Acid reflux and back pain seem to go together like sauerkraut and leather—that is to say, they really don’t. However, they tend to occur in tandem more often than one might expect. This raises a few questions. Why do acid reflux and back pain tend to be comorbid? Does one cause the other, or are they symptoms of something else? Most importantly, how does one go about treating back pain? Here at AICA Lithia Springs, our team has studied this phenomenon and is prepared to give you the answers you need.
Acid Reflux
Though back pain is a familiar enough term, some people may be confused as to what qualifies as acid reflux. Acid reflux, also known as gastroesophageal reflux disease or GERD, is when acid from the stomach backs up into the esophagus. When food is swallowed, a sphincter at the bottom of the esophagus normally closes and prevents backflow. However, if the sphincter doesn’t seal completely or opens too frequently, acid can leak back into the esophagus and cause heartburn.
Sometimes this happens for no particular reason, but if you experience this more than twice a week, it’s considered acid reflux disease and will require treatment. Left alone, acid reflux can result in severe complications later on, namely permanent damage to the esophagus.
How Is It Related to Back Pain?
Oftentimes, the reason you’re experiencing back pain and acid reflux at the same time isn’t that one is causing the other, but because they’re both tied to a different, deeper issue yet to be discovered. There are a few occasions where the back pain is a direct result of acid reflux, but this is not the norm, and it’s often an external factor causing both at once.
Possible Causes
As stated, there are only a rare few cases where there isn’t something behind both your acid reflux and back pain. Many of these cases are the result of outside factors, which can be controlled and potentially eliminated without the need for any medication or intervention. Others are more serious medical issues and may require a doctor’s visit.
The Vagus Nerve
The vagus nerve is a massive nerve in your body that runs through several major organs. The longest of your cranial nerves, it leaves the brain through the right and left sides of the brain stem and runs from the top of your head to the bottom of your torso, passing through your neck and down to your intestines. It travels through your entire body, including your heart, lungs, and stomach, as well as your throat and ears. Infamously, it loops directly under the aortic arch, which is a main component of your heart.
With such a wide reach, it can produce a wide variety of symptoms. If it’s damaged or pinched, say due to bad posture, gastrointestinal distress may ensue. Alternatively, if enough acid is absorbed into the lining of the esophagus, it can also irritate the vagus nerve, causing it to send out errant signals. In some cases, these errant signals can register as pain in the back.
Obesity
Obesity is considered an epidemic in the United States, and it’s a condition with a myriad of negative effects. Most notable for our purposes, it can cause both back pain and acid reflux. The back pain is caused by the body straining to carry the excess weight around, and the acid reflux is caused by the weakening of the muscles in the abdomen, including the sphincter that keeps acid out of the esophagus. Overeating and the consumption of too many fatty foods, things often associated with obesity, can also cause acid reflux.
Stress
One of the most likely ways back pain can lead to acid reflux is through prolonged stress. Some people get heartburn as a result of stress, and dealing with back pain, particularly when it persists or becomes chronic, can be unpleasant. Chronic pain can hinder a person from working or doing activities they enjoy, such as playing a sport or going out with friends. Acid reflux may be exacerbated as a result of this constant stress, leading to the comorbidity of the two.
NSAIDs
Nonsteroidal anti-inflammatory medicines, or NSAIDs, are often used to help with back discomfort, pain, and stiffness. Aspirin, ibuprofen, and naproxen are examples of NSAIDs. Unfortunately, some data suggests that NSAIDs may increase the incidence of acid reflux. While most people who take NSAIDs do not develop acid reflux as a side effect, others do, and they have even been known to cause ulcers on par with some forms of bacterial infection.
More Severe Implications
In some cases, comorbid back pain and heartburn can be an indicator for something far more severe. Most notably, a heart attack can sometimes be mistaken for an extreme case of acid reflux and vice versa. The symptoms of heartburn and a heart attack might be extremely similar. Despite taking your medical history and a physical exam into consideration, even highly qualified doctors can’t always identify the difference. That’s why, if you present to the ER with any form of chest pain, testing to rule out a heart attack will be performed right away.
How to Treat These Symptoms
As you may have guessed, treatment options for chronic heartburn and back pain as comorbid symptoms can be as varied as the causes behind them. Oftentimes, the treatment can be achieved at home through some personal improvements. If you’re obese, lose weight. If you’re stressed, consider scheduling an appointment with a therapist if it’s severe or finding ways to alleviate the stress at home. If it’s NSAIDs, consider switching or stopping the medications altogether. However, there are many other potential causes that could require professional help to treat or cure. Even with the self-treatable options, sometimes sufferers don’t know where to start.
Fortunately, we at AICA Lithia Springs can help. Beyond having multiple members of staff trained in orthopedics, we also have multiple trained chiropractors on staff as it’s important to know how to pick a good chiropractor. Treatment for back pain can often mean treatment for acid reflux, especially when considering the vagus nerve, and there are recorded cases where chiropractic has done just that. If you’ve got any other burning questions on this topic, our team would be glad to assist you.\
Sources
Chu, Eric Chun-Pu, and Kenneth R. Butler. “Resolution of Gastroesophageal Reflux Disease Following Correction for Upper Cross Syndrome—A Case Study and Brief Review.” Clinics and Practice 11.2 (2021): 322-326. https://doi.org/10.3390/clinpract11020045
Clarrett, Danisa M., and Christine Hachem. “Gastroesophageal Reflux Disease (GERD).” Missouri Medicine 115.3 (2018): 214. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140167/#__ffn_sectitle
Merin Jose, A., et al. “Comparative Study Between H. Pylori Induced and NSAIDs Induced Peptic Ulcer”. Journal of Current Medical Research and Opinion, Vol. 4, no. 03, Mar. 2021, p. 842−851 https://doi.org/10.15520/jcmro.v4i03.400
Yolsuriyanwong, Kamthorn, et al. “Impact of Vagus Nerve Integrity Testing on Surgical Management in Patients with Previous Operations with Potential Risk of Vagal Injury.” Surgical Endoscopy 33.8 (2019): 2620-2628. https://link.springer.com/article/10.1007/s00464-018-6562-9