Back Pain or Liver Pain: What’s the Difference?

Key takeaways:

• Back and liver pain may have similar locations, but they are very different in their causes and treatments.
• Liver pain is often associated with other symptoms, including nausea, vomiting, yellowing of the eyes or skin, stomach pains, and itchiness.
• If you are concerned you are having liver pain, you should discuss this with your doctor.

You may be experiencing back pain, but is it an issue with your back? This article will discuss the differences between actual back pain and back pain due to a problem with your liver.

You should be able to recognize what to look for and when to see your doctor about your pain.

Overview: difference between back pain and liver pain

Back pain has the potential to be many things and is most commonly an issue with the muscles or bones of the back. However, the pain you are experiencing may be referred pain due to an issue with your internal organs.

Back pain

Back pain is a general term often used to describe musculoskeletal pain in the back. Musculoskeletal back pain is due to stress or injury to the back muscles, ligaments, or bones. It often develops due to repetitive minor injuries. Repetitive injuries may come from prolonged sitting, poor posture, and heavy lifting with poor form. You may also have an obvious injury from an accident.

Musculoskeletal back pain is often isolated to your spine or the muscles on either side. You may experience a continuous dull ache or have intermittent sharp pain. Waking up with soreness or tightness in the back is common.

Additionally, you may notice spasms or sudden shooting pains that travel up or down your spine. Musculoskeletal back pain may be treated with over-the-counter pain medications, ice or heat therapy, and physical therapy.

Liver pain

When you have issues with your liver, you may also experience back pain. This is called referred pain, which occurs because the nerves to your liver are routed to the right side of your back near your shoulder blade. You may also experience some right shoulder pain as well. Some causes of liver pain include hepatitis, infections, tumors, blood clots, or bile duct blockages.

Liver pain may come and go or feel sharp or dull depending on the cause and whether or not the liver is continuously inflamed or irritated. Liver pain is often associated with other symptoms, which may point to the actual cause of the pain. It is important to understand the underlying cause of liver pain in order to treat it.

Key differences between back pain and liver pain

Sometimes, it can be difficult to determine what the cause of your pain is as it may come on suddenly. You should be aware of important characteristics of back and liver pain. This will help prevent delays in seeing a doctor if you are concerned about your symptoms.

This section will describe some key differences between back and liver pain.

Causes

Any muscle, ligament, or bone injury may cause musculoskeletal back pain. A sports injury, accident, or fall may result in pain in a specific area of your back. If you have an injury to your ribcage, you may also experience symptoms on just one side. Although, you will often know the cause of these injuries when they occur.

Liver pain may come on suddenly, and it is more challenging to determine the potential cause. Any disease or infection that causes liver inflammation can cause liver pain.

Gallstones can cause a blockage of the bile ducts that causes liver irritation. Hepatitis or autoimmune disorders cause liver inflammation. Recent gastrointestinal tract infections, such as diverticulitis or appendicitis, may lead to a pocket of infection in the liver called an abscess. Recent travel to another country could lead to parasitic or amebic infections of the liver. Tumors of the liver may cause pain if the outside of the liver, called the capsule, is stretched.

Timing and type of symptoms

Musculoskeletal back pain may start suddenly after an injury or as soreness from repetitive minor trauma caused by poor lifting form or posture. Pain is often worse in the morning due to stiffness but gradually improves with movement. Symptoms may be irritated by heavy lifting or prolonged sitting or standing.

Liver back pain often starts suddenly and does not improve until the cause is resolved. The pain is typically constant and does not change with movement. The pain may be sharp or vague and difficult to describe. Symptoms may worsen with eating.

Reproducibility

One of the key features of musculoskeletal pain is that it is often reproducible.

This means symptoms worsen by pushing on the area where the pain occurs. Liver pain is not reproducible or made worse by pushing on the area.

Associated symptoms

Musculoskeletal back pain is often associated with pain shooting down your back, arms, or legs. You may experience worsening symptoms with sudden movements or have numbness or tingling.

Liver pain may have many different symptoms depending on the cause. You may notice:

• Nausea or vomiting
• Itchiness
• Yellowing of the eyes or skin
• Stomach pain
• Diarrhea
• Gray-colored stools
• Confusion

Treatment

The treatment of musculoskeletal back pain is typically a combination of over-the-counter pain medication (acetaminophen and/or ibuprofen), ice versus heat therapy, and physical therapy exercises.

Managing liver pain is a bit more tricky as it depends heavily on the cause of the liver inflammation. You should consult with your doctor for more guidance if you believe this to be the cause of your pain.

When to see a doctor about back pain or liver pain

Back pain can significantly impact your daily activity and can be pretty distressing. It is important to understand when you should see a doctor, depending on the type of pain.

You should see a doctor about back pain if:

• You have severe pain has not improved after a few days and is keeping you from performing normal daily activities.
• You have severe pain not relieved with over-the-counter medications.
• You have a personal history of cancer.

You should go to the emergency room for back pain if:

• You have pain associated with new neurologic symptoms, such as numbness, muscle weakness, or loss of bowel or bladder control.
• You have severe pain associated with persistent fevers (>100.4 °F or 38 °C.)
• You have pain with a history of intravenous drug use.

You should see a doctor about liver pain if:

• You have a personal history of cancer.
• You have a personal history of or active heavy alcohol use.
• You experience unintentional weight loss.
• You experience yellowing of the eyes or skin, whole body itchiness, or gray-colored stools.

You should go to the emergency room for liver pain if:

• You experience symptoms of yellowing of the eyes or skin with fevers (>100.4 °F or 38 °C)
• You have severe stomach pains with liver back pain.
• You develop feelings of confusion.

Questions to ask your doctor about back pain or liver pain

Asking your doctor the right questions about back or liver pain can help you better understand the causes, treatment options, and preventive measures for managing your symptoms effectively.

Questions to ask about back pain:

• Should I have any tests or imaging studies to determine the cause?
• How long should I expect to have pain?
• Are there any stretches or exercises I can do to prevent the pain?
• Are there any injections or pain medications that may help the pain?

Questions to ask about liver pain:

• How will I know if something serious is happening?
• Are there any tests or imaging studies to determine the cause?
• Will this happen again or worsen?
• How often will I need to be followed for this pain?

Managing back or liver pain

Back pain and liver pain may feel the same, but some differences help point to the cause. Understanding the differences between the two types of pain is critical to make sure you can monitor for other warning signs. If you are concerned or not sure what the cause of your pain is, you should see your doctor.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Poushali Bhattacharjee, MD.

Sources

"Chapter 4. The Regional Musculoskeletal Examination of the Shoulder." Systematic Musculoskeletal Examinations Ed. George V. Lawry. The McGraw-Hill Companies, 2012, https://accessmedicine.mhmedical.com/content.aspx?bookid=384&sectionid=41842863.

"Symptoms & Causes of Cirrhosis." NIH, 2023, www.niddk.nih.gov/health-information/liver-disease/cirrhosis/symptoms-causes.

Engstrom, John W. "Back and Neck Pain." Harrison's Principles of Internal Medicine, 21e Eds. Joseph Loscalzo, et al. McGraw-Hill Education, 2022, https://accessmedicine.mhmedical.com/content.aspx?bookid=3095&sectionid=262789801.