5 Common Causes of Upper Abdominal and Back Pain

Got pain in your upper abdomen and back?

Upper abdominal and back pain together may be a sign that there's a problem with your gallbladder, pancreas or kidneys. (Image: nensuria/iStock/GettyImages)

This discomfort usually signals a problem with an internal organ in the same area. Several medical conditions can cause this pattern, and the organs most likely involved include the gallbladder, pancreas, kidneys, stomach and small intestine.

1. Gallbladder Disease

Sudden pain in the right upper abdomen that also hurts your back near the right shoulder blade could point to a problem with your gallbladder.

Biliary colic is one possibility. It's a type of pain in the upper abdomen, usually under the right side of the rib cage, and occurs when something blocks the flow of bile from the gallbladder, according to Harvard Health Publishing.

Pain that lasts several hours usually indicates acute cholecystitis, or inflammation of the gallbladder due to persistent blockage of the drainage duct, according to the Mayo Clinic. Repeated attacks of biliary colic or acute cholecystitis can lead to a condition called chronic cholecystitis.

With each of these ailments, duct blockage usually occurs due to gallstones. If a stone gets stuck in a duct, you'll likely experience such symptoms as severe pain in the upper right portion or center of your abdomen, back pain between the shoulder blades, nausea and vomiting, per the Mayo Clinic.

"Treatment here can sometimes be to remove the gallbladder, but prior to that it's best to prevent the conditions which cause the gallstones to form," Neha Vyas, MD, a family medicine specialist at the Cleveland Clinic, tells LIVESTRONG.com.

According to Dr. Vyas, risk factors for developing gallstones include eating an unhealthy diet — especially one that is high in fat and cholesterol, and low in fiber — and being overweight. Gallstones are also more common in women, those who are Native American or Mexican-American, those who are sedentary and someone with a family history of gallstones.

2. Pancreatic Disease

Pancreatic disease is another cause of pain in the center of the upper abdomen and the back.

Inflammation of the pancreas, or pancreatitis, is a possible culprit. With acute pancreatitis, steady and severe pain develops suddenly or over a few days and is often accompanied by nausea, vomiting, clammy skin and rapid heart and breathing rates, according to Merck Manuals.

With chronic pancreatitis, the pain is typically less severe and happens more intermittently, usually after meals, per Merck Manuals. Recurring pain episodes might be accompanied by symptoms of a failing pancreas, such as weight loss, fatigue, abdominal bloating, excess intestinal gas and greasy stools. Cancerous or noncancerous pancreatic tumors can also potentially cause this same ab and back discomfort.

Another disease that affects the pancreas is cystic fibrosis, a genetic abnormality that causes sticky, thick mucus to block your pancreas and prevent it from functioning, notes Dr. Vyas. "And diabetes, if left untreated, can lead to pancreatic disease," she says.

Treatment for pancreatic conditions depends on the cause, but it may include not eating by mouth, pain medications or intravenous fluids, she says.

3. Kidney Disease

Your kidneys live behind your upper abdominal organs on each side of the spine and behind your lower rib cage. Kidney stones and infections can cause upper abdominal and back pain on the right or left, depending on which kidney is affected.

With a kidney stone, the pain tends to be more sudden and severe than typically occurs with a kidney infection, or pyelonephritis, according to the Mayo Clinic. Fever, chills, increased urinary frequency and burning with urination are the hallmarks of pyelonephritis. Additional signs and symptoms that might occur with a kidney stone include blood in the urine, clammy skin and nausea with or without vomiting.

"Kidney stones can get stuck in your ureters (the passageways between the kidney and the bladder), which can be painful," notes Dr. Vyas.

To treat the stones, you may be advised to drink a lot of water or take medication, but for larger stones, surgery may be necessary, per the Mayo Clinic.

4. Peptic Ulcer Disease

With peptic ulcer disease, erosions develop in the lining of the stomach or the duodenum, which is the first part of the small intestine, according to Merck Manuals. Ulcers that erode through the wall of the stomach or duodenum and cause a hole, or perforation, can cause intense pain in the central or left upper abdomen. This discomfort often travels to the shoulder area of the back, depending on the site of the perforation.

Ulcers that have not perforated often cause intermittent, gnawing upper abdominal pain but back pain is absent.

Additional symptoms include bloating, heartburn, nausea and vomiting, per the Cleveland Clinic. Lifestyle changes, medications and sometimes surgery are the usual treatment options.

"Depending on the location and the cause, peptic ulcers can be treated with antibiotics, by avoiding certain medications, avoiding alcohol or by prescription medications," says Dr. Vyas.

5. Other Causes

The conditions discussed above are some of the most common ones associated with upper abdominal and back pain, but others might also provoke these symptoms, including:

  • Atypical presentation of a heart attack
  • Inflammation of the sac around the heart, or pericarditis
  • Tearing of the inner wall of the aorta, or aortic aneurysm dissection
  • Atypical presentation of a lung blood clot, or pulmonary embolism
  • Esophageal inflammation or cancer
  • Spleen enlargement or injury
  • Collection of pus in the liver, or a liver abscess
  • Inflammatory bowel disease with associated spinal arthritis

Warnings and Precautions

Because upper abdominal and back pain can signal a potentially serious or life-threatening condition, contact your doctor right away if you develop these symptoms. And definitely seek immediate help if your pain began after a blow to the chest, back or abdomen, is severe or worsening, or is accompanied by any of the following:

  • Chest pain, pressure or discomfort
  • Jaw, neck or arm pain
  • Shortness of breath or difficulty breathing
  • Fever, chills or clammy skin
  • Rapid heart and/or breathing rate
  • Nausea and vomiting
  • Dizziness, lightheadedness or fainting
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