Heartburn from acid reflux may result in back pain. Treating back pain may involve lifestyle changes and certain medications. Surgery may also be an option in severe or persistent cases.

Acid reflux can cause heartburn, which causes pain in the chest that may radiate to the back. People may also experience pain in the neck and throat.

Acid reflux and back pain may also share some of the same risk factors. Having obesity, carrying excess weight, and smoking may all lead to acid reflux. These factors are also risk factors for back pain.

Musculoskeletal conditions may cause acid reflux, too. Upper cross syndrome (UCS), also known as upper crossed syndrome, is an imbalance in the neck, shoulder, and chest muscles and may occur from extended periods of poor posture. UCS may cause pain in the back, neck, and chest.

According to a 2021 case report, UCS may cause a range of other symptoms, and it may trigger acid reflux and heartburn. Staying in positions with poor posture for long periods of time can put pressure on the abdomen and force stomach acid up through the esophagus.

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If acid reflux is causing back pain, treating acid reflux may relieve back pain. Treatments for acid reflux may include:

Habit changes

Here are habit changes a person can make to reduce back pain caused by acid reflux:

  • Maintaining a moderate weight: Having obesity and carrying excess weight may cause acid reflux, so losing excess weight may help.
  • Elevating the head when sleeping: People can use an extra pillow or soft wedge to raise the head 6–8 inches when lying down.
  • Quit smoking: Smoking may affect the lower esophageal sphincter and cause acid reflux. If a person needs help quitting, they should speak with a doctor, who can recommend smoking cessation programs.
  • Alter eating habits: Eating a meal at least 3 hours before lying down or sleeping may help, as well as avoiding any foods or drinks that typically trigger a person’s acid reflux.

Medications

Over-the-counter (OTC) and prescription medications may help treat acid reflux, such as:

  • Antacids: Antacids may be suitable for mild acid reflux, but they are not suitable for severe symptoms or daily use.
  • H2 blockers: H2 blockers reduce the amount of acid the stomach produces and help heal the esophagus.
  • Proton pump inhibitors (PPIs): PPIs may be more effective than H2 blockers at reducing stomach acid levels. They may also help heal the lining of the esophagus. PPIs are usually safe, but they can cause side effects.

Surgical interventions

If people have persistent acid reflux, or gastrointestinal reflux disease (GERD), which does not respond to other treatments, surgery may help relieve symptoms. Procedures may include:

  • Fundoplication: During a fundoplication procedure, a surgeon will join the top of the stomach to the lower end of the esophagus to prevent stomach acid from passing through the lower esophageal sphincter.
  • Bariatric surgery: If obesity is causing acid reflux, weight loss surgery such as gastric bypass surgery may help relieve symptoms.
  • Endoscopy: In rare cases, a doctor may insert a thin, lighted tube through the mouth to the esophagus. Doctors can use endoscopy to join the stomach to the lower esophageal sphincter or apply radiofrequency energy to tighten the sphincter. Additionally, endoscopy can enable the physician to release esophageal strictures and to biopsy the esophagus under direct visualization.

If musculoskeletal conditions are causing acid reflux, treating the underlying cause of back pain may help relieve acid reflux. This may include:

  • strengthening and stretching muscles to achieve correct alignment and support
  • undergoing chiropractic treatment to correctly align the spine and increase mobility of the joints
  • having a massage to release tight muscles

Other ways to keep the back healthy and aligned may include:

  • using ergonomic furniture
  • switching positions frequently when sitting for prolonged periods and getting up regularly to walk or stretch
  • placing the feet on a low stool when sitting
  • getting regular exercise
  • maintaining a moderate weight

Before pursuing any of the habit changes, medications, or surgical interventions listed above, a person should speak with their doctor to determine which method may be best for them.

People may be able to prevent back pain from acid reflux by reducing the risk of acid reflux and heartburn. This includes maintaining a moderate weight, quitting smoking, and avoiding secondhand smoke.

People can also avoid certain foods and drinks that may trigger symptoms, such as:

  • citrus fruit, tomatoes, or other acidic foods
  • alcohol
  • chocolate
  • spicy foods
  • caffeine
  • high fat foods
  • mint

Other causes of back pain may include:

People will need to see a doctor if they have symptoms of GERD, or if symptoms do not improve with home treatments and lifestyle changes.

People will also need to see a doctor if they have:

  • loss of appetite
  • persistent vomiting
  • difficulty or pain with swallowing
  • vomit that looks like coffee grounds or contains blood
  • black, tarry stools, or blood in stools
  • unexplained weight loss

A heart attack may also cause pain in the chest and back, and people may mistake this for heartburn. Chest pain that comes and goes, or lasts longer than a few minutes, may be a sign of a heart attack, and people will need immediate medical attention.

Acid reflux may cause heartburn, a painful sensation in the chest that may radiate to the back.

Poor posture may also cause back pain and acid reflux, as it may put excess pressure on the abdomen, leading to stomach acid passing through the lower esophageal sphincter.

Treating acid reflux may help relieve any related back pain. Treatments for acid reflux may include diet and lifestyle changes, weight loss, medications, or in some cases, surgery.

Improving posture and maintaining good back health may also help reduce pressure on the abdomen and lessen the risk of acid reflux.