Can Hiatal Hernia Cause Back Pain?

Young man suffering from back pain caused by a hiatal hernia.
Young man suffering from back pain caused by a hiatal hernia.

Understanding Hiatal Hernia

A hernia occurs when tissue or an organ pushes through a weak spot in the muscle or connective tissue around it. A weakness in the abdominal wall causes it. While hernias commonly affect the abdomen and groin area, certain types can also cause back pain. Although hernias sometimes cause back pain, not all hernias necessarily result in back pain.

A Hiatal Hernia occurs when the natural defect in the diaphragm through which the esophagus passes to connect with the stomach is too large. This allows the stomach to herniate into the chest cavity. If the hernia defect is large enough, other organs, such as the colon or small intestines, can move into the chest.

Hiatal Hernia Symptoms:

The common symptoms can range from mild discomfort to more severe complications. Depending on the underlying cause, these are the following symptoms:


A burning sensation or discomfort in the chest, often occurring after eating or when lying down. The acid formed can also move upward when the stomach changes its position.


The sensation of stomach acid or food returning to the throat or mouth is sometimes accompanied by a sour or bitter taste.

Difficulty Swallowing (Dysphagia):

Feeling like food is stuck in the throat or chest or experiencing pain or discomfort when swallowing.

Chest Pain:

Some individuals with hiatal hernias may experience chest pain that can mimic symptoms of a heart attack. It may be sharp, stabbing, or pressure-like and can radiate to the back, neck, or arms.

Nausea or Vomiting:

Some individuals may experience occasional nausea or vomiting, particularly if reflux is severe.

Shortness of Breath:

A large hiatal hernia may sometimes compress the lungs or diaphragm, leading to difficulty breathing or shortness of breath, especially during physical activity.

Potential Mechanisms for Back Pain:

Nerve Irritation:

The diaphragm, a large muscle separating the chest and abdomen, is crucial for respiration. When a hernia occurs, the displaced stomach can put pressure on the diaphragm and nearby nerves, potentially causing referred pain to the back.

Muscle Strain:

Chronic irritation and inflammation associated with hiatal hernias may lead to muscle tension and discomfort in surrounding areas, including the back.

Posture Changes:

Individuals with hiatal hernias may unconsciously alter their posture to alleviate symptoms such as heartburn or difficulty swallowing. These changes could contribute to musculoskeletal strain and eventual back pain.

Is Back Pain and Hiatal Hernia related?

While research investigating the direct link between hiatal hernia and back pain is limited, some studies have provided insights. A study published in the Journal of Spinal Disorders & Techniques in 2012 found that patients with hiatal hernias were more likely to experience lower back pain compared to those without the condition. However, further research is warranted to establish a definitive causal relationship with body pain.

Back Pain: Lumbar Hernia

There is a type of Hernia that causes back pain, called lumbar Hernia. It refers to the protrusion of abdominal contents through a weakness in the connective tissues of the lower back, specifically in the lumbar region. While lumbar hernias are relatively rare, they can cause symptoms such as Back pain, which includes pain in the lower back or a dragging sensation. While hiatal hernias and lumbar hernias share the commonality of being types of hernias, they occur in distinct anatomical regions and involve different underlying mechanisms.

Improve Comfort with Home Remedies:

While home remedies cannot cure hiatal hernias, they may help alleviate symptoms and improve comfort. Home remedies for hiatal hernia are associated with lifestyle changes and maintaining a healthy body weight. Elevating the head of the bed while sleeping can help reduce reflux by preventing acid from flowing back into the esophagus. Take enough rest, especially when the pain flares up, to relieve pain. But, it is also important to avoid strenuous exercise and excessive bed rest. Avoid large meals, especially before bedtime. Practice the proper posture to prevent body and muscle pain. Certain dietary modifications include avoiding trigger foods like spicy or acidic foods, caffeine, alcohol, and fatty foods for keeping your body healthy. There are physical therapy techniques that can help back pain caused by a hernia; you can help find expert physical therapists near you. Additionally, seeking medical advice from a healthcare professional before starting any remedies to rule out any underlying complications is essential.

How Do I Know If A Hiatal Hernia Needs Surgery?

Persistent Symptoms: If you experience persistent and severe symptoms associated with your hiatal hernia, such as frequent heartburn, regurgitation, difficulty swallowing, chest pain, or respiratory issues, despite conservative treatments such as medications or dietary changes, it may require surgery.

Complications: Certain complications of hiatal hernias, such as Barrett’s esophagus (a precancerous condition), severe esophagitis, or recurrent volvulus, may necessitate surgery. These complications can pose significant health risks and may require surgical repair of the hernia. You need to seek medical attention to prevent further complications and improve outcomes.

Size and Type of Hernia: Large hiatal hernias, particularly paraesophageal hernias, have a higher risk of complications such as gastric volvulus or strangulation and may require surgical repair even without a significant symptom.

Management and Treatment by Dr. Harris’:

Hiatal hernia falls within the spectrum of conditions associated with heartburn, a medical issue Dr. Harris has notable expertise in treating. During his time at the Mayo Clinic, he received training under Dr. C. Dan Smith, a renowned authority in reflux and esophageal surgery nationwide. Despite evidence indicating high patient satisfaction with anti-reflux surgery, certain gastroenterologists in this region may hesitate to refer patients for such procedures. Nonetheless, patients with significant hiatal hernias are frequently directed toward surgical intervention.

For patients with a substantial hernia, even if symptoms are minimal, hiatal hernia repair surgery should be considered, provided the patient is deemed suitable for surgery (meaning they are healthy enough to undergo general anesthesia, laparoscopic hiatal hernia repair and understand the potential risks involved).

Contact Dr. Adam Harris for Hiatal Hernia Surgery

Are you experiencing symptoms of a hiatal hernia and considering surgical intervention? Dr. Harris offers specialized expertise and compassionate care to help you with your health conditions. Take the first step towards reclaiming your comfort and well-being—your path to relief starts here!

Contact Dr. Adam Harris, MD, a Mayo Clinic-trained General Surgeon in Birmingham, Alabama, to schedule a consultation and explore your treatment options for hiatal hernia surgery. To learn more about how Dr. Adam can help you with your hiatal hernia treatment, schedule an appointment at (205) 995-9700.

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