Many individuals experience chest and back pain at some point in their lives. In some cases, both chest and back pain may occur simultaneously.
Within the chest wall are many organs and systems (e.g. heart, lungs, liver, kidneys & pancreas) essential to life.
The causes of chest pain can range between those that are relatively innocuous and routine to extremely serious conditions. Some of these conditions are even potentially life threatening. Emergency care should be sought immediately if you think any of these is the cause of your chest and back pain.
In this article, we first describe the standard techniques a doctor might use to identify the cause of this pain.
We then set out to list 6 of the most common causes of this pain together with the typical accompanying symptoms. We then suggest the typical treatment plans to address the underlying cause and eliminate the resulting chest and back pain.
Diagnosis
To diagnose the cause of chest & back pain, a doctor will ask questions to obtain a clearer understanding of the symptoms. The doctor will also review the patient’s medical history. This would be done to look for any clues as to the cause of the pain.
A physical examination of the patient will be an important stage of the diagnosis process.
If the doctor still requires more information to make a diagnosis, she may request an imaging scan. This can take the form of a chest X-Ray, CT Scan or a magnetic resonance imaging (MRI) study.
Based on whether the results point to possible heart disease, she may request further studies to check heart function. Such studies may includes 12 lead electrocardiogram or a coronary heart angiogram.
Possible Causes & Treatments
We will now review the 6 most common causes of chest and back pain. For each of these, we will suggest what you should do to address the problem.
We emphasize that this list of 6 causes is not exhaustive. There are many other possible causes of chest and/or back pain. Unexplained chest pain in particular should not be ignored. Instead, seek medical advice as soon as possible to determine the cause.
Heart Attack
This is probably the most serious underlying cause of chest and back pain. It is caused by the blockage of blood flow to the heart. This in turn can be a result of clotting in the blood vessels. Alternatively, there may be a buildup of plaque heart on the walls of the arteries leading to the heart.
In addition to chest and back pain, there may also be pain in the shoulders, neck or even the arms. Other possible symptoms include shortness of breath, dizziness and nausea.
Treatment
A heart attack is a medical emergency of the highest order and should be regarded as life threatening. It cannot be treated at home.
Instead, the best course of action is to call 911 to summon emergency medical attention. Alternatively, have someone else do this for you. Try to remain calm until help arrives.
While awaiting medical help, taking an aspirin may help to reduce any blood clotting that may be causing the problem.
Angina
This is another common cause of chest and back pain related to heart disease. The cause is closely related to that of a heart attack. Once again, plaque accumulation on the walls of the coronary arteries is usually a significant factor.
Angina pain frequently increases when you are exercising or engaging in some other physical exertion. However, you may also experience its pain when resting. The pain can also radiate to other areas besides the chest and back. These other areas may for example include the neck and jaw.
Treatment
Although angina is not necessarily as immediately life threatening as a heart attack, it is a serious warning sign. It may be an indication of heart disease and of an increased risk of a heart attack.
If you think your chest and back pain are related to angina, we suggest seeking medical advice urgently.
Pulmonary Embolism
Like a heart attack, a pulmonary embolism can be the result of arterial blockage, typically by a blood clot. Contrary to a heart attack, however, the blockage occurs in a lung artery. In addition to chest pain, affected individuals may feel pain in the back, neck and shoulders.
Treatment
This is a serious and potentially life threatening condition that cannot be treated at home. Instead emergency medical help should be sought.
Heartburn
Heartburn causes a burning sensation in the chest, immediately behind the breastbone. This pain can sometimes spread to the back as well.
The cause of heartburn is usually stomach acid backing up into the esophagus. There is a sphincter between the stomach & esophagus. It would normally prevent this backing up but may be weakened or damaged. This would increase the risk of heartburn.
Chronic heartburn is sometimes referred to as gastroesophageal reflux disease (GERD).
Treatment
The risk of heartburn can be reduced by changing the diet and avoiding greasy, fatty or spicy foods. You can also buy medications called antacids over the counter to relieve the pain. Other medications that can ease the pain include H-2 receptor antagonists and proton pump inhibitors.
Gallstones
This condition is caused by malfunctioning of another important organ inside the chest wall called the gallbladder. It is designed to store an important digestive fluid called bile. However, this fluid can sometimes harden into stones.
The result is pain that occurs on the right side of the chest. The pain can sometimes be felt in the back and shoulders as well.
Treatment
Gallstone treatment may require surgery to remove the gallbladder.
There are also medications that can dissolve the stones over time, but they can take a long time to work. There is also a possibility that the stones may appear again if the medication is stopped.
Peptic Ulcer
This condition is caused by a breach in the digestive tract lining. The resulting ulcer can form in the stomach, esophagus or small intestine. A major underlying cause of this health problem is infection with the helicobacter pylori. Peptic ulcers can also affect individuals who are taking aspirin or other non steroidal anti inflammatory medications.
The ulcers can cause burning in the chest and abdominal cavities and in some cases in the back as well. The pain is similar in nature to that of heartburn (described above).
Treatment
Peptic ulcer treatment may include taking antibiotics to kill the helicobacter pylori bacterium if this is the cause. If NSAIDs are the cause, doctors may recommend stopping or reducing their use. Other medications include antacids, acid blockers and proton pump inhibitors.
Other Possible Causes Of Chest & Back Pain
As mentioned above, there are many other possible causes of chest and/or back pain. Some others can be just as serious as those mentioned above.
These other causes include breast and lung cancer (acting together), herniated discs, gallstones and shingles, to take a few examples. Additional causes can include pleurisy, pericarditis, pancreatitis and & an aortic aneurysm. Muscle overuse injuries can also contribute to chest and back pain.
To summarize, any unexplained chest and back pain should be regarded as a potentially very serious event. Seek medical help urgently to determine the cause and begin treatment.