Your back is highly vulnerable to injury because it’s responsible for bending, twisting, and lifting. Back pain that lasts longer than three months is considered chronic back pain.

Shortness of breath includes any difficulty breathing. You may feel as if you can’t catch your breath, are breathing very fast, or have just engaged in intense physical activity. If you can’t relate the shortness of breath to anxiety or physical exertion, the symptom may indicate a serious medical condition.

Here are 11 possible causes of back pain and shortness of breath.

Pneumonia is an infection in one or both lungs. It can be caused by bacteria, viruses, or fungi. Bacterial pneumonia is the most common type in adults. Read more about pneumonia.

Obesity is defined as having a BMI of 30 or more. Body mass index is a rough calculation of a person’s weight in relation to their height. Read more about the risk of obesity.

Coronary artery disease (CAD) is impaired blood flow in the arteries that supply blood to the heart. Read more about the symptoms of CAD.

Heart attacks (called myocardial infarctions) are very common in the United States. During a heart attack, the blood supply that normally nourishes the heart with oxygen is cut off and the heart muscle begins to die. Read more about heart attacks.

Kyphosis, also known as roundback or hunchback, is a condition in which the spine in the upper back has an excessive curvature. Read more about kyphosis.

Scoliosis is an abnormal curvature of the spine. If your spine is curved from side to side or in an “S” or “C” shape, you might have scoliosis. Read more about scoliosis.

Lung cancer is cancer that starts in the lungs. Early symptoms mimic a cold or other common conditions, so most people don’t seek medical attention right away. Read more about lung cancer symptoms.

The aorta is a large artery that carries blood out of your heart. If you have a dissection of the aorta, it means that blood has entered the wall of the artery that’s between the inner and middle layers. Read more about the dissection of the aorta.

Multiple myeloma is a type of cancer that affects plasma cells. Plasma cells are a type of white blood cell found in the bone marrow. Read more about multiple myeloma.

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare disorder that causes red blood cells to break down sooner than they should. This early destruction can lead to symptoms and complications that range from minimal, such as discoloration of urine, to severe, such as leukemia and stroke. Read more about PNH.

Polio (also known as poliomyelitis) is a highly contagious disease caused by a virus that attacks the nervous system. Children younger than 5 years old are more likely to contract the virus than any other group. Read more about polio.

Seek immediate medical attention if you suspect your back pain and shortness of breath are related to a heart attack. The primary symptoms of heart attack are:

  • chest pain with associated pain in the neck or arms (particularly the left arm)
  • nausea
  • dizziness
  • unexplained sweating

While heart attacks may have the classic symptoms of crushing chest pain, they can also have less severe symptoms, including back pain and shortness of breath. This is especially true for women. When in doubt, seek immediate medical attention to rule out a possible cardiac event.

Make an appointment with your doctor if your symptoms don’t improve with rest.

Because shortness of breath can cause loss of consciousness and anxiety, your doctor will likely address this symptom first. Immediate treatment may include medications that reduce airway spasms or inflammation. If a heart-related condition is causing your shortness of breath, your physician may prescribe diuretics. These reduce the amount of fluid in your body. They might also prescribe heart medications. You may need to have oxygen temporarily delivered through a thin plastic tube in your nose or through a face mask.

If your back pain is due to injury, a physician will evaluate the seriousness of your injury. Most back pain goes away with rest, physical therapy, and other home care measures. However, your doctor may recommend surgery if you are found to have certain conditions, such as a fracture, a ruptured disc, or a pinched nerve.

Special back bracing may be used to treat some fractures and cases of scoliosis.

Resting your back for one to two days and following your doctor’s recommendations can help your back pain improve. While you’ll want to rest your back, doing so for more than two days can lead to stiffness, which can work against the healing process.

Taking an over-the-counter pain reliever such as ibuprofen can help reduce pain.

If you’ve undergone surgery related to your symptoms, follow your doctor’s instructions regarding at-home care.

You may be able to prevent back pain and shortness of breath by doing the following:

  • Maintain a healthy weight and lifestyle, which includes eating a healthy diet and exercising regularly.
  • If you’re overweight and have difficulty exercising, increase exercise in smaller increments to build stamina and promote lung health.
  • Refrain from smoking or take steps to quit if you currently smoke.