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How to Relieve Acid Reflux Back Pain

acid reflux back pain

Could that burning pain in you're back be caused by acid reflux or is it something more serious?

Most acid reflux sufferers don't experience upper back pain because most cases are due to musculoskeletal issues.

However, the key word here is…MOST.

In rare cases, you're acid reflux can cause back pain.

But before I explain how that happens I need to warn you:

Back pain caused by an imminent heart attack is common.

In fact, recurring upper back pain can be the only symptom with this condition.

Upper back pain can be caused by a variety of health conditions.

The key is knowing how to tell the difference between the cause being a life threatening condition or not.


When You're Back Pain Could mean a Heart Attack

Acid reflux and GERD (gastroesophageal reflux disease) can cause chest and back pain scaring many people into thinking that something is seriously wrong with their heart.

How much do the symptoms of heartburn and heart attack overlap? 

Ask any experienced doctor and they'll tell you that heartburn, acid reflux, angina or an impending heart attack can feel very similar.  They can all cause chest and back pain. 

But how do you tell the difference?

What signs and symptoms are more likely to occur with a heart attack than with heartburn?  

The textbook version of a heart attack consists of a sudden 'crushing' pain in the chest with breathing difficulties as a result of exertion.

The fact is, many heart attacks do not happen this way because the symptoms can vary between people.

But the typical heart attack warning signals are... A feeling of pressure or tightness in the chest and that can spread to the left arm, the neck, jaw or back.

  • Shortness of breath
  • Sweating
  • Nausea

If you experience any of these symptoms get to ER immediately!

If there is any kind of recurring or chronic back and chest pain get checked by a doctor to rule out heart disease. 

How Acid Reflux/GERD may Cause Upper Back Pain

Acid reflux back pain is rare.

But to understand acid reflux related back pain we need to understand what causes the pain.

Heartburn is a symptom of gastroesophageal reflux disease (GERD) and is caused when stomach acid regularly enters the lower esophagus.  

The lower esophagus sphincter is a round shaped muscle located at the bottom the esophagus, just before the entrance to your stomach. 

The sphincter acts like a one stop valve. Meaning, it opens one way.

As you swallow the sphincter opens to allow food into the stomach then, closes to stop stomach acid escaping back into the esophagus.

Sometimes, the valve-like muscle is too relaxed or weakens and doesn't close fully. This allows stomach acid to flow back up (reflux) the esophagus and its corrosive effect causes a burning sensation in the chest and sore throat.

Chronic heartburn can cause severe pain that can radiate to the upper back causing pain and discomfort between the shoulder blades. 

The Vagus Nerve

One possible cause could be linked to the vagus nerve.

Let me explain...

GERD and chronic acid reflux causes stomach acid to enter the esophagus on a regular basis damaging the lining and causing ulcers to form. 

In severe cases, the burning pain can radiate to the abdomen and upper back causing extreme discomfort.

Also, the stomach acid can penetrate the lining of the esophagus and irritate the vagus nerve.

The vagus nerve is the longest cranial nerve in the body beginning its journey at the brain stem and where its ends at the lowest part of the colon. 

Along the way, the vagus nerve connects with the heart, liver and other major organs. The vagus nerve is also responsible for the communication between the brain and gut. 

For example, the nerve is required for the production of stomach acid, bile excretion and the release of digestive enzymes. 

The vagus nerve runs down the spinal chord and then like the root system of a tree branches out to the different organs of the body. And weaknesses along the spinal column can cause irritation of vagus nerve.

For example, people with craniocervical instability a condition were the ligaments that support the skull are lose or weak. This weakening can compress the vagus nerve. 

Therefore, vagus nerve damage can cause the muscle to become tight and irritated.

Its more likely acid reflux is being caused by something that's either related to back pain or its treatment than acid reflux causing the back pain.  

If its not GERD What Else Could Cause Back Pain

Peptic Ulcer

The back is a part of the body that's often the site of referred pain. 

Referred pain means the pain that you feel in your back is not the actual source. Its coming from somewhere else.

Certain digestive problems may cause back pain. For example, a peptic ulcer (stomach ulcers) are formed in the lining of the stomach. Often caused by bacterial infections that weaken and penetrate the stomach lining.

Peptic ulcers can cause a severe gnawing pain around the abdominal area and the pain can often radiate to the middle of the back.  

Peptic ulcers are not always painful but they can cause other symptoms such as heartburn, nausea or indigestion.

Trapped or Pinched Nerve 

The cervical spine is connected to 1000's of nerves.

A pinched or trapped nerve refers to a type of damage often caused by a vertebrae, herniated disc or bone applying pressure to the nerve or group of nerves.

If its a pinched nerve you should feel these sensations...

  • Pins and needles
  • Numbness
  •  Tingling
  • Burning

Most pinched nerves can be treated at home by stretching, applying heat, improving posture or avoid sitting for long periods.

Posture and Back Pain

Sitting for long periods hunched over a desk is not doing your back or health any favors.

Poor posture over extended periods creates stress in the muscle tissues, lumbar joints and discs of the spine. Over time weakening the back and causing pain and discomfort.

But bad posture can impact your health in other ways:

  • Increase risk of arthritis
  • Poor blood circulation
  • Restrict breathing
  • Fatigue

Poor Posture Worsens Heartburn

Do you slouch while eating?

It's a bad habit is you do because its probably making your acid reflux worse.

Dr. Kyle Staller gastroenterologist at Harvard Massachusetts General Hospital

Slouched posture after a meal can trigger heartburn

Slouching puts pressure on the abdomen, which can force stomach acid in the wrong direction. And some evidence suggests that transit in the intestines slows down when you slouch. (i)

If poor posture is a problem find a physical therapist who can design a personalized program of exercises.  It should include stretch routines to increase strength and flexibility in the back and core muscles.

Overeating and Back Pain

Dumping large amounts of food in your stomach puts enormous strain on the digestion.

The tell-tale signs of digestive distress as a result of overeating are stomach aches, bloating and indigestion.

As the stomach bloats and expands it puts stress on the spine and back muscles causing discomfort and pain. 

But you can easily remedy the problem with a simple lifestyle change.

Rather than sitting down to 3 heavy meals a day or binge eating at the down town all you can eat buffet... 

You can still eat as much as by eating smaller quantities frequently throughout the day.

Your digestion will thank you for it as its better able to cope with smaller quantities of food and liquid.  

Allergies and intolerance's

And you don't have to overeat. 

If you have a food allergy/intolerance eating a small portion of a trigger food can cause bloating and therefore an increased risk of back pain. 

Other Causes of Back Pain After Eating

  • Gallbladder inflammation
  • Kidney infection
  • Pancreatitis
  • Gallstones
  • Stress

How to Relieve Acid Reflux Back Pain

If acid reflux is causing your back pain treatment should focus on alleviating or eliminating the acid reflux not the back pain.

Avoid Pain Relief Medications 

In fact, if you're taking a Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen or Naproxen you're probably making your acid reflux worse.

Not everyone taking NSAIDs to relieve back pain will develop GERD. 

But, evidence does reveal NSAIDs can increase the risk of developing GERD (ii).

 Use Antacids and PPI's Sparingly

Antacids and Proton Pump Inhibitors are popular acid reflux medications to help relieve indigestion and heartburn.

How to Relieve Acid Reflux Back Pain

If acid reflux is causing your back pain treatment should focus on alleviating or eliminating the acid reflux not the back pain.

Avoid Pain Relief Medications 

In fact, if you're taking a Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen or Naproxen you're probably making your acid reflux worse.

Not everyone taking NSAIDs to relieve back pain will develop GERD. 

But, evidence does reveal NSAIDs can increase the risk of developing GERD (ii).

 Use Antacids and PPI's Sparingly

Antacids and Proton Pump Inhibitors are popular acid reflux medications to help relieve indigestion and heartburn.

According to the World Health Organisation more than $10 Billion is spent on acid reflux medications each year!

Antacids work by either neutralizing stomach acid or forming a raft on top of the stomach contents to stop the acid flowing into the esophagus.

Popular brands are Gaviscon and Rennies.

People with severe GERD symptoms often resort to stronger drugs such as PPI's. Instead of neutralizing stomach acid, PPI's reduce the production of stomach acid.

Like antacids, PPI's can be bought over the counter. However, stronger PPI's require a doctors prescription. 

PPI's Antacids are generally safe when taken correctly. The problem is most people don't.

Because the relief is fast acting many people develop a dependency and thats when the problems start.

Remember, these drugs only relieve the symptoms they don't address the cause and an over-reliance on them may mask a serious problem or create one. 

Nexium, the most popular PPI is one of the top selling drugs in history with over $72 billion in Sales in the US since its inception in 1992.

Growing evidence shows reducing levels of stomach acid makes it harder for the digestive to break down hard to digest foods. 

Over time, undigested foods build up in the digestive tract creating a toxic environment that encourages the growth of bad bacteria which health complications such as IBS, constipation and other gut infections.

If you're heartburn or back pain persist after 14 days go to your doctors and get checked out  

Simple Life Style Changes for Acid Reflux Relief

Acid reflux may not be a terminal condition but its a sign your body is under stress. Left unchecked, the condition could become a serious one.

In most cases, the symptoms of GERD can be irradiated or at least managed by making a few lifestyle changes. 

Lose Weight

Being overweight will make your acid reflux worse.

Excess fat building up around the abdomen acts as a heavy weight that applies pressure on the stomach pushing the stomach acid into the esophagus.

Incorporating more exercise into your daily life can be as simple as taking the steps instead of the escalator or lift.

If you're not use to exercise start out slowly. Begin with a 15 minute walk everyday and build up from there. 

The key thing is not the quantity you do but the consistency. The goal is to build a habit of doing exercise that it becomes second nature to you.

Eating habits

How you eat can have just as big an impact as what you eat.

Overeating often leads to heartburn because the stomach is unable to cope with the huge quantity of foods it needs to break down.

The stomach needs to release more acid which can cause indigestion, bloating and heartburn.

Being aware of your eating habits can go a long way to reducing acid reflux.

Consider these two steps...

Step 1 - Eating smaller quantities: 

You can still eat the same amount of food the only difference is that you're eating smaller amounts but more frequently throughout the day.

Step 2 - Chew your food 

Digestion begins in the mouth. But most people don't chew their food properly creating extra work and stress for the stomach to deal with. You should chew each mouthful 30 times before swallowing. Its not an easy habit to acquire but it it will reduce heartburn and improve your overall digestive health.

Sleeping Position

GERD symptoms can show up while in bed and ruin a good night sleep.

When you're standing or sitting gravity is your best friend because it keeps gastric acid where it should be, in the stomach.

Unfortunately, the act of lying horizontally on a bed can encourage the symptoms of GERD.

Lying flat makes it far easier for the stomach acid to flow back up into the lower esophagus.

What's more, sleepers swallow less which reduces esophageal contractions that help keep  food moving down the esophagus and stopping gastric acid from moving upwards.

The good news, doctors recommend GERD sufferers he following do's and don't's to get a good nights sleep...

Do

  • Raise the head 6 to 8 inches to help gravity do its magic to stop your gastric acid from refluxing. 
  • Sleep on your left side because your stomach will be positioned below the esophagus therefore lowering the risk of acid reflux. 

Don't

  • Sleep on your right side as it has the effect of relaxing the lower esophageal sphincter - the round muscular valve connecting the stomach to the esophagus right side that prevents stomach acid flowing back into the esophagus.
  • Sleep on your back, especially if you are overweight as the pressure on the stomach can push the gastric acid into the esophagus.

Would sleeping on your left side at an incline be the ultimate sleeping position to defeat acid reflux?

According to recent scientific trials (ii) (iii) that seems to be the case.

When you combine the left sided inclined sleeping position the esophagus is positioned high above the contents of your stomach making acid reflux virtually impossible. 

Even in the rare case acid reflux does happen gravity works in your behaviour by pushing the acid back into the stomach.

Avoid foods that Trigger Acid Reflux 

Common culprits are:

  • raw onions and garlic
  • Spicy foods
  • Chocolate 
  • Citrus fruits
  • Coffee
  • Alcohol
  • Soda drinks

Discover more about which foods trigger acid reflux.

The REAL Cause of GERD/Acid Reflux

The common diagnosis on the cause of GERD and heartburn is too much stomach acid.

But growing evidence reveals this isn't the case.

Incidences of GERD/acid reflux increase with age while stomach declines. 

Think about it...

If acid reflux was really caused by too much stomach acids then teenagers would be popping TUMs like it was going out of fashion. But in reality, we see the opposite happening.

In his excellent book "Why Stomach Acid is Good for You" Dr Jonathan Wright reveals that in over 25 years of testing he found...

"When we carefully test people over age forty who’re having heartburn, indigestion and gas, over 90 percent of the time we find inadequate acid production by the stomach. "

Dr Jonathan Wright - mD

Low stomach acid increases the risk of bacterial overgrowth. 

What's more, low stomach acid can lead to carbohydrate malabsorption, mean that carbs are digested properly. The undigested end up in the lower intestine where they ferment causing gas and bloating.

The bloating and gas increases intra-abdominal pressure that becomes the driving force behind GERD and heartburn. 

 So, GERD is caused by low levels of stomach acid and bacterial overgrowth in the gut. 

Therefore, successful treatment of GERD involves 

  1. Reducing the causes of low stomach acid and bacterial overgrowth.
  2. Replenish gastric acid and digestive enzymes.
  3. Restore friendly bacteria and protective lining of the gut.

1. Reducing the causes of low stomach acid and bacterial overgrowth  

H.pylori. is a common bacterial overgrowth that can suppress the production of stomach acid. Unfortunately, this creates a vicious were both low stomach acid and bacterial overgrowth exacerbating each other into a downward spiral of digestive dysfunction.

Although more testing needs to be done a low-carb diet has in two studies proved very effective at not only reducing the symptoms of GERD but in some cases eliminated them completely.

It isn't necessary to stay on a low-carb diet permanently. As soon as the symptoms disappear and normal digestive function returns a low to medium low-carb diet should be enough to prevent the symptoms coming back.

2. Replenish gastric acid and digestive enzymes  

At his Tahoma clinic Dr Wright Wright has conducted thousands of tests on stomach acid levels since 1976.

In all those years, the test results have consistently shown that hypochlorydria (low stomach acid) occurred in 90% of people with mild to moderate heartburn.

He also found that replenishing low stomach acid with HCL supplements were successful in helping to increase production of stomach acid and eliminate the symptoms of GERD and heartburn.

3. Restore Friendly Bacteria and Protective Lining of the Gut  

As an overgrowth of bad bacteria plays a big factor in GERD and heartburn, restoring a healthy balance of beneficial bacteria is a key factor in its treatment.

Good and bad bacteria are constantly competing for resources, therefore its important that you have sufficient numbers of probiotics to stop and push back the growth of nasty pathogens.

And there are plenty of medical studies that reveal probiotics to be effective at reducing the spread of bad bacteria with conditions such as IBS. (iv)

In addition, probiotics can substantially increased the cure rate in people being treated with H.pylor. infections. (v)

The best source of probiotics come from natural foods.

Fermented foods have been eaten for their probiotic benefits for thousands of years.

In fact, natural fermented foods such as yogurt and kefir contain more friendly bacteria than commercial yogurts and probiotic supplements. 

Click to learn how to make your own probiotic drink.

Fermented dairy products may cause issues for those with severe bacterial overgrowth, however there are non-dairy alternatives such as fermented cabbage (sauerkraut) and kombucha that are easy to make at home.

Even so, probiotic supplements are an effective and convenient way to boost your digestive health.


References:

(i)  3 surprising risks of poor posture - Harvard Medical School Publishing.

(ii)  Use of a positional therapy device significantly improves nocturnal gastroesophageal reflux symptoms - Department of Gastroenterology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

(iii)  A Novel Sleep Positioning Device Reduces Gastroesophageal Reflux: A Randomized Controlled Trial - University of Maryland Gastroenterology, Baltimore, MD †Medical University of South Carolina Gastroenterology, Charleston, SC ‡Amenity Health Inc., San Diego, CA.

(iv) Probiotic effects on intestinal fermentation patterns in patients with irritable bowel syndrome - Department of Medicine, and Department of Gastroenterology, Monash University, Box Hill Hospital, Box Hill, Victoria 3128, Australia.

(v) Do probiotics improve eradication response to Helicobacter pylori on standard triple or sequential therapy?  - Department of Gastroenterology, ADSC Center, Sharjah, United Arab Emirates.