There are several reasons for the association between heartburn and back pain. Some can occur when those suffering from chronic heartburn attempt different home remedies to treat their condition, which can result in back pain. Heartburn and back pain together also may indicate a more serious problem related to the gallbladder, which should be diagnosed by a physician.

Heartburn is typically caused by digestive acids churning back through the upper opening of the stomach. This generally occurs in individuals with poor functioning sphincters, which should keep the stomach closed. These acids may erode the lining of the esophagus and burn the back of the throat.

Following multiple episodes of severe heartburn, the soft tissues of the digestive track may begin to experience long-term damage. This can cause pain in the upper-middle back. This type of back pain should cease when the heartburn is treated and the esophageal tissues begin to heal.

Episodes of chronic heartburn commonly occur late at night, often just before bed. Sufferers may attempt to treat the condition, initially, by changing their sleeping positions. This can be achieved by sleeping in an elevated position through the use of multiple pillows. This inclined sleeping position can then lead to back pain. Severe heartburn may also induce fits of coughing which, over a period of time, can cause back pain.

Heartburn and back pain, coupled with other symptoms, are indicative of a malfunctioning gallbladder. When there are problems with this organ, such as disease or gallstones, heartburn may become intense. This may be accompanied by a backwash of food into the mouth or severe vomiting. Pain related to the diseased organ can occur in the back, beneath the shoulder blades.

Those experiencing back pain, specifically that located beneath the shoulder blades and accompanied by severe heartburn and acid reflux, should consult a medical professional. Treatment of such symptoms may require removal of the gallbladder or stones. A doctor generally performs a sonogram, or similar test, to diagnose whether the gallbladder is the source of the pain.

Pain in the chest — that is accompanied by pain in the back — may also be a sign of a heart attack. In some cases the heartburn and back pain can also include a tightness or pain in the shoulder and arm as well. This may follow a period in which the sufferer feels an overall sense of being unwell. Those suspecting a heart attack should seek emergency medical services immediately.