Treating Acid Reflux and Back Pain Together

Acid reflux contributes to back pain symptoms

Medically reviewed by Robert Burakoff, MD

Acid reflux is a condition in which the contents of your stomach (such as food and acid) flow back up into the esophagus at the back of your throat. This can lead to heartburn, a painful burning sensation in the chest.

Some people with acid reflux also report back pain with episodes of heartburn. This back pain may be associated with common acid reflux triggers like spicy foods, alcohol, or coffee.

This article goes over why you might experience acid reflux and back pain at the same time, as well as what to do to manage your symptoms.

Acid Reflux vs. GERD vs. Heartburn

Many people use the terms "acid reflux," "GERD" (gastroesophageal reflux disease), and "heartburn" interchangeably. However, they actually have related but different meanings, as follows:

• Acid reflux is the process by which stomach acid flows back upward into the back of the throat.

• Heartburn is the uncomfortable burning sensation that follows.

• GERD is a chronic condition in which acid reflux occurs regularly, causing persistent heartburn.

The Link Between Acid Reflux and Back Pain

It’s unclear exactly why acid reflux can cause back pain. Many people feel that the burning sensation of heartburn in the middle of their chest, behind their breastbone, radiates to their upper or lower back.

This may get worse just after eating or when lying down. Other symptoms of acid reflux, such as nausea and bloating, can also cause or worsen referred back pain.

Some researchers also believe that there is a relationship between the muscles of the esophagus and the bottom part of your lower back, just above the pelvic region.

They argue that structural or functional problems with the lower back muscles could contribute to problems with the esophagus, such as acid reflux, heartburn, dysphagia (difficulty swallowing), and regurgitation.

Acid reflux is also associated with a number of other conditions that affect posture, breathing, or all three. Examples include:

• Scoliosis (abnormal lateral curvature of the spine)

• Hiatal hernia (uppermost part of the stomach pushes through an opening in the diaphragm)

• Upper crossed syndrome (UCS) (muscles of the chest, neck, and shoulders become weak and tight)

• Respiratory conditions, such as asthma and chronic obstructive pulmonary disease (COPD)

All of the above conditions have also been linked to back pain. Poor posture can put pressure on the chest and lower body, making it harder to breathe efficiently and for the esophagus to work properly. This can make it unclear whether the underlying reason for the back pain is acid reflux itself or another risk factor.

Other risk factors that back pain and acid reflux have in common include:

• Poor posture (especially sitting in a hunched position for long periods of time)

• Obesity

• Pregnancy

• Smoking

• Excessive alcohol use

Acid Reflux, Back Pain, and Pregnancy

Back pain is common during pregnancy due to hormonal changes, postural shifts, added weight, and the growing uterus. Many people also experience acid reflux during pregnancy, which can contribute to back pain.

Avoiding common acid reflux triggers and using a lumbar support or maternity pillow for sleep may help.

How Back Pain Due to Acid Reflux Feels

Back pain related to acid reflux may feel like a burning, stabbing, cramping, or squeezing sensation in the upper, middle, or lower back, as if your heartburn is wrapping around or shooting down from your chest to your back. It may also feel like a dull ache, especially in the lower back.

In addition to heartburn and back pain, you may also experience other symptoms of acid reflux, such as:

• A sour, unpleasant taste in your mouth and throat

• Hoarseness

• Foul-smelling breath

• Bloating

• Nausea

• Burping

• Cough

• Hiccups

• Pain when swallowing

Location

There are several different possible locations where you may experience acid reflux-related back pain, including:

• Upper back: Sometimes, the pain of heartburn behind the sternum (the center of the chest) can also be felt in the upper back, particularly between the shoulder blades.

• Middle or lower back: Some people experience pain in the middle or lower back due to acid reflux. This may be due to a related condition, such as scoliosis or COPD, or other risk factors, such as obesity.

• One side: One-sided back pain may be a sign of postural problems related to acid reflux. However, it can also be caused by other problems, such as kidney infections.
  

Severe Symptoms

In rare cases, your back pain may become so severe that you have difficulty sleeping, walking, bending over, or standing up. It may significantly interfere with your quality of life. A physical therapist may be able to address your back pain, while a gastroenterologist can help you manage your acid reflux.

If you experience heartburn due to acid reflux two or more times per week, you may have gastrointestinal esophageal disease. This is a chronic condition that occurs when the lower part of your esophagus relaxes too much, which allows stomach acid, food, and other contents to be regurgitated into the back of your throat.

Hospitalization for Severe Acid Reflux Back Pain

It’s unlikely that you would need to be hospitalized for acid reflux–related back pain. However, you should seek medical help right away if you experience any of the following symptoms often associated with GERD:

• Severe chest pain

• Difficulty eating or swallowing

• Appetite loss

• Severe vomiting

• Bloody stool or vomiting

You should also consider seeing a healthcare provider if you have the following symptoms alongside your back pain:

• Tingling or numbness

• Muscle weakness

• Fever

• Difficulty walking

• Unintended weight loss

These may be signs that your back pain is not due to acid reflux.

How to Manage Mild to Moderate Back Pain at Home

There are many different ways you can manage mild to moderate back pain from acid reflux at home. This may involve resolving or preventing acid reflux, addressing the back pain directly, or both.

Learn to Recognize Acid Reflux Triggers

The best way to prevent back pain due to acid reflux—or any other symptom—due to acid reflux is to recognize and avoid your heartburn triggers. Acid reflux triggers vary from person to person, but some of the most common ones include:

• Caffeine

• Alcohol

• Tobacco

• Citrus fruits

• Spicy foods

• Carbonated beverages

• Fried foods

• Sour foods

• Mint

• Chocolate

• High-fat foods

• Garlic

• Onions

• Tomatoes

Change Your Posture

Acid reflux symptoms often get worse when you bend over or lie down. Standing or sitting up straight can help to stretch out your abdominal muscles and provide more space for the digestive process. Particularly while you’re eating, it’s important not to sit hunched over or slouched down in your chair.

Sleeping With Acid Reflux

It can be difficult to sleep comfortably with acid reflux. Sleeping with your head elevated around 6 to 8 inches (such as with a wedge pillow or adjustable bed) may help to prevent symptoms of heartburn and promote healthier rest.

Eat Smaller Meals

Eating large meals, especially close to bedtime, can increase the chance of developing acid reflux. Opting for smaller meals throughout the day and not eating for three hours before you go to sleep may decrease your risk of heartburn.

Take Over-the-Counter Medications

There are several over-the-counter (OTC) antacids that can help with gastrointestinal symptoms related to acid reflux, including diarrhea and bloating as well as heartburn. Meanwhile, OTC pain-relieving medications, such as Advil or Motrin (ibuprofen), may work to manage mild to moderate back pain.

Manage Stress

Many studies have linked acid reflux to stress, and high stress levels can make existing acid reflux symptoms worse. Stress is also linked to chronic pain, especially neck and back pain.

Managing your stress levels through lifestyle changes, such as mindfulness techniques, deep breathing exercises, and physical activity, may reduce your back pain due to acid reflux. If you have persistent anxiety, depression, panic, or other mental health symptoms, consider reaching out to a mental healthcare provider for help.

Lose Weight If Necessary

Studies show that weight management may help with acid reflux symptoms. If necessary, talk to a healthcare provider about how to lose weight in a healthy way, such as through exercise and dietary changes.

Acid Reflux Treatment Approaches

In addition to the above lifestyle changes, your healthcare provider may recommend any of the following treatment option(s) to treat your acid reflux:

• Quitting smoking

• Prescription medications, such as H2 blockers and proton pump inhibitors (PPIs)

• Surgery, such as fundoplication (top of the stomach is wrapped around the esophagus), if symptoms are persistent and severe

Complications and Effect on Quality of Life

While acid reflux is common, it can lead to complications if left untreated. These complications may negatively affect your overall quality of life, especially if you’re also experiencing chronic back pain. Potential complications of untreated acid reflux or GERD include:

• Asthma

• Laryngitis (inflammation of the larynx)

• Chronic cough

• Tooth damage and loss

• Esophagitis (inflammation of the esophagus), which may lead to bleeding and ulcers

• Esophageal stricture (narrowing of the esophagus)

• Barrett’s esophagus, which may lead to esophageal adenocarcinoma (a certain type of cancer)
  

Summary

In some cases, acid reflux may contribute to or exacerbate back pain. This may be due to risk factors that back pain and acid reflux have in common, such as postural concerns, respiratory conditions, and obesity. It may also be because pain behind the chest radiates to the upper or lower back.

There are several ways to manage mild to moderate acid reflux-related back pain at home, including taking over-the-counter medications, identifying your acid reflux triggers, eating smaller meals, adjusting your posture, managing stress, or losing weight if needed. If you have more severe acid reflux and/or back pain, reach out to a healthcare provider to discuss your treatment options.

Read the original article on Verywell Health.