Several different conditions may cause chest and upper back pain together. Causes can be related to the heart, digestive tract, and other parts of the body.

While some causes of chest and upper back pain aren’t emergencies, others are. You should always seek emergency medical attention if you have sudden or unexplained chest pain that lasts more than a few minutes.

Read on to learn more about the causes of upper back and chest pain, how they’re treated, and when to see a doctor.

Here are 10 potential causes of upper back and chest pain.

1. Heart attack

A heart attack happens when the blood supply to the muscles of your heart is blocked. Because of this, people having a heart attack may experience chest pain that can spread into the neck, shoulders, and back.

Other symptoms to look out for include:

  • sensations of pressure or tightness in the chest
  • cold sweats
  • shortness of breath
  • feeling lightheaded or faint
  • nausea

Women are more likely than men to experience heart attack pain involving the back or jaw. It’s also important to note that some people having a heart attack may experience very few symptoms or none at all.

2. Angina

Angina is pain that occurs when your heart tissue isn’t getting enough blood. It can commonly occur in people with coronary artery disease. It often happens while you’re exerting yourself.

Similar to pain from a heart attack, angina pain can spread to the shoulders, back, and neck.

Angina symptoms can vary between men and women. Women may feel pain in the back, neck, or abdomen in addition to or instead of chest pain.

Other angina symptoms can include:

  • feeling fatigued or weak
  • shortness of breath
  • sweating
  • feeling lightheaded or faint
  • nausea

3. Heartburn

Heartburn happens when the acid or contents of your stomach comes back up into your esophagus. This causes a painful, burning sensation in your chest, behind your breastbone. It may also sometimes be felt in your back or abdomen.

Heartburn tends to be worse after eating a meal or in the evening. You may also notice an acidic taste in your mouth or pain that gets worse while lying down or bending over.

Being pregnant, overweight, or obese can also increase your risk of developing heartburn. Some foods can also trigger the condition, including spicy foods, citrus, and fatty foods.

4. Pleurisy

Pleurisy happens when the membranes that line your lungs and your chest cavity become inflamed.

Normally, these membranes move smoothly past each other. When they’re inflamed, they can rub against each other, which leads to pain.

Pleurisy can be caused by a variety of things, including infections, autoimmune conditions, and cancers.

The pain of pleurisy gets worse as you breathe in deeply or cough. It can also spread to your shoulders and back.

Other symptoms that can occur include:

  • coughing
  • shortness of breath
  • fever
  • chills
  • unexplained weight loss

5. Gallstones

Your gallbladder is a small organ that stores a digestive fluid called bile. Gallstones occur when this fluid hardens inside your gallbladder, forming stones.

Gallstones may cause pain to occur in several different places, including:

  • the upper right area of your abdomen
  • right below your breastbone
  • between your shoulder blades
  • in your right shoulder

The amount of time you experience pain from gallstones can last for a few minutes to several hours. You may also experience symptoms such as nausea or vomiting.

There are several risk factors that may increase your risk of gallstones, including being female, being pregnant, and being overweight or obese.

6. Pericarditis

The pericardium lines the surface of your heart. Pericarditis happens when the pericardium becomes inflamed. It can be caused by an infection or autoimmune condition. It can also happen after a heart attack or heart surgery.

Pericarditis causes sharp chest pain. This pain may become worse while breathing deeply, lying down, or swallowing. The pain from pericarditis may also be felt as pain in the left shoulder, back, or neck.

Other symptoms to be aware of include:

  • dry cough
  • feelings of fatigue
  • anxiety
  • difficulty breathing when lying down
  • swelling in your lower extremities

7. Musculoskeletal pain

Sometimes muscular problems may cause pain in the chest and upper back. Repetitive use or overuse of multiple muscle groups, for example through activities such as rowing, can lead to aching pain in the chest, back, or chest wall.

Other symptoms you may experience include muscle stiffness, muscle twitching, and feelings of fatigue.

8. Aortic aneurysm

Your aorta is the largest artery in your body. An aortic aneurysm happens when part of the aorta becomes weakened. In some cases, this weakened area may tear, which can lead to life-threatening bleeding. This is called aortic dissection.

Many times, an aortic aneurysm will develop with very little or no symptoms. However, some people may feel pain or tenderness in their chest. In some cases, pain may also occur in your back.

Other symptoms to look out for include:

  • shortness of breath
  • cough
  • feeling hoarse

9. Spinal problems

In some cases, a pinched nerve in the upper part of the spine may cause pain to radiate to the area of the chest and possibly to the extremities.

In addition to pain, other symptoms you may experience include muscle spasms and stiffness in the affected area of the spine, which may restrict movement.

Additionally, there are some case studies in which a herniated disc in the upper portion of the spine has caused pain in the chest or chest wall.

10. Lung cancer

Chest and back pain can also occur as a symptom of lung cancer. Although chest pain is a common symptom, the Dana-Farber Cancer Institute reports that 25 percent of people with lung cancer reported back pain as a symptom.

Back pain from lung cancer can happen when a tumor in the lungs begins to put pressure on the spine. Pain from lung cancer may feel worse when you breathe deeply, laugh, or cough.

In addition to chest and back pain, other signs of lung cancer can include:

  • persistent cough, which may include coughing up blood
  • feeling hoarse
  • shortness of breath or wheezing
  • feeling weak or fatigued
  • unexplained weight loss
  • recurrent lung infections, such as pneumonia

The treatment for your upper back and chest pain will depend on the underlying cause.

Heart attack

Some treatments for heart attack are typically given immediately. These can include aspirin to limit blood clotting, nitroglycerin to improve blood flow, and oxygen therapy. Clot-busting medications, which help to break up any blood clots, may then be given.

A procedure called percutaneous coronary intervention (PCI) can help open up any arteries that are found to be narrowed or blocked. This procedure uses a small balloon attached to a catheter to compress plaque or clotted blood against the wall of the affected artery and restore blood flow.

Other potential treatments can include:


A variety of medications can be prescribed to help manage angina. These medications may prevent blood clots, reduce angina pain, or widen blood vessels. Examples of angina medications include:

  • beta-blockers
  • calcium channel blockers
  • blood thinners
  • nitrates
  • statins

Heart-healthy lifestyle changes will also be recommended as part of your treatment plan. If medications and lifestyle changes can’t successfully manage the condition, procedures like PCI and heart bypass surgery may be necessary.


Several over-the-counter (OTC) medications can be used to relieve heartburn. These can include antacids, H2 blockers, and proton pump inhibitors. If OTC medications aren’t helping to relieve your symptoms, your doctor may prescribe you stronger medications.


Pleurisy can be treated through addressing the underlying condition that may be causing it. Medications may also help relieve symptoms, including acetaminophen or NSAIDs for pain, and cough syrups to ease cough.

In some cases, fluid may need to be removed from the affected area. This can help to prevent lung collapse.


Many times, gallstones don’t require treatment. In some cases, your doctor may prescribe medication to help dissolve the gallstones. People with recurring gallstones may have their gallbladder removed.


Pericarditis can be managed with treatments that relieve inflammation and pain, such as NSAIDs. If these aren’t effective, your doctor may prescribe a stronger anti-inflammatory medication.

If an infection is causing your condition, an antibiotic or antifungal medication will also be prescribed.

In some cases, you may need a procedure to drain fluid. This can help reduce pressure on your heart.

Musculoskeletal pain

Muscle issues that result in upper back and chest pain may be treated with rest and medications that relieve pain and inflammation, such as NSAIDs.

Applying heat to the affected area may also help. In more severe cases, physical therapy may be recommended.

Aortic aneurysm

In some cases, your doctor will recommend monitoring of your aneurysm using imaging technology such as CT scan or MRI scan. Additionally, your doctor may prescribe medications such as beta-blockers, angiotensin II receptor blockers, and statins to help lower blood pressure or cholesterol levels.

People with larger aortic aneurysms may require repair surgery. This can be performed via open-chest surgery or endovascular surgery. Emergency surgery is required for an aortic aneurysm that has ruptured.

Spinal problems

Treatment for spinal problems depends on their severity. It can include reducing your activity level and taking medications such as NSAIDs and muscle relaxers to help with pain or inflammation. Physical therapy exercises may also be recommended.

More severe cases may require surgical intervention to repair them.

Lung cancer

Several therapies can help treat lung cancer. Which type is used depends on the type of lung cancer and how far the cancer has spread. Your doctor will work with you to create a treatment plan that’s right for you.

Treatment options can include chemotherapy, radiation therapy, and targeted therapy. Additionally, surgery may be recommended to remove the cancer tissue.

Here are some good rules of thumb for preventing many of the causes of upper back and chest pain:

Some additional tips include:

  • Limit foods that may trigger heartburn, such as spicy foods, fatty foods, or acidic foods.
  • Try not to lay down right after eating to prevent heartburn symptoms.
  • Avoid eating late or large meals to help prevent gallstones.
  • Stretch properly before engaging in exercise or sports to avoid muscle injury or strain.

You should always take chest pain seriously, as sometimes it may be an indicator of a serious health condition, like a heart attack.

Always seek emergency medical attention if you have unexplained or sudden chest pain, especially if you have difficulty breathing or the pain has spread to other areas like the arm or jaw.

You should also make a doctor’s appointment for any condition that isn’t relieved using OTC medications or has symptoms that recur, are persistent, or begin to worsen.

You can connect to a physician in your area using the Healthline FindCare tool.

There are several things that can cause upper back pain and chest pain to occur together. Some of the causes of this type of pain aren’t serious, but it’s always important to take chest pain seriously.

Chest pain can be a sign of a potentially life-threatening condition, such as a heart attack. If you have unexplained chest pain that comes on suddenly or is severe, seek emergency medical assistance.