Acid Reflux and Back Pain – Is Back Pain a Heartburn Symptom?
If you have heartburn and back pain, then you need to read this article, as it just may be the only place online where you will find the answer to the connection between these two problems.
Until today, I had never heard of back pain mentioned as one of the symptoms of heartburn, a reader has brought it to my attention that many sites list back pain as one of the heartburn symptoms.
After thoroughly reviewing the research, right now there is no evidence that suggests that acid reflux can lead to back pain, at least not with any regularity. I suspect someone inaccurately reported this on a personal website or blog, and then others simply accepted it as truth without investigating the claim.
Fortunately, there are three reasons why you might experience both heartburn-like symptoms and back pain at the same time, which may help answer why you are experiencing both acid reflux and back pain.
Possible Scenario #1 – It’s Not Heartburn!
In many cases, what is perceived as acid reflux could be something different altogether. The number one contender which matches up with heartburn-like symptoms and back pain is gallbladder disease, such as gallstones.
Gallstones are infamous for their uncanny ability to refer pain to other parts of the body. One group of researchers reported that 63% of gallstone patients experienced back pain (1). Out of the 220 studied patients, 66% of the patients reported general stomach pain, whereas 3% reported pain behind the sternum (1).
Furthermore, 77% of studied patients said their pain came late in the evening or at night (1). Acid reflux pains also typically occur at night. It is very possible that nighttime sternum or general stomach pain could easily be confused for heartburn.
Given the high correlation of gallbladder disease and back pain, people who are experiencing “acid reflux” and back pain at the same time may be indeed the result of gallbladder disease instead of reflux. If you experience these two symptoms, you should make an appointment with your doctor so that he (or she) can sort things out.
Possible Scenario #2 – Posture-Related Heartburn
Another possible reason that heartburn and back pain may occur together is due to poor posture. One group of researchers found that elderly patients with extreme kyphosis (rounding of the upper spine) were very likely to experience heartburn (2). In the particular study, the researchers were able to use the same medication to treat both back pain and acid reflux, though the medicine seemed to reduce the production of stomach acid as a side effect (2).
However, the correlation between the two suggests that it is possible (but certainly yet to be proven) that abnormal postures might lead to both heartburn and back pain (2). This is most likely to occur in the elderly population or in those with osteoporosis (2).
Possible Scenario #3 – Correlation But Not Causation
The final reason why acid reflux and back pain may be connected is simply due to correlation rather than causation. If you are unfamiliar with this term, if two things are correlated, it means that the two events seem to occur together, but may not directly influence each other. Both events could simply have the same causative factor.
There is one factor that is a strong causative factor for both acid reflux and back pain: obesity. Both adults and children who are obese are much more likely to develop both heartburn and back pain (3, 4).
As a result, people who have both acid reflux and back pain may just be feeling the effects of obesity. Obesity puts undue stress on the back and stomach, which may cause both acid reflux and back pain and causes many more problems than people realize (3).
Note: For those that do not understand correlation versus causation, read this quick analogy. Both drownings and ice cream consumption are correlated – as ice cream consumption increases, so does the number of people who drown. Correlation simply refers to the numbers increase or decrease at the same time.
This is just causation (which means one thing actually causes another thing to happen), as eating ice cream does not lead to people drowning. However, both have the same underlying factor: summer-time and warm weather. Warm weather causes people to both want to eat ice cream and go swimming.
Heartburn and Back Pain – The Bottom Line
Note that some heartburn remedies recommended on this site aid digestion and could even reduce gallbladder symptoms, but will not fix the problem. Additionally, certain foods can trigger gallbladder pain attacks (1).
Because of the high number of similarities between these two conditions, it is not surprising that people may mix up these up or associate acid reflux with back pain.
The bottom line is that acid reflux does not cause back pain. If you are experiencing both heartburn and back pain, see a doctor, as this is not a normal condition and may not be acid reflux at all! Of course, referred pain is within the realm of possibility, but if that is the case it is best to hear that coming from your doctor rather than just assuming it is the case (since it is rare if it occurs at all).
If your doctor tells you really do just have both acid reflux and back pain, consider a weight loss plan (if you are overweight), as well as working your posture, as these two things are likely to help out both your acid reflux and your back pain.
1. Berhane T, Vetrhus M, Hausken T, Olafsson S, Søndenaa K. Pain attacks in non-complicated and complicated gallstone disease have a characteristic pattern and are accompanied by dyspepsia in most patients: the results of a prospective study. Scand J Gastroenterol. 2006 Jan;41(1):93-101.
2. Yamane, Y., et al. Elcatonin is effective for lower back pain and the symptoms of gastroesophageal reflux disease in elderly osteoporotic patients with kyphosis. Geriatr Gerontol Int. 2011 Apr;11(2):215-20.
3. Wiklund I. Review of the quality of life and burden of illness in gastroesophageal reflux disease. Dig Dis. 2004;22(2):108-14.
4. Lazorick, S., et al. Prevention and Treatment of Childhood Obesity: Care Received by a State Medicaid Population. Clin Pediatr (Phila). 2011 Apr 27 (Epub ahead of print).