Backache from a Cold and Flu

Backache from the flu

Backache from the flu is common due to dehydration

When you have a cold or the flu you’ll often find that your whole body aches, sometimes it’s even the first symptom, before the congestion, cough, or nausea begin.  Why does this happen? Why does your back ache when you get sick?

The simple answer is dehydration, although the explanation of its effects is as little longer – sorry!  When you have the flu, or even a particularly virulent cold, your body responds by producing a fever as an attempt to kill off any heat-susceptible invading bacteria and viruses.  This means that each cell in your body will use significantly more water and full body dehydration can quickly occur unless you keep taking on fluids and electrolytes.  Unfortunately, the flu can also have the effect of decreasing your appetite and thirst, making dehydration almost inevitable.   As your illness progresses you may also experience nausea, vomiting, and diarrhoea, with further fluid and electrolyte losses.

What are electrolytes?

Put simply, electrolytes are the chemical substances in your body that are responsible for creating nerve impulses, muscle contractions, and are involved in basic metabolic processes of each cell.  If you’re an athlete, or ardent exerciser, then you’ll know that replacing these electrolytes after a vigorous, sweaty, workout can save you from excruciating cramps, headaches, and muscle twitchiness later.  Your major electrolytes are potassium, calcium, magnesium, and sodium and an imbalance of these can cause the muscle aches, low energy, headaches, and other flu-like symptoms (Durlach, et al, 2000).

An electrolyte drink can help if you’re dehydrated from the flu, and, whilst these can be bought at your local healthfood/fitness store, you can also easily replace lost minerals with careful food choices.  Potassium is high in foods like avocados, leafy green veg (e.g spinach), and even bananas provide a fairly decent dose.  Good magnesium sources are almonds, pumpkin seeds, rice, quinoa, and tofu.  Eating these alongside potassium-rich foods will also help as low potassium levels can hinder magnesium status too.

Any Other Nutrition Connections?

Backache from flu

The flu causes electrolyte losses and dehydration leading to back pain

Another potential player in the back-ache/flu scenario is vitamin D.  This fat-soluble vitamin is implicated in the proper functioning of the immune system and so your stores are likely to be run down a little if you have an infection like a cold or the flu.  As most people at higher latitudes have lower vitamin D levels than are recommended (particularly those with darker skin and little sun exposure), any extra demands on your body’s vitamin D stockpile has the potential to cause problems.

But why would it cause back ache if you were low in vitamin D?  Well, the vitamin is also involved in the absorption and utilisation of calcium and magnesium for one thing (thereby affecting your electrolyte status), and it can, therefore, lead to muscle cramps and spasms when low (Merck, 2007).  Drugs like statins can also lower your vitamin D levels and the muscle aches and pains that commonly occur with statins may be due to vitamin D insufficiency.

Vitamin D’s effect on the immune system is also important in the production of inflammation during an infection such as a cold or the flu.  If vitamin D (and other nutrient) levels are low the the body can respond improperly to an attack against the immune system and may continue to create excessive inflammation for a lot longer than is useful and at higher levels than necessary to counter the invaders.  In extreme cases the immune system may fail to recognise the body’s own cells and trigger an autoimmune response implicated in conditions such as multiple sclerosis, fibromyalgia, and lupus, all of which can cause persistent back ache along with myriad symptoms.

What If My Back Hurts When I Cough or Sneeze?

If you have a cold or the flu then it’s likely you’ll sneeze more than usual and cough a lot more and that can be quite painful for a number of reasons.  Clearing your throat can cause localized inflammation and pain, and the added pressure in your sinuses due to congestion may make the whole of the front of your face and your ears hurt when coughing or sneezing.  Unfortunately sneezing and coughing can both cause back pain too, partly because they both expand the torso for a brief period and can stretch your muscles causing cramps and pain.

Coughing and sneezing also involve contraction of the abdominal muscles which can cause temporary misalignment of the back muscles and a redistribution of weight.  This may be what causes the back pain either in the muscles themselves or because the change in posture leads to extra pressure put on spinal nerves that are already constricted by spinal stenosis.  In extreme cases the action of sneezing or coughing can lead to herniated disc in neck or upper back due to sudden increases in pressure on the cervical spine.  This is particularly true if you have a lot of inflammation in the neck during your cold with enlarged lymph nodes and stiffness of the neck.  Some gentle stretching and neck exercises can help, as can ice-packs to take down the inflammation.

Video explaining coughing and disc herniations

How to Remedy Back Ache from the Flu

Plenty of cold and flu remedies contain Ibuprofen, acetaminophen, and other analgesics which can mask your pain and back ache but do little to solve the underlying problem.  Instead, if you have a fever, make sure you take on lots of fluids and snack on foods that contain good mineral levels, such as bananas, nuts, seeds, spinach, and even a bowl of rice if you can’t face much else.  Electrolyte drinks can help too, although those that are sugar-heavy should be avoided as excess sugar can compromise your mineral status too.  If you can get out in the sun a little, even for fifteen minutes or so each day, then your body will get a chance to boost its vitamin D synthesis (assuming you have a little skin exposed!).  Otherwise, fortified foods such as cereals, margarine, and even some milk replacements or fruit juices, often contain vitamin D.  Taking a good multivitamin is also helpful as an insurance against deficiency.

Above all, keep your fluids up, try to control your temperature through cold flannels (or even a cold bath), try to eat a little of something nutritious or sip an electrolyte drink throughout the day.  Pineapple juice (which contains bromelain) can be helpful, as can ginger, as natural anti-inflammatories, although ginger can also raise your temperature if you take too much.  Don’t just mask the pain with caffeinated, analgesic OTC cold and flu remedies as this will prolong the condition and could cause its own problems.  Also, make sure that you move from the sofa once in a while, get out from under the duvet, and stretch out your back a little to avoid it aching through simple lack of use.


Durlach J. Bac P. Bara M. Guiet-Bara A. Physiopathology of symptomatic and latent forms of central nervous hyperexcitability due to magnesium deficiency: a current general scheme. [Review] [64 refs] [Journal Article. Review] Magnesium Research. 13(4):293-302, 2000


Guo R, Canter PH, Ernst E. Herbal medicines for the treatment of rhinosinusitis: a systematic review. Otolaryngol Head Neck Surg. 2006 Oct;135(4):496-506. Review.

Helms S, Miller A. Natural treatment of chronic rhinosinusitis. Altern Med Rev. 2006 Sept;11(3):196-207.

Klein G, Kullich W, Schnitker J, Schwann H. Efficacy and tolerance of an oral enzyme combination in painful osteoarthritis of the hip. A double-blind, randomised study comparing oral enzymes with non-steroidal anti-inflammatory drugs. Clin Exp Rheumatol. 2006 Jan-Feb;24(1):25-30.

Merck Manuals, Vitamin D, 2007,

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