What damage can sneezing cause? Understanding the risks

September 23, 2025 •

5 min read

While typically a harmless reflex, a single forceful sneeze can generate immense pressure within the body, potentially leading to surprising and, in extremely rare cases, severe health issues. This article explores what damage can sneezing cause, both when performed naturally and when suppressed.

Quick Summary

Despite being a common and usually harmless bodily function, a powerful sneeze can exert significant pressure, leading to rare but possible injuries like muscle strains, rib fractures, or damage to blood vessels. The risk of harm increases substantially when a sneeze is deliberately held in, which can cause severe, though uncommon, complications like a ruptured eardrum or a cerebral aneurysm. Knowing the potential risks can help you sneeze safely.

Key Points

Rare but Possible Injuries: A natural, forceful sneeze can cause rare injuries like fractured ribs, muscle strains in the back or chest, and temporary blood vessel rupture in the eye.
The Danger of Suppression: Holding in a sneeze is far riskier than letting it out, as it redirects immense pressure internally.
Ear Damage: Suppressing a sneeze can force air into the middle ear, potentially causing a ruptured eardrum, ear infections, or vertigo.
Vascular Risks: In extremely rare cases, the pressure from a suppressed sneeze can cause a pre-existing brain aneurysm to rupture or lead to aortic dissection.
Musculoskeletal Risks: Suppressing a sneeze can also cause damage to the throat cartilage or fracture other small, delicate bones in the body.
Safe Sneezing: The safest method is to let the sneeze happen, covering your mouth and nose with a tissue or elbow to prevent germ spread.

The Powerful Mechanics of a Sneeze

A sneeze, or sternutation, is a powerful and involuntary expulsion of air from the lungs, triggered by irritants in the nasal passages. This reflex involves a complex, coordinated effort of multiple muscles, including the chest, abdomen, and diaphragm. When you feel the pre-sneeze sensation, air is forcibly inhaled, and then the glottis (the part of the larynx consisting of the vocal cords and the slit-like opening between them) closes, building up pressure in the chest. This pressure is then released in a forceful, rapid burst through the nose and mouth.

While urban legends persist about eyeballs popping out or hearts stopping, neither is true. The eyes close instinctively as a reflex, and while heart rhythm can temporarily change due to the pressure, it does not stop. However, the sheer force and velocity of a sneeze—with air sometimes traveling at speeds exceeding 100 miles per hour—do carry the potential for certain types of physical damage, particularly in specific circumstances.

Rare but Possible Injuries from Sneezing

For most healthy individuals, a sneeze is completely harmless. However, there are documented, albeit rare, cases of injury resulting from a particularly violent or ill-timed sneeze.

Musculoskeletal Injuries

Back and Rib Injuries: The sudden, violent contraction of core muscles can cause strain, especially if the body is in an awkward position. People have reported experiencing sharp back pain, herniated discs, or even fracturing a rib. Individuals with underlying bone conditions like osteoporosis may be at greater risk.
Intercostal Muscle Strain: The muscles between the ribs, known as intercostal muscles, can be strained by the intense contractions. This can lead to significant pain in the chest or ribcage area, often mistaken for more serious issues.

Vascular Injuries

Ruptured Blood Vessels: The abrupt increase in blood pressure can sometimes cause small, superficial blood vessels to burst. This is most commonly seen in the eyes, appearing as a subconjunctival hemorrhage—a patch of bright red blood on the white of the eye that looks alarming but is usually harmless and resolves on its own.

Urinary and Pelvic Issues

Pelvic Floor Weakness: A powerful sneeze can cause a sudden loss of bladder control, a condition known as stress incontinence. This is most common in people with weakened pelvic floor muscles, such as after childbirth, or due to age or obesity.

The Dangers of Suppressing a Sneeze

While allowing a sneeze to happen naturally carries minimal risk, forcibly holding one in by pinching the nose and closing the mouth can be far more dangerous. When you suppress a sneeze, the explosive pressure is redirected internally, and that energy has to go somewhere.

Ear Damage: Redirecting the pressure can force air up the Eustachian tubes into the middle ear. This can lead to a ruptured eardrum, causing pain, infection, and potential hearing loss. In very rare cases, the small bones of the middle ear can also be damaged.
Throat Damage: There are documented medical cases of people tearing their pharynx (throat) by suppressing a sneeze. This can lead to a painful and potentially dangerous condition called subcutaneous emphysema, where air becomes trapped under the skin in the chest or neck.
Blood Vessel and Aneurysm Concerns: While incredibly rare, the extreme internal pressure could potentially rupture a blood vessel in the head, neck, or brain, particularly if a pre-existing aneurysm exists. One reported case even linked a forceful sneeze to an aortic dissection, a tear in the major artery of the heart.
Laryngeal Fractures: The small cartilage of the voice box (larynx) has been known to fracture in rare cases due to a suppressed sneeze.

Comparison of Risks: Natural Sneezing vs. Suppressing a Sneeze


Feature	Natural Sneeze	Suppressed Sneeze
Mechanism	Pressure is safely expelled outward.	Pressure is redirected internally.
Common Injuries	Minor muscle strains, pelvic floor issues (in susceptible individuals).	Ear infections, temporary vision issues from burst eye vessels.
Rare, Serious Injuries	Rib fractures, back injuries, severe vascular events (extremely rare).	Ruptured eardrum, pharyngeal tear, fractured larynx, ruptured brain aneurysm (extremely rare).
Germ Spread	High risk of spreading airborne germs.	Redirects germs inward, potentially causing ear infections.
Recommended Action	Recommended; cover mouth/nose with elbow or tissue.	Strongly advised against due to potential for greater internal injury.

How to Sneeze Safely

The safest way to sneeze is simply to let it out. To minimize germ spread and avoid injury, follow these simple etiquette tips:

Cover Your Mouth and Nose: Use a tissue to cover your mouth and nose. Immediately throw the tissue away to prevent spreading germs.
Sneeze into Your Elbow: If you don't have a tissue, sneeze into the crook of your elbow. This prevents germs from getting on your hands, which can then touch surfaces.
Use Good Posture: When you feel a sneeze coming, try to stay upright and avoid twisting your torso. Bending at the knees rather than the back can help reduce the strain on your spine.
Practice Good Hygiene: Always wash your hands with soap and water after sneezing to eliminate any lingering germs.

For more information on proper respiratory hygiene, please consult reliable sources like the Centers for Disease Control and Prevention.

When to Seek Medical Attention

While most sneeze-related discomfort is temporary and not a cause for alarm, certain symptoms warrant a visit to a healthcare professional:

Severe, persistent pain in the chest, back, or neck immediately following a sneeze.
Significant hearing loss, dizziness, or ear pain after a forceful or suppressed sneeze.
Sudden, severe headache, especially if accompanied by numbness or weakness.
Changes in vision beyond a simple burst blood vessel in the eye.
Any signs of a possible hernia or other abdominal injury.

Conclusion

Ultimately, a sneeze is a natural and healthy reflex that protects your body from irritants. The risks of serious damage from an uninhibited sneeze are extremely low. The real danger lies in suppressing this powerful reflex, which can cause significant internal pressure and lead to more severe, though still rare, injuries. By understanding the mechanics and following proper etiquette, you can confidently and safely let that sneeze fly when it's time.

Frequently Asked Questions

While it is a rare occurrence, a particularly violent or forceful sneeze can generate enough pressure to fracture a rib, especially in individuals with weakened bones, such as those with osteoporosis.

Yes, deliberately suppressing a sneeze can be dangerous. It traps and redirects high pressure inward, which can lead to rare but serious injuries like a ruptured eardrum, a torn throat, or damaged blood vessels.

Back pain during a sneeze is often caused by the sudden, intense contraction of abdominal and back muscles. This can strain muscles or, in some cases, aggravate pre-existing conditions like a herniated disc.

It is extremely rare, but the abrupt, significant spike in blood pressure from suppressing a sneeze could, in theory, cause a pre-existing, weakened brain aneurysm to rupture. The risk is considered very low for healthy individuals.

Closing your eyes during a sneeze is an involuntary, protective reflex controlled by the nervous system. It is meant to prevent the involuntary spray of germs and irritants from reaching your eyes. The urban legend about eyeballs popping out is completely false.

Yes, but typically only by suppressing a sneeze. The redirection of air pressure can damage the delicate structures of the middle and inner ear, potentially leading to a ruptured eardrum, hearing loss, or vertigo.

The safest way is to let the sneeze out naturally. The CDC recommends covering your mouth and nose with a tissue or sneezing into the crook of your elbow to prevent the spread of germs to others.