While you may experience chest pain or back pain for a number of reasons, in some cases you may experience the two at the same time.
There are several causes of this type of pain and some of them are quite common.
However, sometimes chest and back pain can be a sign of a more serious condition such as a heart attack. If you believe you’re having a heart attack or have new or unexplained chest pain, you should always seek emergency care.
Continue reading to discover more about the potential causes of chest and back pain, how they’re treated, and when you should see a doctor.
The potential causes of combined chest and back pain are varied and can be caused by the heart, lungs, or other areas of the body.
1. Heart attack
A heart attack happens when the flow of blood to your heart tissue becomes blocked. This can be due to a blood clot or buildup of plaque on the walls of the arteries.
Because the tissue isn’t receiving blood, you may feel pain in your chest. Sometimes this pain can spread to other parts of your body, such as your back, shoulders, and neck.
A heart attack is a medical emergency. Seek immediate help if you believe you’re experiencing one.
Angina is pain that occurs when the tissue of your heart isn’t getting enough blood. This is often caused by reduced blood flow due to plaque buildup on the walls of the coronary arteries.
Angina often occurs when you’re exerting yourself. However, it can also happen when you’re at rest.
Like heart attack pain, the pain from angina can spread to the back, neck, and jaw. Angina can be a warning sign that you’re at an increased risk for heart attack.
The pericardium is a fluid-filled sac that surrounds your heart, helping to protect it. When the pericardium becomes inflamed, it’s called pericarditis.
Pericarditis can be caused by several things including infections and autoimmune conditions. It can also occur after a heart attack or after heart surgery.
The pain from pericarditis is caused by your heart tissue rubbing against the inflamed pericardium. It can spread to your back, left shoulder, or neck.
4. Aortic aneurysm
The aorta is the largest artery in your body. An aortic aneurysm occurs when the wall of the aorta weakens due to injury or damage. A bulge may occur in this weakened area.
If an aortic aneurysm breaks open, it can cause life-threatening bleeding.
The pain from an aortic aneurysm can depend on its location. Pain can occur in the chest, back, or shoulder as well as in other locations like the abdomen.
5. Pulmonary embolism
A pulmonary embolism happens when an artery in one of your lungs is blocked. It’s typically caused when a blood clot located elsewhere in your body breaks loose, travels through the bloodstream, and becomes lodged in a lung artery.
Chest pain is a common symptom of a pulmonary embolism, although pain may spread to the shoulders, neck, and back as well.
The pleura is a two-layered membrane. One layer wraps around your lungs, while the other lines your chest cavity. When the pleura becomes inflamed, it’s called pleurisy.
Pleurisy has a variety of causes, including:
- autoimmune conditions
The pain from pleurisy occurs when the two inflamed membranes rub against each other. It can occur in the chest but also spread to the back and shoulders.
Heartburn is a burning sensation that occurs in your chest, just behind your breastbone. It’s caused when stomach acid backs up into your esophagus.
Normally, there’s a sphincter between your stomach and esophagus that prevents this from happening, but sometimes it’s weakened or doesn’t function properly.
Heartburn that occurs frequently and impacts your day-to-day activities is called gastroesophageal reflux disease (GERD).
The pain from heartburn is often in your chest, but you may sometimes feel it in your back.
8. Peptic ulcer
A peptic ulcer happens when there’s a break in the lining of your digestive tract. These ulcers can occur in the stomach, small intestine, and esophagus.
Most cases of peptic ulcers are caused by infection with a bacterium called Helicobacter pylori. They can also occur in people that take aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs).
People with gastric ulcers may feel heartburn in their chest area and abdominal pain. In some cases, the pain may spread to the back.
Your gallbladder is a small organ that stores a digestive fluid called bile. Sometimes this digestive fluid hardens into stones, which can cause pain.
The pain from gallstones may be located in the right side of your torso but can spread to your back and shoulders as well.
Your pancreas is an organ that produces enzymes used in digestion, as well as hormones that regulate your body’s blood sugar levels. When the pancreas becomes inflamed, the condition is called pancreatitis.
Pancreatitis happens when digestive enzymes activate in your pancreas, causing irritation and inflammation. This can happen for a variety of reasons including infection, injury, and cancer.
The pain from pancreatitis occurs in the abdomen but can also radiate to the chest and back.
11. Muscle injury or overuse
Sometimes chest and back pain may be due to injury or overuse of muscles. Injury can occur due to things like accidents or falls.
Overuse can also cause muscle pain. Repetitive motions that are used in day-to-day activities, work, or sports can also contribute to this. An example of a repetitive activity that may cause muscle pain in the chest and back is rowing.
Generally, pain from muscle injury or overuse may be worse when moving the affected area.
12. Herniated disc
The discs of your spine function as a cushion between each of your vertebrae. Each disc has a tough outer shell and a gel-like interior. When the outer shell weakens, the interior portion can begin to bulge out. This is called a herniated disc.
The herniated disc can sometimes press on or pinch nearby nerves, causing pain to occur.
A pinched nerve in the neck or upper back can cause pain in the back that radiates to the chest and can mimic heart disease pain.
Shingles is caused by the reactivation of the virus that causes chickenpox (varicella-zoster). It causes a rash made up of fluid-filled blisters to appear and often affects just one side of the body.
Most often, shingles forms on a band of skin called a dermatome. Sometimes it can span your torso, for example from your back to chest. Pain from shingles can vary by case, ranging from mild to severe.
Some cancers can cause chest and back pain to happen together. Two examples of this are lung cancer and breast cancer.
Although pain in the area of the chest is a common symptom of these cancers, back pain can occur as well.
Approximately 25 percent of people with lung cancer report back pain at some point. This can be due to a tumor pushing on the spine or on surrounding nerves.
When breast cancer has spread to other parts of the body (metastasized), it can lead to back pain.
As we’ve seen above, there are many different causes of chest and back pain. So how can you distinguish them from one another?
Sometimes the location or the timing of the pain can give you a clue to the cause.
Why is the pain on the left side?
Your heart is oriented more toward the left side of your chest. Therefore, pain on the left side of your chest could be caused by:
- heart attack
- aortic aneurysm
Why is the pain on the right side?
Your gallbladder is located on the right side of your body. Pain in this area, which can spread to your right shoulder or between your shoulder blades, may be a sign of gallstones.
Why do I feel pain after eating?
Sometimes you may notice that your chest or back pain occurs shortly after eating. Conditions like heartburn and pancreatitis may cause this.
It should also be noted that pain from peptic ulcers may occur when you have an empty stomach. In some cases, eating may help to relieve pain.
Why do I feel pain when I cough?
Some causes of chest and back pain get worse while coughing. This can happen with:
- a pulmonary embolism
- lung cancer
Why does it hurt when swallowing?
In some cases, you may feel pain when you swallow.
Causes of chest and back pain that can cause pain while swallowing include pericarditis and aortic aneurysm, if the aneurysm is pressing on the esophagus.
Why do I feel pain while lying down?
Have you noticed that your pain gets worse when you lie down? Conditions like pericarditis and heartburn may make chest and back pain worse when you’re lying down.
Why does it hurt when I breathe?
Often, conditions affecting the area around the heart and lungs may cause pain when you breathe in, particularly if you’re taking deep breaths. Some examples include:
- pulmonary embolism
- lung cancer
What type of treatment you’ll receive for your chest and back pain will depend on what’s causing the pain. Below, we’ll explore some of the treatments that you may receive.
Medications or drugs
In some cases, medications may be prescribed to help treat your condition. Some examples include:
- over-the-counter (OTC) medications to help with pain and inflammation, such as nonsteroidal anti-inflammatory drugs (NSAIDs)
- immediate treatments for a heart attack, such as aspirin, nitroglycerin, and clot-busting medications
- treatments to help lower blood pressure or prevent chest pain and blood clots like ACE inhibitors, beta-blockers, and blood thinners
- blood thinners and clot-busting medications to break up blood clots in people with a pulmonary embolism
- antibiotic or antifungal medications to treat conditions that may be caused by an infection, such as pericarditis and pleurisy
- medications to relieve heartburn including antacids, H2 blockers, and proton pump inhibitors
- acid-suppressing medications, often in combination with antibiotics, to treat peptic ulcers
- medications to dissolve gallstones
- antiviral medications to treat a shingles outbreak
- chemotherapy to kill cancer cells
Nonsurgical procedures can also help to treat conditions causing chest and back pain. Some examples are:
- percutaneous coronary intervention (PCI) to treat heart attack or uncontrolled angina
- procedures to drain fluid that may have accumulated in an inflamed area, such as in pericarditis or pleurisy
Sometimes, surgery may be required to treat a condition causing chest or back pain.
These can include:
- heart bypass surgery to treat a heart attack or uncontrolled angina
- surgical repair of aortic aneurysms, which can be done either by open-chest surgery or by endovascular surgery
- removal of the gallbladder if you have recurring gallstones
- surgery to treat a herniated disc, which may include disc removal
- removal of cancerous tissue from your body
In some cases, physical therapy may be required to treat the cause of your chest or back pain. Examples of when this may be necessary are when you’re recovering from a herniated disc or from a muscle injury.
Additionally, surgery and chemotherapy aren’t the only treatments available for cancer. Radiation therapy, targeted therapy, or immunotherapy may be recommended.
Lifestyle changes can be beneficial in treating or preventing some causes of chest and back pain. Examples of lifestyle changes that may be a part of your treatment plan include:
- eating a heart-healthy diet
- making sure that you get regular exercise
- maintaining a healthy weight
- managing your stress levels
- avoiding cigarettes or other tobacco products
- limiting the amount of alcohol you consume
- trying to avoid foods that could upset conditions like heartburn, such as spicy, acidic, and fatty foods
You should always seek immediate medical attention if you’re experiencing the signs of a heart attack.
Signs to look out for include:
- chest pain or pressure
- pain that spreads to your arms, shoulders, neck, or jaw
- shortness of breath
- feeling dizzy or lightheaded
- breaking out into a cold sweat
It’s also important to remember that sometimes a heart attack can have mild or even no symptoms. When in doubt, seek care.
You should make an appointment with your doctor to discuss your symptoms if you have chest and back pain that:
- doesn’t go away or gets worse, despite using OTC medications
- is persistent or recurring
- becomes disruptive to your day-to-day activities
There are many possible causes of chest and back pain that occur together. They can be related to the heart, lungs, or other parts of the body.
Some causes of this type of pain aren’t serious. However, you should always take chest pain seriously. In some cases, chest pain could be a sign of a life-threatening condition like a heart attack.
If you experience chest pain that comes on suddenly or believe that you’re having a heart attack, seek emergency medical attention.