Self Care – Cough less and cough with less pain

When you stop coughing,
continue to practice social distancing.
Act responsibly in protecting
the health of yourself and others.

Practically speaking,
you can stimulate the skin in a way
that reduces the frequency and pain of coughing.

This is based on a neurological principle discovered by English surgeon John Hilton. Loosely stated, hot, cold and pain travel in the same nerve and stimulating the skin changes the musculoskeletal structures underneath it. That’s really handy if you know how to use it. In most cases, a bracing dose of cold is more effective and creates fewer problems than heat.

Getting rid of the dry hack:

Solid research reveals that a dry hack is often associated with the trigger points in this muscle. I’ve gotten rid of and elicited a dry cough during a session many times by working this muscle. If you’re reading, watching TV or doing other things that pull your head forward with a slight twist to one side, this muscle gets tight.

If you’re looking in the mirror and one side seems to lay closer to your neck than the other side, it is probably associated with the cough.

The easy solution is to put one of those little Salonpas patches on, if you have one. Put it along the middle of the muscle where I have the green X. They’re available at every drug and grocery store. They’re even cheaper on Amazon.

This post shows you how to use Ice-and-Stretch to release this muscle at home with stuff you probably already have. I’ve done this countless times when a client gets a cough while laying on the table. It’s a great technique.

This is probably one of the most useful stretches you’ll ever do.

This muscle is complex. It impacts the vagus nerve, which runs in a sheath along the inside of the muscle. This means that it impacts many things from sinus irritation and headaches to coughing and hangover. I have a number of posts about it.

Sore sides or nagging shoulder blade when coughing:

There are several ways to release this but I’m going to strongly suggest that you use a Salonpas patch. Put it right there where the green “X” marks the spot. It works very consistently.

If you don’t have the patch, it’s cheaper and quicker if you don’t have a patch to do the doorway stretches in this post. Here’s the thing: If you don’t use the Ice-and-Stretch method, you might aggravate it. If you do use Ice-and-Stretch, it is REALLY intense when you ice this area, but that means, it’s much more likely to produce great results.

Burning in mid-back from coughing:

This muscle is very involved in coughing and gets aggravated when coughing is relentless. The best solution is a Salonpas patch because this is a hard area to stretch. Put if right on the red spot in the pic.

You can use contrast therapy as well. Here is a post with guidelines.

Contrast Therapy.

Sharp pain in low-back when coughing:

This is a tougher one. It involves two muscles in the low back and is usually part of a bigger low back problem. The multifidi, which are tiny strands that connect the vertebrae are creating pain because the vertebral joints are binding. The quadratus lumborum, which attaches to those same vertebrae is aggravated for the same reason.

These patches are usually very effective. They help with the sharp pain of the cough and make your back feel more stable. The pain relief gets rid of the dragging feeling. I’ve used them a good bit with friends and family when we have been working outside or moving. Always good results.

Put the patch on like the picture on the box but a bit higher. Feel for the section of your spine between your ribs and hips. Center it in that area but make sure that you cover the base of the ribs to dampen the pull of the diaphragm on low back muscles when you cough. Still make sure to have coverage into the lumbar vertebrae to quiet those trigger points as well. I know the pain is lower but it’ll be more effective directly on the trigger points.

If you have trouble getting out of bed in the morning but are good after you move around a bit, IcyHot sticks and stays on a little better than the Salonpas patches. Clients who put them on before bedtime are able to get up at night and in the morning without wincing back pain. Click on the one in the pic. They last 12 hours.

If you have trouble getting out of bed in the morning or pain while coughing at night but are good after you move around a bit, IcyHot sticks and stays on a little better than the Salonpas patches. Clients who put them on before bedtime are able to get up at night and in the morning without wincing back pain. Click on the one in the pic. They last about 12 hours.

As I said before, this is usually part of a larger, on-going low back problem. These yoga poses are variations of some standard PT exercises for this low-back instability. I recommend that you do them with the standard AIS method of reps that are held 1.5 seconds, instead of the typical prolonged yoga stretch. Here’s a post on guidelines for AIS.

There is some real wisdom to the old practice of rubbing your kid’s chest down with Vicks. The vapocoolant relaxes the intercostal muscles and makes it easier to breathe. Relax. Breathe easier. You Mom would approve.

For longer relief and to stabilize your low-back:

Do 3 rounds of these exercises. The second and third rounds should be easier with better range of motion.

variation of supine twist by Yoga Journal

The Supine Twist

The supine twist mobilizes those little facet joints that are the focus of binding pain.

Start with 20 to one side, then 20 to the other side. Bring the feet closer to your hips to target higher in the low back. Move your feet away from your low back to target muscles in the hip.

Many people prefer this variation on the supine twist.

It often produces little clicks of mobilizing vertebrae that release the trigger points creating immediate relief.

Bridge Pose by YogaOutlet


Bridges are good at stabilizing the low back, lengthening the core and strengthening hamstrings.

20 reps. Start off low and easy. Lift a little higher each time. Follow the AIS Guidelines.

Ice your back afterward to stabilize the joints and reduce inflammation.

If you have this sharp pain in your low back when coughing, see your bodyworker for longer-lasting relief.

This site is undergoing changes. Starting in early 2020, we began changing the format of the posts to include more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We’d love your feedback. We are adding posts and converting the old posts as quickly as time permits.

Weekly Featured Post

Can’t Reach the Pain
Under the Shoulder Blade

This pain and tension under the shoulder blade may be the most common pain pattern that I see. It isn’t always the primary complaint as people have gotten used to the constant ache.

It is usually combined with this pattern in the upper neck, which creates upper neck tension to go with the shoulder blade pain.

Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.

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