It’s a familiar scenario: you go to bed feeling fine, and then you roll over to the sound of your morning alarm the following day and suddenly your body feels far different than it did just hours before. You're feeling under the weather.
Once we start to notice we’re feeling sick we can experience a large variety of sometimes disconnected symptoms – a stuffed nose, a headache, soreness, and many other possibilities.
One of those potential symptoms is back pain, whether from soreness, stiffness, or achiness. Upon first feeling back pain, people can begin to worry and, to be sure, back pain that persists for more than a few days isn’t something to shrug off – especially if shrugging doesn’t come easily. But if you’re starting to feel sick and back pain figures into that equation, there’s no reason to leap to any dire conclusions.
Whatever the case may be, routine sicknesses can lead to back pain in various forms, even your run-of-the-mill flu virus.
Back pain that accompanies many common illnesses can often be treated by the old reliables: rest and heat applied directly to the area in pain. Other instances of back pain may require prescriptions or other doctor-prescribed remedies that resolve symptoms in a short period of time.
In this blog post we'll discuss some of the reasons your spine might be hurting while you're sick, what you can do to help fight the pain and when you should call your doctor.
Before we dive into the causes of spine pain in sickness, it's important to define what we mean when we say, "sickness".
The term “sick” covers a wide range of illnesses. In this article, we will focus on “sick” in its most ordinary meaning, the “I woke up and don’t feel great” sick. Usually referring to the common cold or flu.
There are many other reasons why your spine might hurt and our website features numerous articles detailing more specific back and spinal ailments – for more on these, see the Conditions page here.
Why does your back hurt if you’re sick?
Broadly speaking, back pain may accompany being sick owing to inflammation and the body’s natural immune response when fighting off infections, whether viral or bacterial.
As our bodies gear up their defenses to prevent diseases from developing, they wage a battle against the invading viruses by using a process that includes the release of cytokines, an important protein for human immunity.
The American Cancer Society summarizes the role of cytokines as “signal[s for] the immune system to do its job”: specifically, cytokines are released by our bodies to locate the cells in our immune system that are designed to combat infections.
Once the cytokines locate the relevant immune cells, they bind to them and cause those cells to activate, whereupon they aim for the infected areas where they are needed.
When we feel bad while sick, it’s not primarily due to the sickness itself, but rather our bodies’ immune responses attempting to eradicate the illness.
As uncomfortable as it is to experience, the pains, aches, and fevers we suffer during periods of sickness are signs that our bodies are doing what they’re supposed to be doing. In time the heat will die down, and our bodies will restore to their normal resting levels, at which point any pains should subside.
During the war of our immune systems against infections, cytokine release has one key side effect that patients experience: inflammation.
While not all cytokines produce inflammation, some are classified as anti-inflammatory, those that help facilitate our bodies’ immune responses naturally cause inflammation.
(ThermoFisher Scientific provides a helpful breakdown of several cytokines and their relationships to inflammation here, but fair warning to the non-doctor readers: it gets pretty technical.)
If you’ve ever had a cut or scrape that’s red and tender to the touch, that’s a sign of inflammation, which is to say a sign of the body at work on the healing process.
So when our bodies fend off illnesses internally, the inflammation causes the affected areas to swell, which leads to pressing against nerve endings and muscles – hence the pain.
This is also why we feel achy and sore when dealing with the flu; our body is throwing a lot of punches internally, in the form of inflammation.
This inflammatory process may be magnified for flu patients who already have pre-existing back pain. Spinal conditions like sciatica, herniated discs, or bulging discs can feel more painful when we're sick because of the increased inflammation.
Coughing and Back Pain
Moreover, coughing can contribute to back pain along with inflammation. Small coughs cause discomfort; a bigger cough, especially a hacking spell (a series of consecutive heavy coughs), may put additional strain on the muscles and ligaments in one’s lower back.
Taken together, inflammation and cough-induced back strain, which tends to manifest in the lower back specifically, paints a common picture: when we experience back pain while sick, it’s usually not because we’re facing a back-specific malady. Rather, the spine, by virtue of being a central part of the body’s support structure and overall frame, naturally gets caught in the crossfire of symptoms that appear once we become sick.
This discomfort is run of the mill for many of the regular sicknesses we experience.
Common Sicknesses and Back Pain
Back pain, soreness, and achiness is linked to several common diseases that afflict millions of individuals each year. Of these, two stand out:
Influenza is the most common type of sickness that can cause back pain. One of the distinguishing markers between the common cold and influenza is the presence of muscle aches and pains, which typically only occur with the flu.
These aches, caused by the immune responses the body throws at the invading virus, will desist once the healing process has taken its natural course. However, the inflammation it brings can cause spine pain.
COVID-19 symptoms can be a source of back pain as well.
A 2022 study published in International Journal of Infectious Diseases reports that “SARS-CoV-2 infection [is] independently associated with LBP [lower back pain],” and “24.4% of survivors of COVID-19 reported lower back pain.”
Another important factor of COVID-19 identified by the survey is the disease’s capability to impact the health of individuals even in instances where the virus caused minor or no symptoms.
For some people, the fallout of the virus amounts to what many are calling “long COVID,” or depreciated health conditions caused by the damage left behind in certain instances. One symptom under the long COVID umbrella is joint and muscle pain, the back included.
As the medical literature on the virus continues to grow, we will likely hear about more links between it and back pain.
How can I help my back pain when I’m sick?
Because the “back pain while sick” phenomenon usually stems from the immune reaction to a pathogen, the way for individuals to treat back pain is to treat the thing that’s making them sick. The best ways to address routine sickness include the following:
- Rest: While sick, one’s body performs a lot of work internally to dispel the disease-causing agent, whether viral or bacterial. Placing the body under additional stressors during that time will slow down and perhaps impede recovery. This means that if you don’t rest, you’re likely to sustain the inflammatory response that causes back pain during bouts of the flu.
- Drink Water: Keeping your body hydrated with fluids is not only critical for ensuring your body has what it needs during a time of healing; it’s also critical for spinal health in general – a topic we’ve covered before. Lack of hydration can directly impact the structural integrity of one’s spinal discs and reduce inflammation under normal conditions, so the role of hydration takes on a heightened importance during sickness that results in back pain and soreness. Relatedly, you should also avoid liquids that dehydrate you, particularly sugary drinks and alcohol.
- Pain Relievers: The kind of back pain that stems from ordinary sickness can usually be treated by responsibly taken over-the-counter painkillers that use acetaminophen (the active ingredient in Tylenol) or ibuprofen.
- Eat Inflammation-Reducing Foods: Eating certain types of anti-inflammatory foods like blueberries, leafy vegetables, tomatoes, and fatty fish can help reduce the effects of inflammation.
Along with these direct responses to sickness-related back pain, you can also address your back issues by performing some practices that are beneficial no matter how well you’re feeling:
- Practice Good Posture: Keeping up back health-promoting posture is especially key for those of us who, in an era where “work from home” has become a new normal rather than a pandemic-induced backup measure. Improper posture habits will lead to the magnification of back pain when inflammation places additional stress on the nerves and muscles in the back.
- Stretch: You will need to stretch more gently when you’re sick and resting, of course, but stretches remain essential to keeping our muscles from tensing up and becoming more susceptible to tears and injuries.
- Rest in a Comfortable Place: While you’re allowing your body to heal, ensure that the place you’re resting provides you with the optimal level of comfort – whether that’s your bed, or an especially plush sofa.
These simple at-home procedures can be done well before needing to step foot into a doctor’s office. Provided that one has a healthy immune response to the sickness, the back pain should fade as the disease does.
When should I see a doctor?
Sickness-induced back pain should not linger after you’ve recovered from your illness. If it does, or if during the sickness the back pain becomes particularly severe during the time you’re sick, you should schedule a medical visit.
In cases of routine sickness, back pain isn't often the primary symptom that you feel, but rather one of many. So, if it becomes overwhelming or persistent it may be a sign of a separate issue, or an agitation of a pre-existing back and/or spinal concern that you may not have detected before.
Fortunately, those cases are far from the majority.
It's tempting to go to the doctor straight away once back pain emerges. In fact, many people do just that. A 1996 article in the journal Spine identifies back pain as “the second leading symptom prompting all physician visits in the United States.”
But if you know the common reasons why back pain appears when you feel sick you can be empowered to take the situation more calmly, and know more confidently when you can stay home, and when you should call your doctor.