Heartburn is a common digestive condition characterized by a burning sensation felt in the chest, just behind the breastbone. This occurs when stomach acid flows backward into the esophagus, the tube connecting your mouth to your stomach. Unlike the stomach, the esophageal lining is not designed to withstand this acid, leading to irritation and the familiar burning feeling. While occasional heartburn is common, frequent episodes may indicate a more persistent issue.
How Heartburn Can Cause Back Pain
Heartburn can manifest as pain in the back, a phenomenon known as “referred pain.” This occurs when discomfort originating in one part of the body is perceived in another, often due to shared nerve pathways. The esophagus, irritated by acid reflux, shares nerve connections with areas of the back, particularly between the shoulder blades and across the upper and middle back. When stomach acid irritates the esophageal lining, these interconnected nerves activate a pain response that the brain can interpret as originating from the back.
The vagus and spinal nerves are involved in this neural crossover. Irritation of the vagus nerve due to acid reflux can send pain signals that are transferred to other nerves branching to the neck and middle back. This can result in a burning sensation, dull ache, or sharp discomfort in the back, commonly felt after meals or when lying down.
Common Heartburn Symptoms
Beyond the potential for back pain, heartburn presents with several classic symptoms. The most frequent is a burning sensation in the chest, directly behind the breastbone. This burning can extend upwards into the throat, and may be accompanied by a sour or acidic taste in the mouth.
Individuals may also experience regurgitation, the involuntary return of food or sour liquid from the stomach into the mouth. Difficulty swallowing or a sensation of food being stuck in the throat are also common. Other associated symptoms include a persistent cough, hoarseness, or a feeling of pressure behind the breastbone.
When Back Pain Might Not Be Heartburn
While heartburn can cause back pain, back pain has numerous other potential causes. Musculoskeletal issues, such as muscle strains, ligament sprains, or disc problems in the spine, are common culprits for back discomfort. Conditions like upper cross syndrome, an imbalance in neck, shoulder, and chest muscles often due to poor posture, can also cause back pain and sometimes mimic acid reflux symptoms.
Other internal organ issues can also lead to back pain that might be mistaken for heartburn. These include kidney problems, gallstones, or pancreatitis, an inflammation of the pancreas. In some cases, cardiac issues, such as a heart attack, can present with chest pain that radiates to the back, arm, or jaw, sometimes accompanied by shortness of breath or sweating.
Consult a healthcare professional for an accurate diagnosis, especially if back pain is severe, persistent for more than a few weeks, or worsens despite rest. Seek immediate medical attention if back pain is accompanied by symptoms like severe chest pressure, shortness of breath, sudden numbness or weakness in the legs, loss of bowel or bladder control, fever, unexplained weight loss, or pain that radiates to an arm. Prompt evaluation can help ensure appropriate treatment and rule out more serious conditions.