Can Heartburn Cause Back Pain?
When The Burning Pain Spreads...
The Short Answer – Severe heartburn (often referred to as GERD or GORD depending on your country) can in certain circumstances actually cause physical back pain. It is however much more likely that back pain is causing heartburn or even that a 3rd condition is causing both as symptoms.
In this article, we look at the various potential causes of back pain that could be linked to heartburn.
Understanding Persistent Heartburn – GERD or GORD?
Persistent heartburn in medical terms, is often referred to as GERD (gastro esophageal reflux disease) or GORD (gastro oesophageal reflux disease). And this sometimes causes confusion.
I once carried out some work for one of the proton pump inhibitors (a common treatment for GORD) and frequently came across this.
GERD is often used in the US, while GORD is more common in the UK and Europe, although both have now crossed-over to some extent. Neither is incorrect though.
I mention this because persistent heartburn would be considered to be a symptom of GERD (or GORD) and would be treated differently to simply getting a one-off case of acid reflux (heartburn) after a late night out and a curry.
When considering the case of heartburn and back pain, we will break it down in to three key questions –
- Can Heartburn Cause Back Pain?
- Can Something Else Cause Both Back Pain And Heartburn?
- Can Back Pain Actually Cause Heart Burn?
So… Can Heartburn Cause Back Pain?
In terms of you developing heartburn and the heartburn itself being so severe that it causes you back pain, this is unlikely, but possible.
Most back pain comes from muscular strain or injury. There are times where other conditions may cause pressure on the spinal cord and therefore cause you back pain – but there is no evidence of heartburn ever doing this.
However, if you suffer with severe GERD/ GORD, you will most likely feel a burning sensation in your chest. Accompanying this sometimes will be a sour taste in your mouth and burning feeling at the back of your throat.
With more severe cases of GERD/ GORD, it is however possible that you will feel a pain in middle of your back.
So there is a chance that your heartburn can cause back pain.
Can Something Else Be Causing Both Your Heartburn And Your Back Pain?
A peptic ulcer is effectively a sore in your small intestines or stomach. Mild ulcers offer minimal symptoms.
However, more severe peptic ulcers can cause the following symptoms –
- Abdominal (stomach) pain
- Severe gas
- Back Pain
This isn’t heartburn causing back pain or the other way around, but if you are suffering with a severe peptic ulcer, then both heartburn and back pain are likely. This is known as ‘referred’ back pain, since it is back pain without an actual direct injury to your back.
There are numerous other potential sources of referred back pain, where severe inflammation causes pressure on the nerves around your spine.
And in some cases, this inflammation can also cause heartburn – but those cases are rare. Peptic ulcers are the main source of both heartburn and back pain.
Can Back Pain Actually Cause Heart Burn Instead?
However, there are three ways in which back pain can cause heartburn. These are –
- Reaction to medications
- Reaction to stress
- Lack of fitness/ deteriorating diet
Reaction To Medications
NSAIDs (Non Steroidal Anti Inflammatory Drugs) are often given to reduce inflammation and thus reduce the pain of a back injury.
These NSAIDs typically include ibuprofen and naproxen.
It has been suggested that being on NSAIDs for a while can actually lead to you developing GERD (GORD) and persistent heartburn (Rusziewski et al).
Reaction To Stress
If you suffer with chronic pain, there is every likelihood that you will also suffer at some point with stress and potentially even some form of depression.
Published in the Journal of Digestive Diseases and Sciences, a study into ‘The association between reflux esophagitis and psychological stress’ provided evidence of a direct link between increased stress levels and heartburn (GERD/ GORD).
We have covered at length some of the mental challenges behind coping with chronic pain, but it is worth also remembering the power of the brain.
If stress starts making you feel unwell, then symptoms such as persistent heartburn could quite easily become a reality.
In that sense then, chronic back pain could cause you the stress that ultimately triggers heartburn.
Lack of Fitness/ Deteriorating Diets
Another downside of back pain is sometimes an inability to get up and go out to exercise, in the way you might have before.
It is not uncommon then for your diet to suffer as well, since being constrained in movement is not generally conducive to leading a healthy lifestyle.
Given how important living a healthy lifestyle is to avoiding issues like heartburn, it is not a big leap to see a poorer diet and a lack of exercise as two major contributors to the development of heartburn.
The Final Word –
Can heartburn cause back pain? Yes – when if you have severe GERD/ GORD it is a symptom.
Can heartburn and back pain both be caused by something else? Yes – most commonly from peptic ulcers
Can back pain cause heart burn? Absolutely, if your back pain causes you to take certain medications, increases your personal stress or leads to generally poor health (diet/ fitness).
So heartburn has a complex relationship with back pain, but it can (in certain circumstances) be the cause of back pain….. as well as having more than a few links elsewhere.
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References Used –
1. Ruszniewski P1, Soufflet C, Barthélémy P. (Oct 2008). Nonsteroidal anti-inflammatory drug use as a risk factor for gastro-oesophageal reflux disease: an observational study. Alimentary Pharmacology and Therapeutics.
2.Song EM, Jung H-K, Jung JM. (Feb 2013). The association between reflux esophagitis and psychological stress. Digestive Diseases and Sciences.
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