Pain in the middle of the chest or upper back can result from disorders of the esophagus Overview of the Esophagus The esophagus is the hollow tube that leads from the throat (pharynx) to the stomach. Food does not just fall through the esophagus into the stomach. The walls of the esophagus propel food to... read more or from disorders of the heart or aorta ( see Chest Pain Chest Pain Chest pain is a very common complaint. Pain may be sharp or dull, although some people with a chest disorder describe their sensation as discomfort, tightness, pressure, gas, burning, or aching... read more ). Symptoms may be similar. Gastroesophageal reflux disease Gastroesophageal Reflux Disease (GERD) In gastroesophageal reflux disease, stomach contents, including acid and bile, flow backward from the stomach into the esophagus, causing inflammation in the esophagus and pain in the bottom... read more (GERD), caused by stomach acid splashing up into the esophagus, can cause a burning sensation or a tightness under the breastbone (sternum), which may resemble the pain of heart disease. Spasms of the esophagus Esophageal Spasm Esophageal spasm is a disorder of the rhythmic waves of muscular contractions (peristalsis) of the esophagus. The cause of this disorder is not known. Symptoms include chest pain and difficulty... read more and other esophageal muscle disorders can cause a severe squeezing sensation also resembling the pain of heart disease.
Some symptoms are more suggestive of esophageal disorders. Severe pain that occurs suddenly after vomiting or after a procedure involving the esophagus suggests a rupture of the esophagus, although this is rare. Heartburn is a burning pain caused by GERD that rises into the chest and sometimes the neck and throat, usually after meals or when lying down. Heartburn is among the most common digestive symptoms in the United States. Difficulty swallowing Difficulty Swallowing Some people have difficulty swallowing (dysphagia). In dysphagia, foods and/or liquids do not move normally from the throat (pharynx) to the stomach. People feel as though food or liquids become... read more and discomfort that occurs only with swallowing also suggest an esophageal disorder. Chest discomfort that occurs routinely with exertion and goes away after a brief rest suggests a heart problem. However, because symptoms frequently overlap, and because heart disease is particularly dangerous, doctors often do a chest x-ray X-Rays of the Chest X-rays are a type of medical imaging that use very low-dose radiation waves to take pictures of bones and soft tissues. Chest x-rays are sometimes used in people who may have a heart disorder... read more , an electrocardiogram Electrocardiography Electrocardiography (ECG) is a quick, simple, painless medical test that measures the heart’s electrical impulses. During an ECG, the heart's electrical impulses are measured, amplified, and... read more (ECG), and sometimes a cardiac stress test Stress Testing Stress testing measures the heart's function with electrocardiography (ECG) while the heart is under stress, either from exercise or from a medication used to stress the heart. Stressing the... read more before doing tests to look for esophageal disease.
Treatment of Chest or Back Pain
Depends on cause
Treatment of chest or back pain is usually given only when the cause is known, but people with very typical symptoms of GERD may be given a trial of acid-blocking drugs.