Causes of Chest and Back Pain Based on Location
Medically reviewed by Katrina Carter, DPT
There are several reasons why your back might hurt, and why you have chest pain. When these two symptoms occur together, it can be worrisome. There are several explanations for chest pain that appears with back pain.
This article covers causes of chest and back pain.
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What Could Cause Chest and Back Pain?
Many muscles, nerves, tendons and more run throughout your torso, so when pain strikes your chest or back, it can be difficult to pinpoint the exact location and cause. Your healthcare provider will ask you questions about the location and nature of the pain to help discover the underlying cause.
There are many potential causes of pain in different areas of your chest and back, and some may require immediate medical treatment.
Related: Heart Disease
Right-Sided
Chest pain that is focused on the right side can be caused by a cardiac event like a heart attack, but it is more likely linked to other organs and structures in this area. Only a small portion of your heart rests in the right chest, and chest pain related to a heart attack is typically felt in the center or left chest.
Other causes of chest pain that is focused on the right side of your chest include:
Lung pain from and injury like a pleural effusion or even pneumonia
Muscular pain from a strained or torn muscle or ligament
Traumatic injury, like with a broken rib
Blood clots in the lung or other vessels
Indigestion and damage in the esophagus
Inflammation around the heart, lungs, or other structures
Some conditions that may be investigated or ruled out if you are having recurrent right-sided chest pain include:
Coronary artery disease (CAD): Damaged arteries
Pericarditis: Membrane-like sac around the heart becomes stiff
Aortic aneurysm: A bulge in a large artery
Pneumonia: Lung infection
Pulmonary embolism: Blood clot in the lungs
Pleurisy or pleural effusion: Membrane that lines the lungs becomes filled with fluid
Pneumothorax: Accumulation of gas in the area between the lung and chest
Gastroesophageal reflux disease (GERD): Chronic condition that causes stomach acid to flow into the esophagus
Muscle strain: Common soft-tissue injury
Learn More: What Are the Causes of Right-Side Chest Pain?
Left-Sided
Left-sided chest pain is more often associated with cardiac events like a heart attack than right-sided chest pain. The bulk or your heart is located on the left side of your chest, so a lack of oxygen to blood, or any traumatic injury to the heart would be felt strongest in this area.
Your healthcare provider will also consider and may want to rule out all the possibilities listed above, too, since the same muscles, lung, and structural problems that can happen in the right chest can also happen in the left chest.
Learn More: Why Do I Have Chest Pain on My Left Side?
Upper Back
Not only is your back the structural workhorse for your body, but it also houses your spinal cord. Nerves from all over your body run through your spinal cord, so pain signals from different areas of the body can appear in certain sections of your back.
Your back is also susceptible to muscle strain. Upper back pain may be focused on your neck and shoulders, but it can also be related to head and neck disorders, breathing problems, or other, more distant conditions.
Learn More: Causes of Pain Between the Shoulder Blades
Middle Back
The middle of your back isn't as delicate as your upper back, but it is ground zero for many muscles, tendons, ligaments, and bones. Muscle strain is a leading cause of pain in the middle area of the back, but referred pain from other areas of the body is also a possibility.
Some other organs in the middle of your torso can also radiate pain to the back, specifically the liver or gallbladder.
Learn More: Common Middle Back Pain Red Flags
Timing of Chest and Back Pain
When trying to determine the cause of your chest and back pain and what is causing it, your healthcare provider will ask you questions concerning when you experience the pain and what may be contributing to it. Time of day, activities you are or aren't doing when the pain occurs, and how long the pain lasts can all provide clues about the source of the problem.
Causes of Pain When Sleeping
Back and chest pain that happens at rest or when you are sleeping can be the result of awkward positioning. When it happens often in the chest, though, your healthcare provider may suggest that you are having vasospastic angina. Symptoms are small spasms that are usually most noticeable when you are resting late at night or early in the morning.
These spasms aren't usually considered a medical emergency, but they could be a sign of other medical issues such as:
Coronary artery disease caused by damage to the arteries
Inflammation
Respiratory problems
Stress or anxiety
Talk to your healthcare provider if these spasms and pains are happening more often or in clusters, as these could be signs your chest pain is worsening and could progress to a cardiac event like a heart attack.
Causes of Pain With Activity
Pain is your body's signal that something isn't right, so if you are experiencing pain with strenuous exercise or during certain activities, talk to your healthcare provider. Chest pain with exertion can be a sign that your heart isn't getting enough oxygen, and this could lead to a heart attack or other problems.
Back pain is a red flag, too, as pain with certain activities could indicate a more serious muscular or structural problem in your back. Your spine is made up of many vertebrae stacked upon each other, and these vertebrae can shift and cause pain. They can even trap nerves and other tissues that send pain from the back to other areas of the body.
Don't Ignore These Symptoms
Pain that runs through your chest and back can be chronic, but there are some signs you shouldn't ignore that could indicate that something serious is happening. Call 911 if you experience chest or back pain with the following symptoms:
Pain or pressure in the middle or left chest that is crushing or squeezing
Pain that doesn't go away with rest, or gets better for awhile and then returns
Pain that starts in your chest and travels to other areas like your back, arm, or jaw
Chest pain that is accompanied by nausea, shortness of breath, or dizziness
Get immediate help if you have any of these symptoms. Immediate medical care is crucial to surviving a heart attack.
Describing Chest and Back Pain Symptoms
How you describe your pain will give your healthcare provider or emergency personnel valuable information about your condition. When it comes to chest and back pain, be as specific as possible when describing:
How the pain feels (sharp, dull, radiating, etc.)
Where the pain is located
Whether your pain moves from one place to another
What makes your pain better
What makes your pain worse
What events or activities seem to trigger the pain
Be sure to have information ready about any other medical conditions you may have, other symptoms you've been experiencing such as nausea, and a list of the medications you take.
How to Relieve Nonemergency Chest and Back Pain
Chest and back pain that is chronic or that your healthcare provider has ruled out as urgent is usually attributed to muscle pain or stable angina.
For muscle pain, stretching, physical therapy, and over-the-counter (OTC) pain relievers may help. If stable angina appears to be the cause, some things you can do to relieve your pain may include:
Switching to a heart healthy diet
Exercising
Managing your stress
Taking a hot shower or a soak in the tub may help, too, as the warm water can relax muscles and cause your blood vessels to widen and move blood to your tissues more efficiently. Make sure you have clearance from your healthcare provider, though. If your chest or back pain is caused by cardiac disease, you may need to avoid things like hot tubs, saunas, and other steamy therapies.
Medical Treatment for Chest and Back Pain
If your back or chest pain is caused by an underlying medical condition like heart or lung disease, infection, or injury, your healthcare provider will guide you to the appropriate treatment.
They may prescribe medications to support your heart health, antibiotics to clear an infection, steroids for inflammation, or even procedures to make physical or structural repairs to different areas of the body.
Read Next: Chest Pain and Angina
Summary
Your chest, back, and torso contain nearly all of your vital organs, as well as the supportive structure for your entire body. Despite this, the combination of chest and back pain is not always an emergency.
Pain can be either chronic or short term. Learn the warning signs of a serious cardiac event, and know when to seek help for chest or back pain.
Talk to your healthcare provider if you have frequent or recurring chest or back pain that is making it difficult to carry out your everyday tasks.
Read the original article on Verywell Health.
