Pain in both the back and stomach can be confusing. While often due to common issues, this discomfort can signal a more significant underlying health condition. Pinpointing the exact cause can be challenging due to the interconnectedness of the body’s systems. The pain’s nature and location offer clues to its origin, indicating problems from digestive upset to more urgent medical situations.
Common Causes
Many common conditions can lead to pain felt in both the back and stomach. Digestive system issues frequently cause referred pain, where discomfort originating in the abdomen is perceived in the back.
Indigestion, gas, and bloating can cause abdominal pressure or burning that radiates to the back. Constipation, with infrequent bowel movements, creates abdominal cramping that extends to the back. Irritable bowel syndrome (IBS) often presents with abdominal pain, bloating, and changes in bowel habits, which some individuals report feeling in their lower back. Gastritis, an inflamed stomach lining, and acid reflux can cause upper abdominal pain extending to the back or chest.
Musculoskeletal factors also contribute. Back muscle strains, often due to poor posture or physical activity, can cause localized pain radiating to the abdomen. Abdominal muscle strains can also cause discomfort perceived in the back due to the close proximity of these muscle groups. Lifestyle factors like prolonged slouching or an unsupportive mattress may impact spinal health, contributing to back pain.
Urinary tract infections (UTIs) are another common cause. UTIs can cause lower abdominal pain, pelvic discomfort, and back pain, especially if the infection affects the kidneys. Symptoms include painful urination, frequent urges, and cloudy or foul-smelling urine.
For women, gynecological conditions are a common source of simultaneous back and stomach pain. Severe menstrual cramps (dysmenorrhea) cause lower abdominal cramping and radiating lower back pain. Endometriosis, where uterine-like tissue grows outside the uterus, also results in abdominal and back pain, often worsening during periods. Ovarian cysts may contribute to this dual pain, particularly if large or ruptured.
Conditions Requiring Urgent Attention
While many causes of back and stomach pain are not severe, some conditions require immediate medical evaluation.
Appendicitis
Appendicitis, an inflamed appendix, begins with dull pain around the navel that shifts to the lower right abdomen, intensifying over hours. This pain can include nausea, vomiting, loss of appetite, and a low-grade fever. The pain may also be felt in the lower back. Untreated, an inflamed appendix can rupture, leading to a serious abdominal infection.
Kidney Stones
Kidney stones, hard deposits in the kidneys, cause severe, sharp pain starting in the side and back, below the ribs. This pain radiates to the lower abdomen and groin, often in waves as the stone moves. The intensity of kidney stone pain can be extreme. Other symptoms include nausea, vomiting, blood in the urine, and painful urination.
Pancreatitis
Pancreatitis, inflammation of the pancreas, causes severe upper abdominal pain that radiates to the back. This pain may worsen after eating fatty foods and can include nausea, vomiting, fever, and a rapid heart rate. Leaning forward may offer relief, while lying flat often intensifies discomfort.
Gallstones
Gallstones, hardened deposits in the gallbladder, can cause sudden, severe pain in the upper right abdomen or center abdomen. This pain, sometimes called a “gallbladder attack,” can radiate to the back, between the shoulder blades, or to the right shoulder. Nausea, vomiting, and bloating may also occur, often triggered after eating fatty meals.
Ectopic Pregnancy
For women of childbearing age, an ectopic pregnancy is a serious condition where a fertilized egg implants outside the uterus, usually in a fallopian tube. Symptoms include lower abdominal and pelvic pain, which may be localized to one side, along with lower back pain and vaginal bleeding. If the fallopian tube ruptures, sudden, severe abdominal pain, dizziness, weakness, and shoulder pain can occur, requiring immediate medical attention.
When to Seek Medical Care
Prompt medical evaluation is important when experiencing back and stomach pain, especially if certain warning signs are present.
Seek immediate emergency medical attention if:
The pain is sudden and severe, making it difficult to move, eat, or drink.
Any pain accompanied by a high fever, vomiting, or blood in stool or vomit warrants urgent care.
You experience difficulty breathing, chest pain, irregular heartbeat, or feeling light-headed are additional red flags.
Consult a healthcare provider for non-urgent situations if:
Pain is persistent and does not improve within a few days, or recurs frequently.
Recurring pain affects daily activities or is accompanied by unexplained weight loss.
You are pregnant or suspect pregnancy and experience abdominal pain.
Diagnostic Approaches
Diagnosing the cause of simultaneous back and stomach pain typically begins with a thorough medical history and physical examination. A healthcare professional will ask about the pain’s nature, location, duration, and any associated symptoms. The physical exam involves pressing on the abdomen to check for tenderness, swelling, or masses, and listening to bowel sounds.
Laboratory tests are frequently ordered to help identify underlying issues. Blood tests, such as a complete blood count, indicate infection or inflammation, while liver and kidney function tests assess organ health. Urinalysis detects urinary tract infections or kidney stones, and stool samples may be analyzed for digestive issues.
Imaging studies provide visual insights into internal organs. An ultrasound examines the gallbladder, kidneys, and reproductive organs for issues like gallstones, kidney stones, or ovarian cysts. Computed tomography (CT) scans offer detailed images, effective in diagnosing conditions like appendicitis, pancreatitis, kidney stones, and certain infections. In some cases, a doctor may refer to specialists like a gastroenterologist for digestive problems or a urologist for urinary tract concerns.