Stomach aches and back pain can make you feel terrible, particularly when they occur together. As they are both common problems, when abdominal and back pain occur at the same time, it may be just a coincidence. But several medical conditions can cause both symptoms. Because there are many different organs in your abdomen, determining the exact cause of your pain can be difficult. However, many of the conditions are serious, so it is best to see a doctor if you have both symptoms.

Is This an Emergency?

If you are experiencing serious medical symptoms, seek emergency treatment immediately.

Acute Cholecystitis

Acute inflammation of the gall bladder -- called acute cholecystitis -- is a common cause of pain in the upper abdomen, which may extend through to the back or to the right shoulder blade. The abdominal pain is primarily on the right side, where the gall bladder is located. It is usually sharp and severe, and becomes worse when taking a deep breath. Nausea and vomiting often accompany the pain, and about one-third of people with acute cholecystitis develop a fever, according to “Merck Manual.” Acute cholecystitis is generally caused by gallstones and usually resolves on its own in about a week 6. The gall bladder is often removed when people have repeated attacks of acute cholecystitis.

Acute Pancreatitis

Inflammation of the pancreas causes sharp pain deep within the upper abdomen, which goes through to the back in about 50 percent of people, according to “Merck Manual.” The pain tends to improve with leaning forward or curling up into a ball and worsens with coughing, deep breaths or vigorous body movements. Nausea or vomiting often accompany the pain. A person with acute pancreatitis usually feels sick, may have a fever and can have trouble breathing. When severe, acute pancreatitis can cause inflammation in other areas of the body, leading to heart, lung or kidney failure. Acute pancreatitis is most frequently due to gallstones, but excessive alcohol intake is another common cause. Treatment in the hospital is usually required.

Peptic Ulcers

Peptic ulcers are open sores in the stomach or small intestine. Peptic ulcers can cause both abdominal and back pain. The pain is typically worse between meals, when the stomach or intestines are relatively empty. Nausea and vomiting may accompany the pain. Peptic ulcers may also bleed, causing a person to vomit up blood or have black, tar-like bowel movements. The most common cause of peptic ulcers is an infection with a bacteria called Helicobacter pylori. Stress and diet may also play a role in causing peptic ulcers. Nowadays peptic ulcers are usually treated with medications, although emergency surgery may be required if severe bleeding occurs.

Kidney Stones and Pyelonephritis

Kidney stones can cause pain that begins in the back and travels around the front of the body to the abdomen. The back pain is one-sided, depending on which kidney contains the stone. Kidney stone pain is typically intermittent, coming in cycles lasting up to an hour. Nausea and vomiting commonly occur with the pain. Blood and sometimes small stones can be seen in the urine as well. Kidney stones may require surgery.

Inflammation of the kidney -- known as pyelonephritis -- can produce pain in the same area as kidney stones, but the pain is constant and usually less severe. Nausea and vomiting may accompany the pain and a fever is often present. Pyelonephritis is most commonly caused by a bacterial infection, often starting as an infection in the bladder that travels to the kidneys if not adequately treated. Intravenous antibiotics may be necessary to treat pyelonephritis.

Abdominal Aortic Aneurysm

An aortic aneurysm occurs when an area of the aorta weakens and bulges outward. The aorta is the largest artery of the body, which travels from the heart to the middle of the abdomen. Many aneurysms in the abdominal aorta cause no symptoms 5. Others cause a steady, deep pain in the mid-abdomen that can penetrate through to the back. Sometimes a person will also notice the aorta pulsating in the area around the navel. If the aneurysm ruptures, it typically causes severe pain throughout the abdomen and lower back, along with very low blood pressure due to internal bleeding. This is a life-threatening condition that is fatal without emergency surgery.

Abdominal Tumors

Tumors in almost any area of the body can cause pain if they become large enough. When tumors in the abdominal cavity grow, they press on surrounding organs and tissues, causing pain in the abdomen that can extend through to the back. The pain is usually dull when it first appears but may later become more severe. Surgery, chemotherapy or radiation therapy are possible treatments for abdominal tumors, depending on the type and size of tumor and other factors.

Seeking Medical Attention

Many of the conditions that cause both stomach aches and back pain require medical attention. If you have both symptoms at the same time, see a doctor to determine the cause. Seek immediate medical care if you have:

  • severe abdominal or back pain
  • high fever
  • tar-like stools or vomiting of blood
  • symptoms of low blood pressure, such as lightheadedness, confusion or fainting 

Reviewed by: Mary D. Daley, M.D.