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Back pain can be caused by so many things that it can often be very difficult to diagnose. One of the things that can be easily diagnosed and that can cause back pain, though, is a hiatal hernia. Back pain and hiatal hernia go together because of the location of the hernia. It’s at the area where the stomach meets the esophagus, and occurs when the stomach rolls up a bit and doesn’t fit correctly. Because the ‘lay of the land’ has been changed, acid can back up there and make people very uncomfortable.

This pain, which is often in their chests, can often be mistaken for the pain that a person would go through if they were having a heart attack. That’s why it’s so important that a person with this kind of pain be seen by his or her doctor. When it comes to back pain and hiatal hernia problems, though, they’re more common than you might think. Anyone who has a hiatal hernia can experience pain that ends up in the back, not just the chest. Pain in the body is an odd thing, and sometimes it can hurt far away from the actual problem. This occurs because there are so many pain receptors, and they don’t always react the same way in every person.

In other words, don’t assume that the pain in your back is a pulled muscle. It could be something else. At the same time, panicking or becoming an alarmist isn’t what you really want to do, either. Instead, you want to balance safety and care with realistic understanding. When you do research into a hiatal hernia and find that it could be causing back pain, you may want to make an appointment with your doctor to see if that’s the source of the pain in your back. That’s especially true if the pain has been there for a long time, it’s getting worse, or it’s accompanied by other hiatal hernia symptoms.


Don’t underestimate the ability of your doctor and modern medical technology to find out what’s causing your back pain. If the pain is from a hiatal hernia, you can rest assured that it can be corrected, which is the best way to handle something like that. It’s not a good idea to just let the hernia sit, because it can cause other problem. Some hiatal hernias also grow and get worse, so you want to have them corrected before they get a chance to do that.

Hernias can be made larger when you strain to do something, so your doctor might advise you not to lift anything heavy and/or not to do certain types of exercises. If you lead a very active lifestyle and are suddenly sidelined by back pain and hiatal hernia problems, it makes sense that you would want to find a way to get better quickly. Your doctor is the one to help you, because he can quickly diagnose you and then find what works for your treatment.

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Back From Hiatus

Medically reviewed by Last updated on Nov 16, 2020.

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  • Care Notes
  • Overview


What is a hiatal hernia?

A hiatal hernia is a condition that causes part of your stomach to bulge through the hiatus (small opening) in your diaphragm. The part of the stomach may move up and down, or it may get trapped above the diaphragm.

What increases my risk for a hiatal hernia?

The exact cause of a hiatal hernia is not known. You may have been born with a large hiatus. The following may increase your risk of a hiatal hernia:

  • Obesity
  • Older age
  • Medical conditions such as diverticulosis or esophagitis
  • Previous surgery of the esophagus or stomach or trauma such as from a motor vehicle accident

What are the types of hiatal hernia?

  • Type I (sliding hiatal hernia): A portion of the stomach slides in and out of the hiatus. This type is the most common and usually causes gastroesophageal reflux disease (GERD). GERD occurs when the esophageal sphincter does not close properly and causes acid reflux. The esophageal sphincter is the lower muscle of the esophagus.
  • Type II (paraesophageal hiatal hernia): Type II hiatal hernia forms when a part of the stomach squeezes through the hiatus and lies next to the esophagus.
  • Type III (combined): Type III hiatal hernia is a combination of a sliding and a paraesophageal hiatal hernia.
  • Type IV (complex paraesophageal hiatal hernia): The whole stomach, the small and large bowels, spleen, pancreas, or liver is pushed up into the chest.

What are the signs and symptoms of a hiatal hernia?


The most common symptom is heartburn. This usually occurs after meals and spreads to your neck, jaw, or shoulder. You may have no signs or symptoms, or you may have any of the following:

  • Abdominal pain, especially in the area just above your navel
  • Bitter or acid taste in your mouth
  • Trouble swallowing
  • Coughing or hoarseness
  • Chest pain or shortness of breath that occurs after eating
  • Frequent burping or hiccups
  • Uncomfortable feeling of fullness after eating

How is a hiatal hernia diagnosed?

  • An upper GI series test includes x-rays of your esophagus, stomach, and your small intestines. It is also called a barium swallow test. You will be given barium (a chalky liquid) to drink before the pictures are taken. This liquid helps your stomach and intestines show up better on the x-rays. An upper GI series can show if you have an ulcer, a blocked intestine, or other problems.
  • An endoscopy uses a scope to see the inside of your digestive tract. A scope is a long, bendable tube with a light on the end of it. A camera may be hooked to the scope to take pictures.

How is a hiatal hernia treated?

Treatment depends on the type of hiatal hernia you have and on your symptoms. You may not need any treatment. You may need any of the following:

  • Medicines may be given to relieve heartburn symptoms. These medicines help to decrease or block stomach acid. You may also be given medicines that help to tighten the esophageal sphincter.
  • Surgery may be done when medicines cannot control your symptoms, or other problems are present. Your healthcare provider may also suggest surgery depending on the type of hernia you have. Your healthcare provider can put your stomach back into its normal location. He may make the hiatus (hole) smaller and anchor your stomach in your abdomen. Fundoplication is a surgery that wraps the upper part of the stomach around the esophageal sphincter to strengthen it.

How can I manage symptoms?

The following nutrition and lifestyle changes may be recommended to relieve symptoms of heartburn.

  • Avoid foods that make your symptoms worse. These may include spicy foods, fruit juices, alcohol, caffeine, chocolate, and mint.
  • Eat several small meals during the day. Small meals give your stomach less food to digest.
  • Avoid lying down and bending forward after you eat. Do not eat meals 2 to 3 hours before bedtime. This decreases your risk for reflux.
  • Maintain a healthy weight. If you are overweight, weight loss may help relieve your symptoms.
  • Sleep with your head elevated at least 6 inches.
  • Do not smoke. Smoking can increase your symptoms of heartburn.

When should I seek immediate care?

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  • You have severe abdominal pain.
  • You try to vomit but nothing comes out (retching).
  • You have severe chest pain and sudden trouble breathing.
  • Your bowel movements are black or bloody.
  • Your vomit looks like coffee grounds or has blood in it.

When should I contact my healthcare provider?

  • Your symptoms are getting worse.
  • You have nausea, and you are vomiting.
  • You are losing weight without trying.
  • You have questions or concerns about your condition or care.

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Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Learn more about Hiatal Hernia

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Symptoms and treatments

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