In my more than 25 years as a spine surgeon at Long Island Neuroscience Specialists, I’ve often encountered patients alarmed by the combination of back pain and chest pain. Understandably, these symptoms together can be concerning, as they bring to mind potential heart or lung conditions.
While chest pain might sometimes point to serious medical issues, it can also be the result of musculoskeletal causes originating in the spine or surrounding tissues. Let’s explore this topic and address the common concern: “Will back pain cause chest pain?”
The spine—particularly the thoracic region—plays a pivotal role in the communication of pain signals between your back and chest. Nerves running through this area can send pain signals to multiple locations, creating a phenomenon known as “referred pain.”
This means discomfort originating in the back can feel like chest pain, and vice versa. Many of my patients report dull or burning sensations in their chest that also extend into their upper back.
This is often due to nerve impingement, such as from a herniated disc or misalignment in the thoracic spine. It’s important to note that pain in these areas can sometimes be mechanical in nature—caused by posture, muscle strain, or repetitive motion.
However, distinguishing these mechanical causes from life-threatening conditions like a heart attack is essential, as the symptoms can overlap.
To understand why back pain might lead to chest pain, it helps to examine the anatomy involved. The thoracic spine connects to your rib cage, which protects vital organs like the heart and lungs.
Nerves branching out from the thoracic vertebrae travel between the ribs, making them vulnerable to compression or irritation. For example, a herniated disc in the thoracic region can press against these nerves, causing pain to radiate from your back into your chest.
Similarly, strained intercostal muscles—the muscles between your ribs—can mimic chest pain due to their proximity to the heart and lungs. As a surgeon, I’ve also observed that poor posture—such as slouching at a desk for hours—can lead to muscle imbalances that tighten the chest and upper back, resulting in pain.
Understanding these mechanisms is crucial because it allows us to differentiate between musculoskeletal issues and more serious internal organ problems. The overlap in symptoms underscores the need for thorough evaluation and an accurate diagnosis.
In my practice, I’ve seen a range of causes for this symptom combination, and these are the most frequent:
Muscle strain and nerve compression are common culprits. For instance, lifting a heavy object improperly can strain your thoracic muscles and cause pain to radiate into your chest. Similarly, a pinched nerve from a herniated disc can send sharp or burning pain along a rib, mimicking cardiac pain.
One of the most preventable causes is poor posture. Whether it’s slumping at your desk or hunching over your phone, poor alignment can place undue stress on your thoracic spine and surrounding muscles. Over time, this can lead to persistent pain that’s felt both in the back and chest.
Stress often manifests physically, especially in the neck, shoulders, and upper back. Chronic tension in these areas can lead to referred pain in the chest. In fact, some of my patients initially believed their pain was cardiac-related when it was actually stress-induced muscle tightness.
Conditions like fibromyalgia and myofascial pain syndrome often present with widespread pain, including in the upper back and chest. These conditions require a holistic approach to treatment, often involving physical therapy and lifestyle adjustments.
Rib fractures or thoracic spine injuries from falls or accidents can cause pain that travels from the back to the chest. Even repetitive motion injuries, such as those seen in athletes, can result in similar symptoms.
While many cases of back and chest pain are musculoskeletal in origin, certain symptoms warrant immediate medical attention. For example, if you experience a crushing sensation in your chest, pain radiating to your arms or jaw, shortness of breath, or dizziness, these could be signs of a heart attack.
Similarly, sharp pain that worsens with breathing could indicate a pulmonary embolism or pleurisy.
In my experience, patients with aortic aneurysms often describe a sudden, tearing pain in their chest or back.
These are true medical emergencies. If your pain is severe, persistent, or accompanied by nausea, sweating, or fever, don’t hesitate to go to the ER. Read more here.
Differentiating between musculoskeletal and cardiac pain is one of the most important steps we take during diagnosis. Typically, musculoskeletal pain is localized and changes with movement or pressure.
For example, you might notice the pain worsening when you twist your torso or press on the affected area. Cardiac pain, on the other hand, often feels like a deep pressure or squeezing sensation and may worsen with exertion but not with movement.
Diagnostic tools like EKGs, chest X-rays, and MRIs help us identify the root cause. In some cases, additional tests like stress tests or blood work are needed to rule out cardiac conditions. Read more here.
Effective treatment often depends on addressing the underlying cause. For musculoskeletal issues, I typically recommend a combination of physical therapy, pain management, and lifestyle adjustments.
Exercises that strengthen the back and core can provide much-needed support to the spine and reduce the strain causing your pain. In addition to physical therapy, ergonomic changes can make a significant difference.
For instance, ensuring your workstation is set up to support good posture can prevent future episodes. Stress management techniques, such as mindfulness and yoga, are also invaluable, as they help release tension in the upper back and chest.
For immediate relief, hot and cold therapy can reduce inflammation and alleviate pain. Over-the-counter medications like ibuprofen are also helpful.
However, persistent pain should always be evaluated by a professional to rule out more serious conditions.
Preventing back and chest pain is often a matter of maintaining good posture, staying active, and managing stress. I advise my patients to incorporate regular exercise into their routines, focusing on activities that promote spinal flexibility and strength.
Yoga and Pilates are excellent choices, as they target both the back and core muscles. Simple ergonomic adjustments can also go a long way.
Using a chair with proper lumbar support, keeping your screen at eye level, and taking frequent breaks to stretch can help maintain spinal alignment. Additionally, managing your stress through meditation or counseling can prevent the muscle tension that often triggers pain.
A healthy diet is another key factor. Ensuring you get enough calcium and vitamin D can keep your bones strong and reduce the risk of spinal issues.
Avoiding smoking and excessive alcohol consumption is also crucial, as these habits can weaken your bones and muscles over time.
Accurately diagnosing the cause of your symptoms often requires a multidisciplinary approach. Imaging tests like MRIs and CT scans provide a detailed look at the spine and surrounding structures, while blood tests can help rule out infections or inflammation.
In cases where cardiac or lung issues are suspected, specialists like cardiologists or pulmonologists may be consulted. For musculoskeletal issues, physical therapists and orthopedists play a central role in both diagnosis and treatment.
At Long Island Neuroscience Specialists, we use a team-based approach to ensure our patients receive comprehensive care. If you’re experiencing persistent back and chest pain, don’t hesitate to schedule a consultation.
Early intervention can prevent complications and help you return to your normal activities sooner.
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285 Sills Road
Building 5-6, Suite E
East Patchogue, NY 11772
(631) 475-5511
184 N. Belle Mead Road
East Setauket, NY 11733
(631) 675-6226
GET IN TOUCH +
285 Sills Road
Building 5-6, Suite E
East Patchogue, NY 11772
(631) 475-5511
184 N. Belle Mead Road
East Setauket, NY 11733
(631) 675-6226
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