4 Serious Causes of Referred Back Pain

Back pain is back pain, right? Not so fast. Sometimes pain in your back can come from an entirely different region of your body, and the cause could be serious.

Referred pain is when you feel pain in one part of your body caused by disease or an injury in another. It often occurs in problems with chest and belly organs. For example, an infection in your kidneys may cause pain in your back or sides.

Read on to learn about four causes of referred back pain that can signal you have a serious health problem.

Serious Referred Back Pain Causes
Verywell / Gary Ferster

Kidney Stones

Kidney stones are hard collections of crystals that can form in one or both kidneys. They can cause sharp pain in your back and sides below your ribs. The pain can come in agonizing waves until you finally pass the stone.

The National Institute of Diabetes and Digestive and Kidney Diseases estimates that 11% of men and 6% of women will develop a kidney stone at some point in their lives.

Kidney stones can form when your urine has high levels of certain minerals, like calcium and oxalate. The minerals combine with salts and create pebble-like pieces.


If you have kidney stones, you may notice blood in your urine. You might also have pain while urinating, nausea, and vomiting.

If your kidney stones are too big to pass, healthcare providers can use ultrasound treatments to break them up. If there's any good news when it comes to kidney stones, it's that you often pee out small ones with no symptoms at all.

Preventing Kidney Stones

If you've had a stone, you're more like to get another.

One of the best things you can do to avoid getting another kidney stone is to drink plenty of fluids. Water is best. Women should drink 11.5 cups of fluids each day, and men should drink 15.5 cups.

You should also limit how much meat you eat each day to about the size of a deck of cards. A diet high in animal proteins increases levels of a substance in urine that forms stones, and it reduces other chemicals that protect against them.

You might also want to cut back on how much tea you drink. Tea contains high levels of oxalate. Foods that are also high in this mineral include:

  • Beets
  • Chocolate
  • Spinach
  • Rhubarb
  • Nuts
  • Sweet potatoes

Another tip is to watch your salt intake. Check labels, because even foods like salad dressing can have surprising amounts of hidden salt. Experts advise limiting yourself to less than 2 grams per day. That's less than 1 teaspoon of salt per day.


Prostate Problems

Back pain in men can be a sign of a serious problem with their prostate. The prostate is a walnut-size gland located between the penis and bladder.

Routine prostate screenings are vital, because when symptoms like lower back pain due to prostate problems show up, it's usually after a cancer has formed and spread.

Prostate Cancer Symptoms

Most men with prostate cancer do not experience symptoms, especially in the early stages. Men might have difficulty urinating, but this can occur in men without prostate cancer as well.

When prostate cancer spreads, it almost always goes to the bones first. Back pain may signal that cancer has spread to the spine. These bones can weaken and may collapse, compressing the spinal cord or nerve roots.

Severe compression of the lumbar nerve roots is known as cauda equina syndrome. Symptoms include weakness in the legs and difficulties walking and controlling the bladder or bowels. Back pain is variably present with this condition.

Cauda equina syndrome is a medical emergency. If you think you may have this, get help immediately, or you could end up with permanent spinal cord damage and paralysis.

Enlarged Prostate

An enlarged prostate is a common condition in older men. It's usually harmless. Symptoms typically involve difficulty urinating, but not usually back pain.


Prostatitis, or swelling of the prostate gland, is another harmless but common condition of this gland. However, unlike enlarged prostate, prostatitis strikes men of all ages.

Symptoms include pain or burning when urinating and difficulty ejaculating. You also may experience pain in the area between the scrotum or rectum and your lower back.

The type of prostatitis may determine the kind of pain you have. For example, pelvic and lower back pain and achy muscles occur with an acute prostate infection.

With chronic prostatitis, your nerves are affected. This can lead to persistent pain in the pelvic area.


Abdominal Aortic Aneurysm

The aorta is the main artery that carries blood from the heart to other parts of the body. An aneurysm is like a bubble that forms in an artery wall. This condition causes an expansion and weakening of the walls of the aorta as it extends into the belly.

Most abdominal aortic aneurysms (AAA) generally don't cause health problems. Almost 90% identified by screening are less than 3.5 centimeters (cm) in size. However, larger ones can burst and bleed into the belly, requiring emergency surgery.


The two main symptoms of a burst AAA are sudden, severe stomach and back pain.The pain may spread to the groin and buttocks and may radiate down the leg. Other symptoms include:

  • Fainting
  • Clammy skin
  • Dizziness
  • Nausea and vomiting
  • Rapid heart rate
  • Shock

If you think you may have an aortic aneurysm in your belly, get help immediately. Surgery is often required to save a patient's life.



Like kidney stones, gallstones are hard masses that form in the gallbladder and bile ducts. Your gallbladder is a small organ on the right side of your belly under your liver. It stores a chemical called bile needed to digest fats.

The bile ducts are tubes that carry the bile from the liver and gallbladder to the small intestine.

Gallstone Formation

When certain substances in the bile combine, deposits can form. These bits may stay in the gallbladder or bile duct. Over time they become gallstones and cause the organ to become inflamed.

Experts aren't sure what causes gallstones. They know that most stones contain cholesterol. That's why they believe a diet high in animal fat increases the risk of gallstones.


Gallstones often don't cause symptoms. When they do, you can have severe pain in your upper belly on the right side. It usually starts suddenly and lasts for at least a half-hour.

The other main symptom is back pain under your right shoulder blade. Some people with gallstones also get indigestion after eating a high-fat or high-protein meal.

In 2006, Scandinavian researchers surveyed 220 patients with gallstones. They found that 63% had referred back pain. For 5% of participants, back pain was their main symptom.

If you have gallstone pain, your healthcare provider will likely suggest surgery to remove your gallbladder.


Referred pain is when you feel pain in one part of your body caused by a problem in another. Referred back pain can be due to diseases in organs in your belly or chest. Some of the conditions that cause this kind of back pain can be serious.

Making sure you drink plenty of fluids and watching how much salt and fat you eat can help prevent kidney and gallstones. Regular prostate check-ups are essential to detect cancer early. If you think you may have an aortic aneurysm in your belly, get help immediately.

16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading

By Anne Asher, CPT
Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert.