In a client with a herniated intervertebral disk, what activities may cause a sudden increase in pain?

Coughing or sneezing can significantly increase intra-abdominal pressure, which may exacerbate pain in a client with a herniated intervertebral disk. When a disk is herniated, the surrounding structures, including nerves, can become compressed or irritated, leading to pain. Sudden increases in pressure due to actions like coughing or sneezing can exacerbate this compression, resulting in a sharp or intensified pain response.

In contrast, sitting on cold surfaces, standing for extended periods, and lying supine while flexing the knees are less likely to provoke a sudden increase in pain. Sitting on cold surfaces might lead to discomfort due to muscle tension or generalized muscle spasms but is not typically associated with the immediate pain exacerbation linked to herniated disks. Standing for extended periods could contribute to ongoing discomfort due to static posture but is a continuous issue rather than a sudden increase. Lying supine while flexing the knees often helps alleviate pressure on the lumbar spine and can promote comfort rather than causing an acute pain response.