What Happens If You Sneeze Really Hard? Understanding the Risks and Realities

September 28, 2025 •

4 min read

A single, powerful sneeze can expel air at speeds of up to 100 miles per hour. Given this immense force, it's natural to wonder what happens if you sneeze really hard? While minor muscle pain is common, very forceful sneezes can carry rare but serious risks.

Quick Summary

A forceful sneeze can cause temporary discomfort like a muscle strain in the back or chest due to the sudden muscle contraction, or in extremely rare cases, more serious issues such as a herniated disc, rib fracture, or ruptured eardrum. Let the sneeze out naturally to reduce risk.

Key Points

Pressure Builds: A powerful sneeze generates and expels significant pressure from the lungs and chest, which is typically well-managed by the body's natural reflexes.
Muscle Strains are Common: The most frequent result of a forceful sneeze is a minor muscle strain or spasm in the back, chest, or neck due to sudden muscle contractions.
Holding a Sneeze is Riskier: Suppressing a sneeze is more dangerous than letting it out, as it can multiply internal pressure and increase the risk of injury to the eardrums, throat, or blood vessels.
Rare but Serious Injuries: In rare cases, especially with underlying health issues like osteoporosis or a pre-existing aneurysm, a powerful sneeze can cause a herniated disc, fractured rib, or ruptured blood vessel.
Check Underlying Conditions: Pain from a forceful sneeze can signal an underlying issue that needs medical attention, such as a herniated disc, pinched nerve, or muscle vulnerability.
Proper Technique is Key: To prevent injury, sneeze naturally and avoid holding it in. Lean slightly forward to reduce strain on the back and always cover your mouth and nose to prevent germ spread.

The Inner Mechanics of a Sneeze

A sneeze, or sternutation, is a reflex action designed to clear irritants from your nasal passages. The process is a rapid and coordinated expulsion of air that starts when an irritant—like dust, pollen, or pepper—activates nerve cells in your nose. This signal is sent to the sneeze center in your brainstem, which orchestrates a sequence of events. Your chest muscles contract, your eyes and mouth close, and a huge burst of pressurized air is released. This complex physiological response is why a sneeze feels so powerful and can sometimes lead to unexpected bodily sensations or discomfort.

The Common Outcomes of a Forceful Sneeze

For most people, a powerful sneeze is a benign, albeit startling, event. The most frequent outcomes are not serious and typically involve muscular pain or discomfort. These are generally temporary and not cause for alarm.

Muscle strain: A sneeze causes a sudden, involuntary contraction of the muscles in your chest, abdomen, and back. If these muscles are already tense, weak, or caught off-guard, this sudden jolt can cause a minor strain. The pain is usually sharp and can feel like a pulled muscle, especially in the lower back or between the ribs.
Existing injuries: For those with pre-existing conditions like a pinched nerve, arthritis, or a muscle injury, a forceful sneeze can aggravate the area and cause a flare-up of pain.
Leakage: Increased abdominal pressure from a sneeze can sometimes cause urinary leakage, particularly in individuals with weak pelvic floor muscles. This is common in people who have given birth, are obese, or are going through menopause.

The Extremely Rare Dangers of a Sneeze

While the vast majority of sneezes are harmless, there have been documented—though exceedingly rare—cases of serious injury. These are almost always associated with significant underlying vulnerabilities or specific actions, such as holding the sneeze in.

Herniated disc: The pressure from a sneeze can, in rare instances, put enough strain on the spine to cause a disc to bulge or herniate. The discs, which act as cushions between the vertebrae, can be damaged if the sudden force is too great, leading to sharp, radiating pain known as sciatica.
Rib fracture: Case reports have shown that an especially violent sneeze or prolonged sneezing fits can cause a rib fracture, particularly in people with weakened bones from conditions like osteoporosis or chronic steroid use.
Ruptured eardrum: If you stifle a sneeze by pinching your nose and closing your mouth, the pressure is redirected towards the eustachian tubes connecting the nose and ears. This can potentially cause a ruptured eardrum, leading to hearing loss or infection.
Vascular damage: In extremely rare cases, the sudden increase in blood pressure from a forceful sneeze can lead to a vascular incident. These have included subconjunctival hemorrhage (a burst blood vessel in the eye) or, in the case of a pre-existing aneurysm, a rupture.

Holding it In: Why Suppressing a Sneeze is Even Riskier

Suppressing a sneeze can significantly increase the internal pressure your body experiences. While a normal sneeze channels pressure outward, stifling it traps that force inside. In fact, holding in a sneeze can create 5 to 24 times more pressure than a regular sneeze. This makes suppressing a sneeze far more dangerous than allowing it to be expelled naturally. Case reports have described serious injuries from stifled sneezes, including a torn windpipe and fractured voice box.

Reducing the Risks of a Forceful Sneeze

Most people will never experience a severe sneezing injury, but those with pre-existing conditions can take steps to minimize their risk. The best approach is to manage any underlying issues and adjust your body position when a sneeze is coming.

How to Minimize Sneeze-Related Pain

Adjust your posture: If you feel a sneeze coming, try to avoid awkward positions. Straighten your back and support your spine by standing tall or sitting upright.
Strengthen your core: Strong core muscles can better absorb the force of a sneeze. Incorporating core-strengthening exercises into your fitness routine can provide better support for your back and abdominal muscles.
Lean forward: Some experts suggest leaning forward slightly as you sneeze to help protect your back.
Be mindful of existing conditions: If you know you have a pre-existing condition like osteoporosis, a herniated disc, or chronic muscle stiffness, be particularly cautious and consult a doctor on preventive measures.

Comparison: Dangers of a Natural vs. Suppressed Sneeze


Feature	Natural Sneeze	Suppressed Sneeze
Pressure Level	Controlled, expelled outward	Trapped, increased significantly (up to 24x)
Common Outcomes	Minor muscle strain, momentary discomfort	Discomfort, pain in chest, head, or ears
Rare Risks	Herniated disc, rib fracture, vascular issues (very rare)	Ruptured eardrum, torn throat, ruptured aneurysm
Spread of Germs	Expels droplets, requires proper hygiene	Traps germs within nasal passages, potentially pushing them to middle ear
Prevention	Cover mouth/nose with tissue or elbow	Not recommended, as it's riskier

Conclusion

So what happens if you sneeze really hard? In the vast majority of cases, the outcome is nothing more than a momentary, and sometimes surprising, burst of physical energy that might cause a minor muscle strain. The human body is remarkably resilient and designed to handle the pressure of a sneeze. However, for those with specific vulnerabilities or pre-existing conditions, the force can potentially lead to more serious, though rare, injuries. The key takeaway is that the safest way to sneeze is to let it out naturally, covering your mouth and nose with a tissue or your elbow to prevent the spread of germs, as recommended by the CDC. Suppressing a sneeze, by comparison, can create significantly more internal pressure and carries a higher, though still low, risk of serious complications. If you experience persistent or severe pain after a sneeze, it's always best to consult a healthcare provider for a professional assessment. For more information on proper hygiene, visit the CDC website.

Frequently Asked Questions

No, a sneeze cannot cause a heart attack. While a sneeze can momentarily affect your heart rhythm by increasing chest pressure, it does not stop your heart or lead to a heart attack in a healthy individual. The effect is temporary and not dangerous.

While it is rare, a forceful sneeze can put enough sudden pressure on the spine to cause a disc to bulge or herniate, especially if there is a pre-existing weakness in the spinal column. If you experience sharp, persistent pain after sneezing, it is wise to consult a doctor.

No, this is a myth. Your eyes are held firmly in place by muscles and nerves, and your respiratory airways have no connection to your eyeballs. Closing your eyes during a sneeze is an involuntary reflex, not a protective necessity.

Back pain from a forceful sneeze is most often caused by a muscle strain or spasm. The sudden contraction of your back and abdominal muscles can pull or stress them, especially if they are already tight or weak. Poor posture during a sneeze can also contribute to this pain.

It is possible but very rare. Rib fractures from sneezing are most likely to occur in individuals with weakened bones, such as those with severe osteoporosis, or as a result of prolonged, severe bouts of coughing or sneezing.

Yes, you should always cover your mouth and nose when sneezing. This helps prevent the spread of germs to others. The CDC recommends sneezing into a tissue and then disposing of it, or using the crook of your elbow if a tissue isn't available.

Subcutaneous emphysema is a rare condition where air becomes trapped under the skin, which can occur from the immense pressure of holding in a forceful sneeze. It can cause swelling and a crackling sensation and requires medical attention, though it is usually not life-threatening.