Can Heartburn Cause Back Pain & How Do You Fix It?

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If you've ever felt a burning sensation in your chest or throat after eating, it was probably heartburn. It's a common condition that affects millions daily.

In fact, some 60% of adults experience heartburn at least once a year, and about 20% get it weekly. Heartburn is a pretty straightforward condition. But there are cases where it can cause other symptoms, such as back pain.

This phenomenon is often overlooked and misunderstood, causing even more discomfort in patients.

So if you think your heartburn is causing you back pain, let's explore the relationship between these two conditions, including the underlying causes, potential risks, and effective treatments to alleviate both of your symptoms.

What Is Heartburn?

Heartburn, also known as acid indigestion or acid reflux, is a burning sensation in the chest or throat that occurs when stomach acid backs up into the oesophagus ^[1].

It can be a symptom of gastro-oesophageal reflux disease (GERD), a chronic form of this type of condition. Heartburn can also be caused by lifestyle factors, such as diet and stress, or by certain medications ^[2].

We'll get into those in more detail too so you know if your lifestyle may be the root cause of your back pain.

Types & Causes Of Heartburn

There are two types of heartburn: episodic and frequent ^[3]. Episodic heartburn occurs less than twice a week and is usually caused by temporary factors, such as eating spicy foods or drinking alcohol.

On the other hand, the frequent type of heartburn is when it occurs two or more times in a week and that can be a symptom of GERD. If that starts happening to you, considering checking in with your doctor.

10 Most Common Causes of Heartburn

Let's look at the top 10 causes, plus a little info about what's happening inside your body when those causes are at play.

• Eating spicy or acidic foods - Spicy foods and those high in acid can irritate the lining of the oesophagus and cause heartburn ^[4].
• Drinking alcohol - Alcohol can relax the lower oesophageal sphincter (LOS), the muscle that separates the stomach from the oesophagus, and allow stomach acid to flow back into the oesophagus ^[5].
• Smoking - Smoking can weaken the LOS and increase the risk of heartburn ^[5].
• Eating large meals or lying down after eating - Both of these habits can increase pressure on the LOS and cause stomach acid to flow back into the oesophagus ^[6].
• Pregnancy - Hormonal changes during pregnancy can relax the LOS and cause heartburn.
• Obesity - Excess body weight can put pressure on the stomach and cause acid reflux ^[7].
• Medications - Certain medications, such as aspirin and ibuprofen, can irritate the stomach and cause heartburn ^[2].
• Hiatal hernia - A hiatal hernia occurs when part of the stomach pushes up through the diaphragm and into the chest. This can cause acid reflux and heartburn ^[8].
• Stress - Stress can cause the LOS to relax and increase the production of stomach acid, leading to heartburn ^[6].
• Acid reflux disease (GERD) - GERD is a chronic form of acid reflux that can cause frequent heartburn and damage to the oesophagus ^[2].

If you're seeing unusual symptoms in addition to back pain, see my article on upper back pain red flags here.

Groups and Demographics Susceptible to Heartburn

Heartburn can affect people of all ages and backgrounds, but some groups are more susceptible than others. These groups include:

• Pregnant women
• Overweight or obese individuals
• Smokers
• People with a family history of GERD
• People with a hiatal hernia
• People who consume a diet high in fat, acid, and spicy foods

What's Going On In Your Body When You Get Heartburn?

So, yes... excessive juicy, spicy BBQ steaks with ice cold beers and so many other other delicious things can unfortunately cause heartburn.

But what's going on inside the body when that happens? Well, the food passes from the mouth to the oesophagus and then to the stomach.

The LOS (as a reminder, that's the Lower Oesophageal Sphincter) is a muscular ring at the bottom of the oesophagus that acts as a valve. It allows food to enter the stomach and prevents stomach acid from flowing back into the oesophagus.

When the LOS doesn't close properly, stomach acid can flow back into the oesophagus, causing heartburn ^[4]. And the lining of the oesophagus just isn't designed to handle the acidity of stomach acid.

When acid flows back into the oesophagus too often, it can cause inflammation and damage to the lining, a condition known as oesophagitis ^[4]. When you've got heartburn, the acidic stomach contents irritate the sensitive lining of your oesophagus, causing a burning sensation.

This can also lead to other symptoms, such as chest pain, back pain, difficulty swallowing, and even a sour taste in your mouth from all those things that were initially so delicious.

Can Heartburn Cause Back Pain?

While heartburn isn't typically associated with back pain, you may experience both symptoms at once.

But can heartburn really cause back pain? Let's check out the scientific evidence to be sure.

What Scientific Evidence Suggests Research

Studies have shown some association between heartburn and back pain, with some even suggesting a stronger link between the two symptoms than previously thought.

Several online resources suggest that people with gastro-oesophageal reflux disease (GERD), a chronic form of acid reflux, are more likely to report back pain than those without the condition ^[9].

As of all this wasn't bad enough, one research study found that people with heartburn and back pain were more likely to have worse quality sleep than those with heartburn alone ^[10].

How Heartburn Causes Back Pain

The mechanisms of back pain from heartburn aren't well understood, but it doesn’t rule out the association between the two.

When you get heartburn, your stomach acid flows back into your oesophagus, causing irritation and inflammation. Some medical experts believe that back pain associated with heartburn happens because of how close the oesophagus is to the spine.

When the oesophagus is irritated, it can cause the surrounding muscles to tense up, leading to pain in the mid-back ^[9]. This pain usually happens between the shoulder blades ^[7].

In our clinical practice, any mid-back pain accompanied by a burning sensation or pressure in the chest is mostly linked with the underlying cause of heartburn, so I can share my experience on this one.

What's more, it’s believed that the pain is caused by stomach acid irritation of the oesophagus, which can cause inflammation and discomfort.

The nerves supplying the oesophagus and the back are closely connected, which may explain why some people experience back pain and heartburn ^[11].

Other Common Co-occurring Symptoms Several

Other symptoms may suggest a correlation between heartburn and back pain. These include occurring symptoms of:

• Chest pain or discomfort
• Difficulty swallowing
• A sour taste in your mouth
• Regurgitation of your food or liquid
• Nausea or vomiting
• Belching or bloating

If you experience any of these symptoms along with heartburn and back pain, your back pain is probably because of your heartburn.

It’s important to speak with your healthcare provider to determine the underlying cause and receive appropriate treatment.

Holistic Ways To Manage Back Pain Heartburn

Heartburn is a common condition that can be uncomfortable and even painful. Luckily for all of us, there are many ways to stop the symptoms and prevent heartburn in the first place.

Here, we'll share some tips to help you manage your heartburn and the back pain that comes with it.

Healthy Habits For Heartburn Relief: 10 Lifestyle Changes to Make Today

• Avoid trigger foods and drinks: Certain foods and drinks can trigger heartburn symptoms, including spicy foods, fatty foods, citrus, coffee, and alcohol ^[1]. Avoiding these foods can help reduce symptoms.
  Eat smaller meals: Overeating can lead to heartburn, so try eating smaller meals more frequently throughout the day. You'll get used to smaller portions in no time.
• Avoid lying down after eating: Wait at least 3 hours after eating before lying down or going to bed.
• Elevate the head of your bed: If you raise the head of your bed 6-8 inches, it can help prevent stomach acid from flowing back into your oesophagus while you sleep.
• Quit smoking: Smoking can weaken the muscle that controls the opening between the stomach and the oesophagus, leading to heartburn.
• Lose weight: Being overweight can increase the pressure on your stomach, leading to heartburn. Losing weight can help reduce symptoms ^[6].
• Wear loose-fitting clothing: Tight clothing can put pressure on your stomach and make your heartburn worse.
• Manage stress: Stress can increase the production of stomach acid, leading to more heartburn. Try relaxation techniques like deep breathing or yoga ^[4].
• Chewing gum: Chewing gum can stimulate the production of saliva, and that can help to neutralise stomach acid ^[12].
• Avoid eating before exercising: Eating before exercise can cause heartburn, so wait at least 2-3 hours after eating before engaging in physical activity, especially after a big meal.
• Swimming: Swimming is also good for back pain, and some studies show that it can also be good for acid problems in the stomach. Just don't go too soon after eating as all the motion can upset your stomach.

5 Proven Treatment Methods To Help You Feel Better

• Antacids: Over-the-counter antacids can help neutralize stomach acid and provide temporary relief from heartburn symptoms ^[8].
• H2 blockers: H2 blockers are a type of medication that can reduce the production of stomach acid, providing longer-lasting relief from heartburn ^[7].
• Proton pump inhibitors (PPIs): PPIs are another type of medication that can reduce stomach acid production. They're more potent than H2 blockers and can give you longer-lasting relief from heartburn ^[2].
• Traditional remedies: Some traditional remedies like drinking a glass of warm milk or taking a spoonful of baking soda mixed with water may help alleviate heartburn symptoms ^[13].
• Non-traditional therapies: Some non-traditional therapies like acupuncture or hypnotherapy may also be effective in reducing heartburn symptoms.
• Pain Killers: If your symptoms aren't due to acid reflux then pain killers can help with back pain, but check in with your doctor first. 
• Heat Rubs: Similarly, if your symptoms turn out not be from heartburn, Deep Heat can help in some situations. 

Exercises & Other Effective Tips To Help

• Change your posture: Slouching can put pressure on your stomach and lead to heartburn and back pain. Sit up straight and avoid hunching over.
• Apply heat: Applying heat to your back can help relax muscles and reduce pain. Try using a heating pad or taking a warm bath.
• Gentle exercise: Gentle exercises like walking or yoga can help alleviate back pain and improve overall health. I have a full article on back pain exercises here.
• Massage therapy: Massage therapy can help relax muscles and improve circulation, reducing back pain.
• Stretching: Stretching can help relieve tension in your back muscles, reducing pain.
• Acupuncture: Acupuncture may be effective in reducing back pain related to heartburn ^[11].
• Over-the-counter pain relief: Over-the-counter pain relief medications like acetaminophen can help alleviate back pain.
• Posture braces: Posture braces can help improve your posture and reduce back pain.
• Physical therapy: A physical therapist can help you develop a personalised exercise and stretching plan to alleviate back.

Don't Ignore Your Heartburn: When To See A Doctor

In some cases, heartburn can be a sign of a more serious condition, and medical attention may be necessary. Here are some guidelines on when to seek medical attention for your heartburn:

• Persistent symptoms: If you experience heartburn more than twice a week or if it persists for several weeks despite lifestyle changes and medications, see your doctor.
• Severe symptoms: If your heartburn is accompanied by severe chest pain, difficulty swallowing, vomiting, or weight loss, seek immediate medical attention. These symptoms could indicate a more serious condition, such as GERD, a hiatal hernia, or even oesophageal cancer.
• Medication isn't effective: If you've been taking over-the-counter medications for more than two weeks and you're not getting relief, it's time to see a doctor.
• Other health issues: If you’ve other health issues, such as diabetes or asthma, that could exacerbate your heartburn, it's a good idea to see a doctor.
• Need for prescription medication: If your doctor determines that your heartburn needs prescription medication, they can provide a prescription and work with you to determine the best treatment plan.

In summary, if your heartburn symptoms persist, are severe, aren't responding to over-the-counter medications, or are accompanied by other health issues, it's important to seek medical attention.

A doctor can help diagnose the underlying cause of your heartburn and provide the appropriate treatment to manage your symptoms and prevent further complications.

The Takeaway: Expert’s Advice

As a medical expert, my takeaway message for those who suffer from back pain due to heartburn is that it’s preventable and manageable. A variety of lifestyle changes, therapies, and medications are available to help you with your symptoms.

Understanding what heartburn is and how it causes back pain is key to finding effective relief. Heartburn can be caused by several factors including diet, stress, and certain medical conditions.

It's important to try lifestyle changes first. Avoid those trigger foods, eat smaller meals, and don't lie down after eating before you turn to medications.

Medications like antacids and proton pump inhibitors can help you manage symptoms, but it's essential to consult your doctor before taking any medication.

Finally, back pain associated with heartburn should be taken seriously and evaluated by a healthcare professional to rule out any serious underlying conditions.

Overall, taking a proactive approach to managing symptoms can greatly improve your quality of life and prevent long-term damage to your organ systems. So yes, this is important to get right.

References:

NHS. Heartburn and acid reflux. Available from: https://www.nhs.uk/conditions/heartburn-and-acid-reflux/

Mayo Clinic. Heartburn. Available from: https://www.mayoclinic.org/diseases-conditions/heartburn/symptoms-causes/syc-20373223

Cleveland Clinic. Heartburn overview. Available from: https://my.clevelandclinic.org/health/diseases/9617-heartburn-overview

WebMD. Understanding heartburn basics. Available from: https://www.webmd.com/heartburn-gerd/guide/understanding-heartburn-basics

Medical News Today. Heartburn: What is it and what to do about it? Available from: https://www.medicalnewstoday.com/articles/9151#prevention

Healthline. Heartburn. Available from: https://www.healthline.com/health/heartburn

FamilyDoctor.org. Heartburn. Available from: https://familydoctor.org/condition/heartburn/

MedlinePlus. Heartburn. Available from: https://medlineplus.gov/heartburn.html

Healthline. Why do I have back pain after eating? Available from: https://www.healthline.com/health/back-pain-after-eating

Temple Health. Top 5 surprising GERD symptoms. Available from: https://www.templehealth.org/about/blog/top-5-surprising-gerd-symptoms

K Health. Acid reflux with back pain: What to know. Available from: https://khealth.com/learn/gerd/acid-reflux-with-back-pain/

Esophageal motility abnormalities in gastroesophageal reflux disease. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4023328/

MedlinePlus. Sodium Bicarbonate. Available from: https://medlineplus.gov/druginfo/meds/a682001.html