What if your back pain isn’t actually back pain? People often assume that back pain is due to posture or age, or that it’s muscular. But the pain can sometimes be due to indigestion or acid reflux.

Most people think of heartburn as indigestion or acid reflux. It’s one of the most common GERD symptoms. However, in certain cases, acid reflux can present as back pain instead. Below, we explore why this occurs, how acid reflux is linked to a sore back, and how to tell backache and heartburn apart.

What Acid Reflux Actually Is

Acid reflux occurs when stomach acid backflows into the oesophagus (or food pipe). This irritates the lining, causing heartburn. Other symptoms include chest pain, hoarse voice, sore throat, coughing, and even breathing difficulties.

But acid reflux doesn’t always cause heartburn. In some people, there may be no symptoms at all (silent reflux), or the pain might occur somewhere else, including in the back.

Why Acid Reflux Can Cause Back Pain

Bodily pain doesn’t always relate to the underlying cause. Referred pain happens when two parts of the body share a nerve pathway. If the brain can’t identify where the pain is coming from, it may ‘redirect’ it to be experienced in another part of the body.

The oesophagus and upper back share a nerve pathway. That means when the oesophagus is irritated, the brain may interpret the signal as coming from the upper back, often between the shoulder blades.

Where Reflux-Related Back Pain Is Usually Felt

While reflux-related pain can cause a sore back, certain regions are more common than others. Generally, people notice upper or middle back pain rather than lower back pain. The pain is often different from usual, muscular back pain. Common symptoms include a burning, aching, or pressure-like discomfort that worsens after meals or when lying down.

Middle back pain and indigestion are more common in people with a hiatus hernia, where part of the stomach bulges through the diaphragm. Poor posture can cause a similar problem, as can pregnancy, which increases stomach pressure.

How to Tell Reflux-Related Back Pain From Muscle Pain

Back pain due to indigestion or acid reflux can be quite confusing. You find yourself wondering if you slept badly or pulled something. There are a few simple ways to tell the difference.

Here’s an overview of the key differences between reflux-related back pain and muscle pain:

Seek urgent help if back or chest pain is sudden, severe, occurs with shortness of breath, sweating, dizziness, or pain spreading to the arm or jaw.

When Back Pain and Heartburn Occur Together

Acid reflux or indigestion can lead to middle back pain. But sometimes, heartburn and back pain occur together. In fact, they can worsen each other.

Muscular back pain often occurs due to poor posture. Slouching or slumping in a chair can increase your stomach pressure. As the pressure rises, it pushes the acid out of the stomach and into the oesophagus. This is especially bad after meals.

People with back pain are also more likely to lie down to rest their back. The flatter you lie, the easier it is for acid to backflow.

What Helps Relieve Reflux-Related Back Pain

Reflux-related back pain is treated much the same as standard acid reflux. You’ll want to decrease the risk of an acidity attack.

Here are some potential options:

• Avoid Trigger Foods. Limit your intake of trigger foods like fried, fatty, spicy or sour foods, caffeine, alcohol, garlic, onions, or carbonated beverages.

• Eat smaller meals. Don’t eat a large meal just before bed. Sometimes it’s better to eat little and often throughout the day.

• Elevate your head in bed. Sleeping flat increases the risk of acid reflux. Raising the head of the bed or using a wedge pillow is more effective than stacking pillows.

• Consider your posture. If you slump or slouch, try to sit upright to lengthen the oesophagus and prevent pressure on the stomach.

• Take acid-suppressing medication. Antacids, proton pump inhibitors (PPIs), and H2 blockers can either neutralise acid during an attack or reduce acid production.

Ongoing Back Pain and Indigestion?

If your back pain keeps showing up alongside heartburn or indigestion, acid reflux could be part of the picture.

The Functional Gut Clinic uses proper diagnostic testing to determine whether acid reflux is causing your symptoms, giving you clear answers rather than uncertainty. Learn more about GERD and acid reflux, and how getting clarity could reduce your back pain.