Acid reflux, a condition where stomach acid flows back into the esophagus, can cause discomfort and pain, including in the back between the shoulder blades. This unexpected symptom often causes confusion, as it may not initially seem connected to digestive issues. Understanding this link helps address the discomfort more effectively.
How Acid Reflux Can Manifest as Back Pain
Acid reflux can cause back pain, especially between the shoulder blades, due to referred pain. The esophagus and back share interconnected nerve pathways, meaning esophageal irritation can activate pain signals the brain interprets as originating from the back. Vagus and spinal nerves service both areas.
When stomach acid irritates the esophagus’s nerve-rich lining, it causes inflammation and sends pain signals. These signals transfer from the vagus nerve to the superior ganglion nerve, branching to cervical and thoracic spinal nerves, including the dorsal scapular nerve between the shoulder blades. This neural crossover can result in spreading, “wrap-around” pain, or a dull ache or burning sensation in the upper or middle back.
Esophageal spasms, involuntary contractions of the esophagus, can also cause back pain. Triggered by chronic acid reflux, these spasms may cause chest pain that radiates to the back, arms, neck, or jaw. Acid irritation can also extend to the diaphragm and abdominal area, further contributing to referred pain.
Other Potential Causes of Back Pain
Pain between the shoulder blades is common and often unrelated to acid reflux. Musculoskeletal issues are frequent culprits, including muscle strain, repetitive movements, or overuse. Poor posture, especially prolonged slouching, can also stress upper back muscles, leading to discomfort.
Spinal conditions can also cause pain in this region. These include arthritis affecting the spine, herniated discs where a disc bulges and presses on nerves, or spinal stenosis, a narrowing of the spinal canal that compresses nerves. Nerve compression from these issues can result in radiating pain.
Less common but serious causes include cardiac disorders like a heart attack, which can present with pain radiating to the shoulder blade, particularly in women. Gallbladder disease may also cause pain under the ribcage that extends to the upper back. Additionally, conditions like fibromyalgia or certain cancers can manifest as back pain.
When to Seek Professional Medical Advice
Certain symptoms accompanying back pain or acid reflux warrant prompt medical attention. If you experience severe chest pain or pressure, especially if it spreads to your arm, neck, or jaw, or is accompanied by shortness of breath, dizziness, or cold sweats, seek immediate medical care; these could indicate a heart attack.
Other concerning signs include worsening difficulty swallowing, food getting stuck, unexplained weight loss, or persistent vomiting. Vomiting blood or passing black, tarry stools also requires urgent evaluation, as these may signal gastrointestinal bleeding. Any sudden loss of sensation or weakness in the legs or arms, or loss of bowel or bladder control, also requires immediate medical consultation.
Strategies for Managing Acid Reflux and Related Symptoms
Managing acid reflux often involves making lifestyle adjustments and using over-the-counter remedies. Dietary changes play a significant role, as certain foods can trigger symptoms. Common culprits include spicy foods, citrus fruits, tomatoes, chocolate, caffeine, and fatty or fried foods.
Eating smaller, more frequent meals instead of large ones can reduce pressure on the lower esophageal sphincter, the muscle that contains stomach acid. It is also beneficial to avoid eating within two to three hours of bedtime and to remain upright after meals. Elevating the head of your bed by six to eight inches, using bed risers or a wedge pillow, can help gravity keep stomach acid down during sleep.
Additional lifestyle modifications include maintaining a healthy weight, as excess abdominal weight can pressure the stomach and promote reflux. Quitting smoking is also helpful, as nicotine weakens the esophageal sphincter. Over-the-counter medications such as antacids provide quick relief by neutralizing stomach acid, while H2 blockers and proton pump inhibitors (PPIs) reduce acid production for longer-lasting relief.