Chest & Back Pain Together: Causes, Relief & Treatment

Key takeaways:

• Your chest and back pain may be a result of a condition affecting your heart, lungs, muscles, bones, or biliary system.
• The location and type of pain you are experiencing can help identify the cause of your symptoms.
• When experiencing these and other symptoms at the same time, it may require evaluation from a healthcare professional

Chest and back pain are very common and can be frustrating. This article will address these symptoms when they occur together. Because there are multiple causes of both symptoms, it is important to know what you can do to deal with symptoms and identify factors that may suggest something more serious that requires further evaluation from a healthcare professional.

Common causes of chest and back pain at the same time

Chest pain can radiate toward your back, and back pain can radiate toward your chest. You may be experiencing referred pain, which is when you have an injury in one area of your body but feel pain in a different part of your body. This is why these symptoms can appear together even if you are not experiencing a medical problem with both your chest and back.

Heart conditions

One of the most common heart-related problems that may lead to your symptoms is angina. Angina is chest pain or discomfort that occurs because part of your heart may not be getting enough oxygen-rich blood. If this persists for long enough, it can result in myocardial infarction, more commonly known as a heart attack. Many factors can lead to angina, and angina is usually not a persistent symptom. It typically occurs in brief episodes that last for a few minutes at a time.

Another cause of chest and back pain related to your heart is pericarditis. Pericarditis is inflammation of the thin protective lining surrounding your heart, the pericardium. It may be difficult to distinguish from angina or other causes of chest and back pain; however, it typically lasts longer than angina and develops over a longer period.

Lung conditions

The most common cause of chest and back pain related to your lungs is infection, such as pneumonia or bronchitis. With such infections, you may also experience accompanying symptoms like cough, shortness of breath, and fever. The pain may be worse after a coughing spell or changes in body position, particularly when lying flat. Another cause of chest and back pain related to your lungs is a blood clot in your lungs, also known as pulmonary embolism, which can be fatal if untreated.

Your lungs are covered by a thin layer of tissue called the pleura. There are multiple conditions in which the pleura is affected either by injury, infection, or inflammation, and many of these conditions can cause chest and back pain. Some of these pleural conditions include pleurisy, pleural effusion, and pneumothorax.

Musculoskeletal conditions

Chest and back pain can occur due to an injury or problem with a part of your chest wall and the cavity around it. If you recently experienced any trauma or have a repetitive stress injury to your chest and/or back, you may be dealing with a rib fracture(s). Trauma or repetitive stress can also lead to muscle strains, which are small tears in the muscle fibers. Muscle strains themselves can be painful, but they can also lead to surrounding muscles working harder to compensate for the deficit. Other conditions, such as arthritis or nerve compression, can also cause chest and back pain.

Abdominal/biliary conditions

The biliary system is composed of multiple organs that help your body create, utilize, and store bile, which is an important fluid that helps you digest food. Radiating chest and back pain can arise due to a problem in this biliary system. Some of the conditions that affect the biliary system include pancreatitis (inflammation of the pancreas), cholangitis, cholecystitis, gallstones, or hepatitis. Similarly, you may be experiencing chest and back pain due to medical conditions affecting your stomach, such as ulcers or gastroesophageal reflux disease (GERD).

Common causes of chest and back pain based on the pain’s location

Many conditions may be causing your chest and back pain, so location is an important factor that can help lead to an accurate diagnosis. This section will link different causes with the expected location of chest and back pain.

Cardiac causes

Because your heart is located on the left side of your chest, if your chest and back pain is worse on the left side, there may be a condition affecting your heart that is causing your symptoms. It is important to note that you may experience right-sided chest pain that is related to your heart. This pain can also radiate toward your shoulders and neck with associated symptoms of sweating, increased heart rate, palpitations, shortness of breath, passing out, or color changes of your skin, also known as cyanosis. The nature of your chest pain may be described as stabbing or pressure-like, and in most cases, the chest pain will be worse than the back pain.

Lung/musculoskeletal causes

If you have a condition affecting your lungs, you may experience associated symptoms, such as shortness of breath, cough, and/or fever. Position may also affect the severity of your symptoms if caused by a condition related to your lungs, and you may notice that your symptoms are different when lying flat or on one side. In cases of herniated disks or nerve compression, the severity of your back pain will often be worse than chest pain.

Biliary/abdominal causes

Because the organs that make up your biliary system sit on the right side of your body, you are more likely to experience right-sided chest and back pain if it is caused by a biliary issue. You may experience dull pain or a burning sensation in the middle of your chest and back if your symptoms are caused by GERD, peptic ulcers, or other conditions affecting your stomach.

Diagnosis process for chest and back pain

A healthcare professional will take an extensive history regarding your symptoms and any attempted treatment at home. They will use this in addition to a physical exam to better identify the underlying cause, and this will then determine the appropriate treatment plan to help you relieve your symptoms. If they suspect there is a more severe or potentially life-threatening cause, they may direct you to the emergency department.

Treatment options for chest and back pain

While there are many possible causes of chest and back pain, there are also multiple treatment options that can be used in the short and long term that may help relieve symptoms. If you have tried these treatment options with limited relief or your symptoms get worse despite the use of these treatment options, you should seek further evaluation from your primary care provider.

Options for short-term relief

If you are concerned about angina, pericarditis, or other cardiac issues, you should seek advice from your primary care provider. For multiple lung-related causes, you may use over-the-counter pain medications, such as Tylenol or Motrin, in addition to cough drops and tea, to help with the associated symptoms. If you notice that your symptoms are getting worse despite the use of these treatment options, you may require antibiotics to help with possible pneumonia or other bacterial infections. For most of the musculoskeletal causes listed above, you may benefit from using over-the-counter pain medications such as Tylenol or Motrin. Similarly, if there is a specific region of the chest or back that hurts, you can use topical medications, such as a Lidocaine patch.

Options for long-term relief

For long-term relief, most of the options will address biliary and abdominal causes of your chest and back pain. You may need to see your primary care provider to discuss the use of various medications to address reflux, including proton pump inhibitors, which are medications that are used to reduce levels of stomach acid. You may also benefit from dietary changes, including a lower-fat diet which will address gallstones and other biliary issues. For musculoskeletal causes of your chest and back pain, physical therapy and/or occupational therapy may help to address your symptoms.

When to see a doctor about chest and back pain

It’s important to know when you should see your primary care provider regarding chest and back pain. If you have tried some of the listed treatment options with limited improvement in your symptoms, you should reach out to your primary care provider.

You should see a doctor if:

• You have shortness of breath with exertion that is relieved by rest.
• You are experiencing fatigue relative to your normal state.
• You have fevers (temperature greater than 100.4 degrees Fahrenheit).
• You experience weight loss.
• You notice unexplained bruising.
• You have a decreased appetite.

You should go to the emergency room if:

• You have a syncopal episode - an episode where you pass out.
• You are unable to catch your breath, even at rest.
• You start vomiting.
• You feel palpitations - the sensation of your heart racing.
• You experience trauma or have an obvious deformity of the body.
• You start coughing up blood.

Questions to ask your doctor about chest and back pain

• Do you need any imaging or lab work to assess your symptoms?
• Do you need a referral to a specialist, such as a cardiologist, pulmonologist, or gastroenterologist?
• What diagnostic tests can be done to assess what is causing your symptoms?
• If your symptoms continue, worsen, or happen again, should this prompt immediate evaluation by a healthcare professional?

Frequently asked questions: chest and back pain

You may still be curious about what causes chest and back pain. Below are some frequently asked questions that can be helpful.

Can gas, gastritis, GERD, or similar issues cause this type of pain?

Yes, because of the location of the stomach, you may be experiencing pain in your chest and back from the stomach due to problems such as gas, gastritis, GERD, or other abdominal issues.

Can smoking cause chest and back pain?

Although smoking itself is not likely to cause chest and back pain, it can increase the likelihood of developing an associated problem that would cause symptoms, particularly a lung-related issue.

Does the cause or diagnosis for chest and back pain change if you’re a male or female?

Although the diagnoses considered for anyone experiencing chest and back pain are similar, the presentation and underlying cause of symptoms can differ between males and females. If you have any questions about your symptoms, it is best to reach out to your primary care provider.

Final thoughts

Chest and back pain can be caused by many medical conditions that vary in their presentation, duration, and severity. Because some of these conditions can be life-threatening, if you are ever in doubt about your symptoms, it is best to reach out to your primary care provider.

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. Lane Thaut, DO.

Sources

“Pancreatitis - NIDDK.” National Institute of Diabetes and Digestive and Kidney Diseases, www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis.

“What Are Pleural Disorders? | NHLBI, NIH.” NHLBI, NIH, 24 Mar. 2022, www.nhlbi.nih.gov/health/pleural-disorders.

“What Is Angina? | NHLBI, NIH.” NHLBI, NIH, 30 June 2023, www.nhlbi.nih.gov/health/angina.