Gastritis describes the inflammation of the stomach lining, or mucosa. It is often caused by an infection with Helicobacter pylori or the regular use of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin. Gastritis weakens the stomach’s protective barrier, allowing digestive acids to cause irritation and damage. Understanding the relationship between this inflammation and pain felt elsewhere, particularly in the back, helps identify the true source of discomfort.
Typical Location of Gastritis Pain
Gastritis pain is felt in the upper-middle section of the abdomen, known as the epigastrium. The discomfort is described as a burning, gnawing, or aching sensation, sometimes feeling like indigestion or fullness after eating. This pain may improve or worsen depending on when and what a person eats. Nausea, vomiting, and loss of appetite are also common accompanying symptoms. The primary location of gastritis discomfort is the abdomen, not the back.
How Gastritis Causes Referred Back Pain
The connection between stomach inflammation and back pain is explained by referred pain. Referred pain occurs when internal organs, such as the stomach, share a common nerve pathway with a distant body part, like the back. The brain receives pain signals from the inflamed stomach but misinterprets the source, projecting the sensation to the shared nerve network area.
The stomach’s sensory nerves connect to spinal cord segments that also supply the mid-back and upper-back region, specifically between the shoulder blades. Severe or chronic inflammation can irritate these shared neural pathways. This irritation causes the brain to perceive the discomfort as originating from the back, even though the problem is in the stomach. The resulting pain is a dull, persistent ache in the upper back or between the shoulder blades, often occurring alongside typical stomach symptoms.
Serious Conditions That Mimic Gastritis Pain
While gastritis can cause referred back pain, several other serious conditions present with simultaneous upper abdominal and back pain. Pancreatitis, which is inflammation of the pancreas, often causes severe, sudden pain in the center of the upper abdomen. This pain frequently radiates straight through to the back, and unlike many digestive issues, it often worsens when lying flat and improves when leaning forward.
Peptic ulcers, especially those eroded deep into the stomach wall, can also cause pain felt in the back. Unlike gastritis, an ulcer is an open sore that causes intense, localized pain. Gallbladder issues, such as gallstones or cholecystitis, cause abdominal pain that radiates, often to the right shoulder blade or mid-back. This pain is typically felt in the upper right quadrant of the abdomen and is often triggered after eating fatty meals. Because these conditions share similar pain patterns, back pain accompanying stomach discomfort requires careful medical evaluation.
Warning Signs Requiring Immediate Care
Back pain alongside abdominal symptoms should prompt immediate medical evaluation if “red flag” signs appear. Sudden, incapacitating abdominal pain that is severe and unrelenting is a medical emergency requiring immediate attention. Gastrointestinal bleeding is also a serious warning sign.
Bleeding can manifest as vomiting blood or material resembling coffee grounds, or as passing black, tarry stools, which indicates digested blood. Other signs requiring an emergency room visit include pain accompanied by a high fever, a rapid heart rate, or signs of shock, such as lightheadedness or feeling faint. These symptoms indicate potential life-threatening complications, such as a perforated ulcer or severe internal inflammation.