I fractured my L3 in January. I had a severe cough from a flu that lasted a few weeks. While in bed one night from coughing up so much phlegm, I stayed leaned over the side of the bed (it was as if I was vomiting phlegm that's how severe it was) caused the L3 and the rest of the lumbar spine to get out of whack. Before this, I had never had one bit of back problems. The next morning I had a mild discomfort over my left buttock. After that, every day the severe cough lasted brought more and more severe pain in the same area (as well as down the outer thigh) until I no longer could stand or sit. I had become bedridden. The spine doctor surmised that every day I continued with the severe cough (10 days) stressed the vertebra to a point of fracture. After those 10 days, I literally couldn't stand or sit for more than a few seconds. The pain was off the charts. My husband carried me into the spine surgeon's office where he performed two emergency epidural shots (emergency because I had yet to have an MRI -which I did 5 days later - so insurance denied coverage without an MRI). By this time I had tried an opioid which brought the pain down from a 10+ to only an 8 so I stopped it because it wasn't worth the risk. The shots slowly kicked in over the course of two weeks and I was able to stand for a bit more time every day, although I couldn't sit for about a month afterwards. I also lost 12 lbs (down to 97 lbs) because I was bedridden for all that time and lost tremendous amount of muscle. My spine doc (from NYU) believed in conservative treatment and no bracing.

Here's the interesting part: After 3 months, I went to see a physiatrist (a rehabilitation MD) to get the okay to begin physical therapy. He took a long time studying my MRI and said that although vertebra fractures can be excruciating, he's certain - because of where my severe pain was (over left buttock and down outer thigh) - was NOT caused by the fracture. but was caused by severely herniated disks (yup, caused by that excessive coughing). Besides a compressed vertebra, I had herniated disks in all the lower lumbar - the most severe one pressing on the very nerve that caused my out-of-control pain.

Interestingly, I just found an academic article about a 60-year-old man who basically went through the same thing but without a vertebra fracture. He had no prior back pain but due to severe coughing, he herniated his discs on the lower spine.

Needless to say, I paid a visit to a pulmonologist and told him that if I was ever that sick again with that severe of a cough, I need a Z-Pak pronto. It was only after I started the Z-Pak after 10 days that the cough began to get significantly better. I only mention this because many doctors hesitate to prescribe antibiotics for a viral respiratory infection. But after 5 days, if a cough is not getting better, antibiotics are in order. If anything, to protect our fragile vertebrae and disks from the effects of severe cough.