Back and Abdominal Pain: What Are the Causes?

Pain in the back and abdomen usually indicates an inflammatory or irritative process of the tissues in the area, so timely treatment is essential.

Reviewed and approved by the doctor Leonardo Biolatto.

Written by Luis Rodolfo Rojas Gonzalez

Last update: 06 March, 2023

Back and abdominal pain can be caused by a wide variety of conditions. It usually shows that something is wrong with the underlying soft tissues, musculature, and organs. Here are some of the most common causes of this symptom.

Back discomfort tends to be caused by inflammatory processes. Spinal disorders due to wear and tear, as well as poor posture when sitting or sleeping are another common cause. In addition, kidney and respiratory diseases also create discomfort at this level.

However, when back pain is associated with discomfort in the abdomen, visceral conditions should be suspected. Would you like to know the main causes of this type of pain? Keep reading!

9 causes of back and abdomen pain

Back pain that radiates to the abdomen may start abruptly or progressively depending on the severity of the disorder. Structures affected may include the kidneys, bowel, spine, pancreas, and gallbladder.

1. Kidney stones

Kidney stones, also called renal lithiasis or nephrolithiasis, are small stones or crystals formed by salts and minerals that are deposited inside the kidneys or urinary tract. They don’t produce symptoms until their descent begins.

These stones can obstruct the passage of urine from the kidney to the ureters, increasing renal pressure and producing pain, both in the lower back and in the sides of the abdomen. They also generate discomfort as they descend and injure the inside of the urinary tract.

Studies describe renal lithiasis as an intense colic that may produce abdominal, lumbar or groin pain. Similarly, the person may have difficulty urinating, blood in the urine, and increased urinary frequency.

If this condition is suspected, then you should seek medical attention immediately. Treatment is based on the use of medications to destroy and eliminate the stones, and even surgical removal in severe lithiasis.

2. Intestinal gases

Gases are normal products of intestinal metabolism and food fermentation. However, their excessive production and accumulation can cause discomfort.

The pain is usually diffuse and presents itself as abdominal twinges and cramps that radiate to the back. In addition, affected people may also experience flatulence, nausea, retching, heartburn, and indigestion.

In most cases, the discomfort disappears after a couple of hours. It’s also advisable to eat light meals, consume fruits and drink plenty of water. If the discomfort doesn’t disappear, or its intensity increases, you should consult a health professional.

3. Spinal disorders

Spinal pathologies usually cause continuous pain in the back, radiating to the sides of the abdomen. The irradiation occurs in this way because the same nerve can be responsible for innervating multiple areas in both regions.

Osteoarthritis or osteoarthritis of the spine is the main cause of this discomfort. It’s characterized by wear and tear of the cartilage of the intervertebral discs, which causes pain and other abnormalities. The condition can be the result of an inherited disorder, menopause, or aging.

Poor posture while sitting, walking, or sleeping can also be responsible for back pain. In these cases, the vertebrae adopt abnormal positions that injure their structure and degenerate neighboring tissues. The affected person usually reports pain in the neck and back.

Spinal problems should be evaluated by a rheumatologist or an orthopedic surgeon. An x-ray is usually requested to identify the cause of the discomfort. The therapeutic plan includes the use of anti-inflammatory and analgesic medications, as well as physical therapy sessions.

4. Vertebral fractures

In most cases, fractures of the vertebral bodies occur after trauma from a road accident or a fall from height. Similarly, people with osteoporosis or bone cancer are more susceptible to this type of injury.

The discomfort is usually continuous, intense, and disabling. In this sense, the affected person may experience a very strong pain that crosses from the back to the abdomen. Moreover, it isn’t relieved by rest or common analgesics.

Vertebral fracture may produce an iliocostal syndrome. This condition is characterized by pain in the lower abdomen, due to the contact of the ribs with the iliac bone.

If a fracture is suspected, then urgent medical attention should be sought. Treatment usually includes a surgical approach and methods to realign and fix the vertebral structures. Recovery is slow.

5. Intestinal diseases

Irritative and inflammatory intestinal disorders are responsible for producing diffuse abdominal discomfort. Similarly, disorders of the large intestine can cause pain in the sides of the abdomen and in the back. Inflammatory bowel disease (IBD) is one of the most frequent causes.

Abdominal discomfort is accompanied by other symptoms such as nausea, heartburn, reflux, constipation or diarrhea. Pain may be present in half of the people with IBD and studies suggest that relaxation, cognitive change, and dietary adaptations help to relieve it.

As if that weren’t enough, there’s evidence that IBD has extraintestinal manifestations, some of which can affect the spine and generate pain. In fact, a publication in StatPearls suggests that up to 10% of people with IBD have ankylosing spondylitis.

Gastroenterology specialists are trained to identify and treat these types of problems. The therapeutic plan usually includes dietary changes and the use of medications to relieve symptoms.

6. Pancreatitis

Pancreatitis is the inflammation of the pancreas with the consequent alteration of its functioning. It can be acute or chronic, depending on the duration of the inflammation and the changes in the organ.

The pain starts in the upper abdomen and radiates down the sides to the back, as suggested by some studies. Nausea, vomiting, indigestion and fat in the stools due to decreased pancreatic enzymes may also be evident.

Acute pancreatitis usually subsides within a week of starting treatment. However, the chronic form involves irreversible damage to the pancreas and requires lifelong palliative care.

7. Gallbladder problems

Cholecystitis is inflammation of the gallbladder and is most often caused by gallstones. The pain usually appears in the upper abdomen and extends to the back, so it can be difficult to differentiate from muscular pathologies according to studies.

Similarly, abdominal discomfort is accompanied by nausea, vomiting, fever and abdominal distension. Diagnosis is based on clinical findings, being confirmed by ultrasound and blood tests. Surgical removal of gallstones is usually the treatment of choice.

8. Pregnancy and its complications

The discomforts of pregnancy can also cause back and abdominal pain simultaneously. Intercostal neuralgia is a common cause during the first trimester, as the growth of the uterus compresses the nerves and generates the pain.

Uterine contractions are usually responsible for this discomfort in the last weeks. The body gradually prepares for childbirth, so it’s common to feel contractions as the birth approaches.

Some of the complications of pregnancy can also be responsible for causing pain in the back and abdomen. A publication from the American Pregnancy Association suggests that miscarriage, urinary tract infections, and placental abruption may be responsible.

Therefore, it’s essential for pregnant women to be aware of this symptom. Ideally, seek medical attention for severe pain associated with other symptoms such as vaginal bleeding.

9. Pyelonephritis

Pyelonephritis is nothing more than the main manifestation of an upper urinary tract infection. It occurs because the invading microorganism reaches the renal parenchyma, preventing the proper functioning of the organ.

Research published in the journal American Family Physician suggests that pyelonephritis should always be suspected in case of presenting pain in the abdominal flank and evidence of infection. Another typical finding is low back pain with a fist-percussion maneuver.

Treatment of this condition will depend on the causative organism. Antibiotic therapy is usually effective.

When to seek medical attention for back and abdominal pain

Back and abdominal pain can result from a wide variety of conditions. However, most of the conditions responsible can be resolved by medical treatment. In this sense, early assistance from a health professional is vital for a faster recovery.

It’s also essential to seek urgent attention if the pain is disabling, increases in intensity, and persists for several days. On the other hand, post-accident discomfort should be assessed immediately. Warning signs include shortness of breath, tingling in the extremities, and a loss of consciousness.