Chest And Back Pain

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Behind the chest wall are some of the most important organs in the human body. These include the heart, lungs, kidney, liver and stomach. So it should not be too surprising that chest and back pain (particularly when they occur together) can be an indicator of a serious health problem.

In this article, we first describe some of the typical ways to diagnose the causes of chest and back pain. We then discuss six of the most common causes of this pain together with the additional symptoms that may occur in each case..

As always, our suggestions should not be regarded as professional medical advice. Please give priority to the medical advice provided by your doctors or other healthcare advisors. You should also discuss with them any other treatments you may be considering before taking action on those ideas.

Unexplained chest pain should be treated as a serious event that requires urgent medical attention.

Diagnosing Chest & Back Pain

As a first step in determining the cause of your pain, your doctor may review your medical history. She may also ask you questions about the symptoms you are experiencing. For example, when are they most severe and what makes them worse or better?

Your doctor may also conduct a physical examination to clearly understand the exact location of the pain.

An imaging scan in the form of a chest X Ray, CT Scan or even a magnetic resonance imaging study may be conducted if your doctor is still unsure about the cause of your pain.

At this point, if your doctor feels that the cause of the pain may be related to a heart problem, other tests may be conducted. For example, she may request a 12 lead electrocardiogram or a coronary heart angiogram.

Possible Causes Of Chest & Back Pain

We will now briefly discuss six of the most serious causes of this type of pain and suggest corrective courses of action. We emphasize that this list is not exhaustive and that the possible universe of causes is much larger.

We also emphasize that in all cases, the treatment plan from your doctor should take precedence over the opinions expressed in this article.

Heart Attack

This may be indicated by pain in the chest (center to left side) and back. A heart attack is caused by something that cuts off the supply of blood to the heart. The result is usually damage to the heart muscle.

Besides the chest and back pain, you may experience one or more of the following symptoms if you are having a heart attack:

  • A tight or squeezing feeling in your chest cavity;
  • Pain in your neck or jaw;
  • Pain in the arms or shoulders;
  • Nausea;
  • Vomiting;
  • Lightheadedness and/or shortness or breath; and
  • Although heart attack pain may occur on the left side of the chest, it may also occur on the right side or center.

This is a life threatening condition and should be treated urgently. It cannot be treated at home. Instead, call 911 (or have someone call for you) and remain calm until help arrives.


Another possible cause of pain in the back and / or on the left side of the chest is angina. As with a heart attack, the immediate cause is a restriction of blood flow to the heart. Typical other symptoms are:

  • Discomfort or pain in the arm, shoulder, neck and jaw;
  • Pressure or tightness in the chest

Angina is a sign of possible heart disease. You should see a doctor at the first opportunity.

Gallbladder Problems

If your chest and back pain are on the right side it may be indicative of a gallbladder issue. The pain will then be on the upper right side of the chest and/or back.

The gallbladder is an important organ located on the right side of your chest. Its role is the production of bile – a digestive fluid critical to proper digestion.

However, this fluid can sometimes harden and form solid mineral deposits known as gallstones. When this happens, chest and/or back pain on the right side can result from blockages created by the gallstones.

Gallstone pain is frequently temporary – it may last from a few minutes to a few hours. In addition to the pain, you may experience nausea, vomiting and yellowing of the skin (commonly known as jaundice).

Chest Injury

Your chest and back pain may also be the result of injury. Most commonly, this might be damage to the muscles between the ribs or even a fractured rib.

One key difference between this pain and those described above will be the presence of a trigger that initiates the pain. This may be a fall or some other clearly defined incident such as a motor vehicle accident. You will also feel or hear a cracking sound from your chest just before the pain starts.

Particularly with cracked ribs, you may experience increased pain when breathing deeply.

Other typical symptoms of a muscular or bone injury in the chest are:

  • Swelling or tenderness in the chest area; and
  • Bruising on the chest or back.

Gastroesophageal Reflux Disease (GERD)

This type of chest pain is usually not initiated by a specific event (unlike a chest injury). In fact, it is a pain that occurs (or is most severe) when you are lying down (at rest). It is caused by the undigested stomach contents backing up into your esophagus. You may also experience increased GERD pain after a meal.

GERD pain tends to be akin to a burning sensation. You will also usually feel it in the mid to upper chest or abdomen region. You may also experience:

  • Pain when trying to swallow;
  • An unpleasant taste in your mouth;
  • Nausea;
  • Vomiting.

Pulmonary Embolism

This is a condition caused by blood clotting in one of the blood vessels in the lungs. Together with chest and back pain, you may:

  • Cough up blood;
  • Experience shortness of breath, an elevated heart rate and unusual perspiration;

You may also feel lightheaded and notice a blue discoloration on your lips or nails.

This is another example of a medical emergency. If you think you may have a pulmonary embolism, you should seek immediate medical help.

Other Causes

As mentioned above, the list we have presented is by no means exhaustive. Some examples of other causes of chest and back pain (some of which may also be life threatening) are lung cancer, herniated discs, pericarditis and panic attacks.

We stress again that unexplained chest pain should be taken seriously and should be medically evaluated at the earliest opportunity.

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