Several different conditions may cause chest and upper back pain together. Causes can be related to the heart, digestive tract, and other parts of the body.
While some causes of chest and upper back pain aren’t emergencies, others are.
Always get emergency medical attention if you have sudden or unexplained chest pain that lasts more than a few minutes, shortness of breath, or if you feel sweaty or clammy (diaphoresis).
Read on to learn more about the causes of upper back and chest pain, how they’re treated, and when to see a doctor.
Potential causes of upper back and chest pain include:
1. Heart attack
A heart attack happens when the blood supply to the muscles of your heart is blocked. Because of this, people having a heart attack may experience chest pain that can spread into the neck, shoulders, and back.
Other symptoms to look out for include:
- sensations of pressure or tightness in the chest
- cold sweats
- shortness of breath
- feeling lightheaded or faint
- nausea
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2. Angina
Angina is pain that occurs when your heart tissue isn’t getting enough blood. It can commonly occur in people with coronary artery disease. It often happens while you’re exerting yourself.
Similar to pain from a heart attack, angina pain can spread to the shoulders, back, and neck.
Angina symptoms can vary between men and women. Women may feel pain in the back, neck, or abdomen in addition to or instead of chest pain.
Other angina symptoms can include:
- feeling fatigued or weak
- shortness of breath
- sweating
- feeling lightheaded or faint
- nausea
3. Heartburn
Heartburn happens when the acid or contents of your stomach comes back up into your esophagus. This causes a painful, burning sensation in your chest, behind your breastbone. It may also sometimes be felt in your back or abdomen.
Heartburn tends to be worse after eating a meal or in the evening. You may also notice an acidic taste in your mouth or pain that gets worse while lying down or bending over.
Being pregnant, overweight, or obese can also increase your risk of developing heartburn. Some foods can also trigger the condition, including spicy foods, citrus, and fatty foods.
4. Pleurisy
Pleurisy happens when the membranes that line your lungs and your chest cavity become inflamed.
Normally, these membranes move smoothly past each other. When they’re inflamed, they can rub against each other, which leads to pain.
Pleurisy can be caused by a variety of things, including infections, autoimmune conditions, and cancers.
Pleurisy pain gets worse as you breathe in deeply or cough. It can also spread to your shoulders and back.
Other symptoms that can occur include:
- coughing
- shortness of breath
- fever
- chills
- unexplained weight loss
5. Gallstones
Your gallbladder is a small organ that stores a digestive fluid called bile. Gallstones occur when this fluid hardens inside your gallbladder, forming stones.
Gallstones may cause pain to occur in several different places, including:
- the upper right area of your abdomen
- right below your breastbone
- between your shoulder blades
- in your right shoulder
The amount of time you experience pain from gallstones can last for a few minutes to several hours. You may also experience symptoms such as nausea or vomiting.
Several risk factors may increase your risk of gallstones, including:
- being female
- being pregnant
- having overweight or obesity
6. Pericarditis
The pericardium lines the surface of your heart. Pericarditis happens when the pericardium becomes inflamed. It can be caused by an infection or autoimmune condition. It can also happen after a heart attack or heart surgery.
Pericarditis causes sharp chest pain, which may become worse while breathing deeply, lying down, or swallowing. The pain may also be felt in the left shoulder, back, or neck.
Other symptoms to be aware of include:
- dry cough
- feelings of fatigue
- anxiety
- difficulty breathing when lying down
- swelling in your lower extremities
7. Musculoskeletal pain
Sometimes muscular problems may cause pain in the chest and upper back. Repetitive use or overuse of multiple muscle groups, for example, through activities such as rowing, can lead to aching pain in the chest, back, or chest wall.
Other symptoms you may experience include muscle stiffness, muscle twitching, and feelings of fatigue.
Pain may also be “referred,” which means it actually comes from a problem in another part of the body, despite being felt in the muscle.
8. Aortic aneurysm
Your aorta is the largest artery in your body. An aortic aneurysm happens when part of the aorta becomes weakened. In some cases, this weakened area may tear, which can lead to life threatening bleeding. This is called aortic dissection.
Many times, an aortic aneurysm will develop with very little or no symptoms. However, some people may feel pain or tenderness in their chest. In some cases, pain may also occur in your back.
Other symptoms to look out for include:
- shortness of breath
- cough
- hoarseness in your throat
9. Spinal problems
In some cases, a pinched nerve in the upper part of the spine may cause pain to radiate to the area of the chest and possibly to the extremities.
In addition to pain, other symptoms you may experience include muscle spasms and stiffness in the affected area of the spine, which may restrict movement.
10. Lung cancer
Chest and back pain can also occur as a symptom of lung cancer. Although chest pain is a common symptom, the Dana-Farber Cancer Institute reports that 25 percent of people with lung cancer reported back pain as a symptom.
Back pain from lung cancer can happen when a tumor in the lungs begins to put pressure on the spine. Pain from lung cancer may feel worse when you breathe deeply, laugh, or cough.
In addition to chest and back pain, other signs of lung cancer can include:
- persistent cough, which may include coughing up blood
- hoarseness in the throat
- shortness of breath or wheezing
- feeling weak or fatigued
- unexplained weight loss
- recurrent lung infections, such as pneumonia
Lung cancer is rare in people under 40. Just under 50% people who get lung cancer will be 75 years and older.
Here are some good rules of thumb for preventing many of the causes of upper back and chest pain:
- Eat a heart-healthy diet.
- Make sure that you get enough exercise.
- Maintain a healthy weight.
- Avoid smoking and secondhand smoke.
- Limit alcohol consumption.
- Manage your stress levels.
- Stay on top of your routine physical appointments and be sure to see your doctor if new or worrisome symptoms appear.
Some additional tips include:
- Limit foods that may trigger heartburn, such as spicy foods, fatty foods, or acidic foods.
- Try not to lie down right after eating to prevent heartburn symptoms.
- Avoid eating late or large meals to help prevent gallstones.
- Stretch properly before engaging in exercise or sports to avoid muscle injury or strain.
You should always take chest pain seriously, as sometimes it may be an indicator of a serious health condition, like a heart attack.
Always get emergency medical attention if you have unexplained or sudden chest pain, especially if you have difficulty breathing or the pain has spread to other areas, like the arm or jaw.
You should also make a doctor’s appointment for any condition that isn’t relieved using OTC medications or has symptoms that recur, are persistent, or begin to worsen.
There are several things that can cause upper back pain and chest pain to occur together. Some of the causes of this type of pain aren’t serious, but it’s always important to take chest pain seriously.
Chest pain can be a sign of a potentially life threatening condition, such as a heart attack. If you have unexplained chest pain that comes on suddenly or is severe, seek emergency medical assistance.