Chest and Back Pain Causes, Treatment, And More

By Terez Malka, MD
Medically reviewed checkmarkMedically reviewed
February 22, 2022

On its own, back pain is not always a concern, although it can be uncomfortable.

But when back pain and chest pain happen at the same time, it could be a sign of a serious health problem.

It’s important to understand when chest and back pain is an emergency and what to do about it, as well as when it may resolve on its own.

What is Chest and Back Pain?

Chest and back pain can occur for many reasons. The exact location, severity, and timing of pain can help pinpoint the cause.

The pain in your chest and back may be constant or it might come and go. It could be dull, sharp, throbbing, or stabbing.

When you talk to your doctor about back and chest pain, be as specific as possible and tell them:

  • What you were doing when you noticed the pain
  • How long you have had symptoms of the pain
  • Any other symptoms you are having

Some causes of chest and back pain include muscle strains, gastrointestinal issues, heart disease, or lung problems.

If you experience chest and back pain that is new, lasts more than a few minutes, or is concerning, get evaluated by a health care provider.

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Symptoms of Chest and Back Pain

Symptoms of chest and back pain can include:

  • Sudden constricting feelings in the chest and back
  • Dull chest pain that happens on both sides of the abdomen
  • Throbbing or stabbing pain around the trunk
  • General discomfort in your abdominal area
  • Pain that starts in your chest and radiates through to your back
  • A tearing sensation moving down your chest or back

Causes of Chest and Back Pain

There are many causes of chest and back pain.

Many of these are not dangerous and can be safely managed at home or discussed with your primary care provider.

However, chest and back pain can also be a sign of a more serious condition. 

Common Causes

Pain that occurs in the upper right abdomen or right side of the back as a dull, sharp, or cramping feeling may be related to the following:

  • Gallbladder problems: Gallbladder pain, such as pain due to gallstones, may last for a few minutes or could last for many hours. It may also occur with nausea or vomiting. If you notice any fever or yellowing of the skin (jaundice), you should seek medical care immediately, especially if you have a known gallbladder disorder.

If your chest and back pain only occurs when breathing out or coughing, it could be related to any of the following:

  • Muscle injury: You can pull or strain a muscle almost anywhere in the body, but the back and abdomen are common locations. In most cases, this will get better by giving it time to heal. You can pull or injure a muscle without directly knowing it. 
  • Fractured or bruised rib: Fractured ribs typically only happen in response to a major accident or fall, but bruised ribs can still cause chest pain and discomfort. The rib pain may worsen if you try to bend or twist or when you take deep breaths, laugh, or cough. 
  • Pleurisy (inflammation of the lung membranes): Pleurisy may develop after a viral illness or other infection and typically lasts from a few days up to a few weeks. Pleurisy may also cause symptoms of shoulder pain, a dry cough, and a general feeling of shortness of breath. Because these symptoms can overlap with symptoms of a more serious condition, you should not assume you have pleurisy unless you have already been diagnosed. 
  • Costochondritis: Costochondritis is inflammation of the cartilage between the ribs that can be caused by a viral illness, exertion, or sometimes for no obvious cause. It causes pain in any area of your chest, and sometimes back, that is typically worse if you push on the area or move it. This generally gets better on its own within a few weeks with over-the-counter medications.

If the pain you experience in the chest and back happens while you are lying down or resting, it could be a sign of the following:

  • Pancreatitis: The pancreas is an abdominal organ that supports digestion and blood sugar balance. When it becomes inflamed, pancreatitis can occur. It may trigger symptoms of upper abdominal and chest pain that radiate to the back pain along with a tender abdomen, fever, nausea, vomiting, and diarrhea.  Pancreatitis is more likely in those who consume alcohol regularly.

Other causes of chest and back can include:

  • Shingles: A painful adult illness that is triggered by the same virus as chickenpox, shingles tend to cause a painful rash and the feeling of tingling or burning skin. It may also lead to pain or general discomfort before the rash develops.  Shingles causes rash that runs in a horizontal line around one side of your chest, abdomen, or back.  
  • Panic attacks: Anxiety can lead to panic attacks which can have a wide variety of symptoms. Some people experience chest or back pain and may experience overlapping symptoms with a heart attack.

Serious Causes

Pain that is located to the left or center of the back, in combination with chest pain, could be related to a heart condition or heart problems. If you experience chest pain along with back pain, seek emergency medical care.

This could be a sign of a heart attack or other serious condition.

  • Coronary Artery Disease/Heart disease: Coronary artery disease, or disease of the blood vessels of your heart, can cause chest pain that may or may not radiate to your arm, jaw or back.  When blood flow is reduced to the heart, you can experience pain that comes and goes, called angina, or even damage to the heart, known as a heart attack. Some symptoms that may come along with chest pain due to heart disease include dizziness, pressure-like pain, nausea, shortness of breath, and sweating.
  • Pulmonary embolism: This is a blood clot that is blocking an artery in the lungs. A pulmonary embolism is a medical emergency that requires immediate treatment. This causes sudden onset of chest pain that is worse when you try to take a deep breath. The pain can radiate to your back. Other signs of pulmonary embolism include shortness of breath and a rapid heart rate. 

Pericarditis: Pericarditis inflammation of the sac that surrounds the heart. This can be caused by a viral illness or other causes.  Pericarditis pain often feels better when leaning forward and worse when leaning back or lying down. It is constant and may be accompanied by shortness of breath, dizziness, or a rapid heart rate.  When to Go to the ER’

If you develop severe chest and back pain that does not improve after a few minutes, pain that worsens over time or is worsened by physical activity, or pain that occurs with other symptoms like dizziness, nausea, fever, sweating, or shortness of breath, you should go to the ER immediately or call an ambulance.

If you have chest and back pain that are milder and do not feel like an emergency to you, contact your doctor or health care provider about your symptoms.

If it is after-hours, don’t hesitate to be seen in an ER if your symptoms worsen.  

Diagnosing Chest and Back Pain

Do not try to self-diagnose chest and back pain.

While many causes are common and don’t lead to serious consequences if left untreated, it is not always easy to tell.

See your doctor or healthcare provider for an accurate diagnosis and to avoid severe complications.

Your doctor will diagnose chest and back pain in one or more of the following ways:

  • Take your medical history and consider relevant related conditions
  • Perform a physical examination
  • Order x-ray, CT scan, or other diagnostic imaging Order blood workOrder an electrocardiogram

In many cases, a physical exam, history, and electrocardiogram are the only tests that are needed, but your healthcare provider will determine the appropriate test for your symptoms.

After the results of the examination and tests, your provider will be able to give you a diagnosis and a better idea of how to manage your chest and back pain.

Treating Chest and Back Pain

Treatment for your chest and back pain depends on what is causing it. An accurate diagnosis is essential to get relief from your symptoms.

For digestive conditions, you may need to alter your diet or take medication to help manage symptoms.

To treat heart conditions, you may need to make lifestyle changes, diet alterations, and take medication.

For other causes of chest or back pain, your provider will give you clear instructions on how to treat or manage your condition.

Preventing Chest and Back Pain

It is not always possible to prevent chest and back pain.

However, for many conditions, you can be proactive about your health to avoid developing symptoms.

  • Eat a diet that is high in fiber, fruits, vegetables, and low in saturated fat and cholesterol.
  • Get adequate amounts of physical activity or exercise, and stretch beforehand to avoid pulled muscles or injury.
  • Take care of your mental health and manage stress.
  • Reduce alcohol intake.
  • Do not smoke.
  • Avoid secondhand smoke exposure.
  • Maintain healthy body weight.
  • Do not skip routine well visits and appointments to manage conditions.
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When to See a Doctor 

If you experience new or severe chest and back pain, you should check with your doctor, especially if it continues to worsen or is accompanied by other symptoms like shortness of breath or dizziness.

When in doubt, if your chest and back pain concern you, visit an ER and follow up with your doctor for ongoing care.

How K Health Can Help

You can chat with a primary health provider in the K Health app within minutes. Not sure if your chest and back pain means you need to go to the ER? If you are not having emergency symptoms, a K Health doctor may be able to help you manage chest and back pain caused by GERD or other digestive problems.

Frequently Asked Questions

Is chest pain always considered serious?
No, chest pain is not always a sign of a medical emergency. However, since it can be, or sometimes might be the only symptom, you should always have a medical professional diagnose new or unknown chest pain, especially if it continues to worsen or is accompanied by other symptoms like shortness of breath, sweating, and dizziness.
Can COVID-19 cause chest pain?
According to the CDC, chest pain is a symptom of Covid, which may also include shortness of breath. If your chest pain is severe or accompanied by trouble breathing, you should seek emergency medical attention.
How long can chest pain last?
Depending on the cause of chest pain, it can last anywhere from a few seconds to a few hours, or it can be a chronic problem. You should always have chest pain evaluated by a physician to avoid complications and to ensure that you are effectively treating it.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

Terez Malka, MD

Dr. Terez Malka is a board-certified pediatrician and emergency medicine physician.