What is a cough?
Cough is the body’s defence mechanism to clear foreign bodies from the lungs. It can be a voluntary (conscious) or involuntary act (unconscious). Sputum (phlegm) in our lungs is the body’s way of fighting bacteria and infection. The cough reflex is caused by stimulation of cough receptors in the upper airways. Coughing can be caused by dry irritated airways which can increase the sensitivity of cough receptors.
The habit of coughing and throat clearing continues to worsen this cycle. There are three stages to a cough:
- Inhalation (breathing in).
- Increased pressure in the throat and lungs with the vocal cords closed.
- A release of air when the vocal cords open, producing a cough.
Chronic cough is a cough that lasts longer than 8 weeks. Chronic cough is often associated with increased sensitivity of the cough receptors in the upper airways.
Causes of chronic cough might include asthma, acid reflux and rhinitis (inflammation of the nasal passages) or a combination of these.
Common triggers of cough include changes in temperature, sprays, stress or anxiety, smoke, exertion, talking and position changes. It can be helpful to identify what triggers your cough so that you can help to try to control it.
If a cough is caused by a particular irritant, medication might be provided to help reduce it, for example medication for acid reflux. Giving up smoking is important as it can irritate the airways and cause damage to the lungs.
If you would like support with this, please speak to your doctor, physiotherapist or local pharmacy for advice on giving up smoking.
The aim of respiratory physiotherapy in the treatment and management of cough is:
- Reduce sensitivity of your cough reflex through techniques and education.
- Breathing pattern retraining.
- Secretion clearance if this applies to you.
- Pelvic floor exercises (if you experience incontinence with coughing).
Some helpful strategies to implement when experiencing cough are:
- Try to nose breathe as much as you can.
- Breathing pattern retraining.
- If you are having difficulty clearing your secretions, please speak to your physiotherapist about an effective airway clearance plan.
- Stay hydrated by taking frequent sips of water to ensure that your throat is moist and less irritable.
- Sucking on a sugar free sweet can also help to keep your throat moist. Avoid medicinal lozenges as these may cause further irritation.
- If you feel a cough coming on, swallow hard, relax your shoulders and concentrate on breathing in and out slowly and gently.
Following a cough, you might feel the need to take a big breath and cough again. In order to break this cycle of coughing, try this exercise:
Resources and more information
https://www.nhs.uk/conditions/cough
https://www.nice.org.uk/guidance/ng12
Page last updated: 21 May 2024
Review due: 01 January 2026