushions between each of your vertebrae. A sudden spike in pressure in these areas can cause a disc injury and/or a pinched nerve sensation in the back or neck.

One way to avoid injury when sneezing is to reduce the stress on your spine by slightly extending your neck and your lower back. As I discuss in the video below, we tend to bend forward when we cough or sneeze. Bending forward can place more pressure on the spine even when not sneezing, so it is best to avoid that position then next time you feel a tickle in your nose. See the video for more details. Until next time, take care and sneeze safely 🙂

-Dr. Thompson

 

Choosing the right mattress for lower back pain

Proper mattress selection for lower back pain

Which mattress is best for your back?

Sleeping on the wrong mattress can cause or worsen lower back pain. Lack of support from a mattress reinforces poor sleeping posture, strains muscles and does not help keep the spine in alignment, all of which contribute to low back pain.
Sleep comfort is also sacrificed if a mattress does not match one’s individual preferences. A mattress that provides both comfort and back support helps reduce low back pain, allowing the structures in the spine to really rest and rejuvenate during the night.
Choosing the right mattress can be difficult. The following practical guidelines are designed to help patients with low back pain choose the best mattress for both back support and sleep comfort:

  1.  Personal preference should ultimately determine what mattress is best. There is no single mattress style or type that works for all people with low back pain. Any mattress that helps someone sleep without pain and stiffness is the best mattress for that individual. Patients with low back pain should choose the mattress that meets their standards for comfort and support and allows them to get a good nightís sleep.
  2. Understand and inquire about the physical components of the mattress. The coils or inner springs of a mattress provide the support. Different mattresses vary in their number and arrangement of coils. Padding on top of the mattress comes in many different thicknesses. Mattress depths typically range anywhere from 7 to 18 inches deep. Choosing the number of coils, type of padding and mattress depth should be determined by individual preferences.
  3. Find a mattress with back support. A good mattress should provide support for the natural curves and alignment of the spine. The right amount of back support also helps the patient avoid muscle soreness in the morning. While there is not much clinical data about mattresses, one study found that medium-firm mattresses usually provide more back pain relief than firm mattresses.
  4. Achieve a balance between back support and comfort. Overall comfort while sleeping on the mattress is equally important as sufficient back support. Sleeping on a mattress that is too firm can cause aches and pains on pressure points. A medium-firm mattress may be more comfortable because it allows the shoulder and hips to sink in slightly. Patients who want a firmer mattress for back support can get one with thicker padding for greater comfort.
  5.  Know when it’s time to get a new mattress. If an old mattress sags visibly in the middle or is no longer comfortable, it is probably time to purchase a new one. Putting boards under a sagging mattress to keep it from sagging in the middle is only a short-term fix for the sagging; a new mattress is still needed.

Some Considerations

  • Shop for the best value and quality of the mattress, not price. Mattresses with more coils and thicker padding tend to be higher quality and also more expensive; however, a higher price does not guarantee that the mattress is more comfortable or more supportive. Mattress stores often have sales and promotions, so it is a good idea to comparison-shop for the best price after finding the right mattress.
  • Be aware of mattress advertising gimmicks. Claims that a mattress is orthopedic or medically-approved should be viewed skeptically. There has not been extensive medical research or controlled clinical trials on the topic of mattresses and low back pain. The individual must determine whether or not extra features on a mattress make it more comfortable or supportive.
  • Give the mattress a test-run before buying. To sample mattresses, people can try sleeping on different makes and models in hotels or at other peopleís homes before going to a mattress store. When shopping at the store, shoppers should lie on the mattress for several minutes to decide if it is a good fit. If two people will be sleeping on the mattress, both should test it at the same time to make sure they have enough space and are both comfortable on the same style of mattress.
  • Purchase mattresses from stores and companies that are trustworthy. Consider the customer service offered by the mattress store, such as delivery options, warranty, and removal of old mattresses and the store’s return policy. Look for mattress stores where customers can return a mattress if they are not satisfied with the quality or comfort after sleeping on it for a significant amount of time (i.e. a couple of weeks to a month).
  • To help preserve the quality of a new mattress, it should be repositioned every six months to ensure that the mattress is evenly worn. This includes rotating 180 degrees and flipping the mattress lengthwise on a regular basis. The Better Sleep Council advises against putting a mattress on a box spring/foundation that is not made to go with the mattress, as this may decrease the life of the new mattress.