Back and stomach pain together can come from kidney stones, pancreatitis, ulcers, or muscle strain. Seek care if severe.
Common causes
- Kidney stones or infection.
- Pancreatitis.
- Peptic ulcer.
- Gallstones.
- Muscle strain.
- Abdominal aortic aneurysm.
- Appendicitis.
Clues
Pain on one side with urinary symptoms: kidney. Pain after fatty meals: gallbladder.
See a doctor
Soon.
Emergency
Severe pain with fever, vomiting or fainting. Call 911.
How back and stomach pain link
Pain in both areas can come from organs near the spine since nerves share pathways. Common causes include kidney stones or infection, pancreatitis, gallbladder disease, peptic ulcers, gas and constipation, menstrual cramps, endometriosis and muscle strain. Kidney stones cause severe flank pain that radiates to the groin and affects about 1 in 11 people in the US.
- Pancreatitis causes upper abdominal pain that bores through to the back, worse after fatty meals and with vomiting.
- Abdominal aortic aneurysm may cause back and belly pain, and is most common in men over 65 who have smoked.
- Pyelonephritis (kidney infection) brings fever, chills, and flank pain.
When to get help
Same-day care is needed for fever, blood in urine, repeated vomiting, yellow skin or eyes, or pain that lasts over a day. Call emergency services for sudden severe pain, fainting, a rigid abdomen, black or bloody stools, or chest pressure. Keep track of timing, location and triggers to help your clinician.
How back and stomach pain link
Pain in the back and stomach together can come from referred pain from organs, such as the pancreas, kidneys, gallbladder, stomach ulcers or abdominal aortic aneurysm. Muscle strain, gas and constipation can also cause both. Kidney stones typically cause severe pain in the flank spreading to the groin.
When to get help
Seek emergency care for severe or sudden pain, fever, vomiting, blood in urine or stool, fainting or a pulsating abdominal mass. Pancreatitis causes upper abdominal pain radiating to the back. Mild cases may improve with rest, fluids and over the counter analgesics as directed.
Organs that share pain pathways
Visceral pain is referred to the back through shared spinal segments. Duodenal ulcers can radiate to the back, pancreatitis causes epigastric pain boring through to the back, gallstones refer pain to the right shoulder blade and kidney infection causes flank pain. An abdominal aortic aneurysm is a rare emergency with pulsatile abdominal mass and back pain, mostly in men over 65 who smoked.
Triage guide
Call 911 for sudden severe pain, fainting, vomiting blood, black stool or a rigid abdomen. See a doctor within days for persistent pain, fever, urinary symptoms or weight loss. Mild muscular pain with gas may settle with rest and heat. A doctor may order blood tests for lipase and liver enzymes, urinalysis and imaging.
Based on data from the Mayo Clinic and the American College of Gastroenterology
