Why does my back hurt when I cough or sneeze with sciatica?

When you cough, sneeze, or even strain, the pressure inside your spine increases for a split second. If a nerve root is already irritated—such as in sciatica or a disc herniation—this added pressure can cause a sharp pain or shooting sensation in the back or down the leg. While it sounds alarming, it’s a common symptom of nerve involvement. Our physiotherapists identify these patterns and then use proven strategies like McKenzie therapy, manual mobilization, and posture retraining to reduce pressure on the nerve so coughing and sneezing no longer trigger pain.