Back pain and nausea: Possible causes and treatments

If your lower back is screaming and your stomach is doing somersaults, it’s easy to jump straight to the worst-case scenario. The truth is, back pain and nausea are common symptoms, and they can show up together for many different reasonsfrom a simple muscle strain plus a mild stomach bug to conditions that need urgent care.

This guide walks through the most likely causes of back pain and nausea, how to tell what might be going on, which red flags mean “call a doctor now,” and what you can safely do at home. It’s for information only and isn’t a substitute for seeing a healthcare professionalespecially if you’re feeling really unwell.

Why back pain and nausea often appear together

Back pain is incredibly commonaround 8 out of 10 adults will deal with it at some point in their lives. Nausea is also a frequent visitor, whether from infections, food issues, medications, or migraines. Sometimes the two symptoms are unrelated and just happen to show up on the same day (lucky you). But often, they’re connected.

The nerves in your abdomen, spine, and internal organs all talk to the same “control center” in your brain. Strong pain in one area can trigger a queasy stomach. Likewise, abdominal problems can cause “referred pain” in your back. That’s why kidney stones, gallbladder disease, and pancreatitis can all cause pain that seems to live in your backeven though the main problem isn’t in your spine at all.

Common, less serious causes of back pain and nausea

1. Muscle strain plus a mild stomach illness

Sometimes the explanation really is the boring one: you might have pulled a back muscle and picked up a mild stomach virus or food poisoning around the same time.

Acute low back pain is often triggered by lifting something heavy, twisting awkwardly, or spending too long hunched over a desk. Viral gastroenteritis or food poisoning can cause nausea, vomiting, diarrhea, and cramping. When those overlap, it can feel like one big, miserable problem.

Clues this might be the case:

• Back pain started after a clear mechanical trigger (lifting, twisting, awkward movement).
• Nausea began around the time of a suspected food issue or stomach bug in your household.
• No high fever, no severe localized abdominal pain, and symptoms improve over a couple of days.

2. Pregnancy

Back pain and nausea are practically a cliché in pregnancyand for good reason. Nausea and vomiting of pregnancy (often called “morning sickness”) affects up to 70% of pregnant people, especially in the first trimester. As pregnancy advances, the growing uterus shifts your center of gravity, strains spinal ligaments, and can cause persistent low back pain.

Most of the time, this combination is uncomfortable but not dangerous. However, in later pregnancy, nausea and pain can sometimes be related to liver conditions such as cholestasis or other complications that need prompt evaluation.

Anyone who might be pregnant and has new, intense back pain, severe nausea or vomiting, vision changes, strong headaches, or right-upper abdominal pain should call their obstetric provider or go to urgent care.

3. Menstrual pain and endometriosis

Menstrual cramps don’t always stay politely in the pelvis. For many people, period pain radiates into the lower back and can be accompanied by nausea, diarrhea, or general malaise.

Endometriosiswhere tissue similar to the uterine lining grows outside the uteruscan cause chronic pelvic pain, deep back pain, and digestive symptoms, especially around menstruation. If cycles are very painful, heavy, or associated with ongoing back pain and nausea, a gynecologist visit is a smart move.

4. Stress, anxiety, and the mind–body connection

Stress and anxiety can literally be a pain in the backand in the gut. Stress increases muscle tension, especially in the shoulders and lower back, and can aggravate existing spinal problems. At the same time, stress hormones can slow digestion and trigger nausea, indigestion, or a “sour stomach.”

If your symptoms flare during busy or emotionally intense periods, and medical causes have been ruled out, stress managementsleep, movement, therapy, and relaxation techniquescan help both your back and your stomach feel better.

Serious causes that need prompt medical attention

Back pain plus nausea can also be a sign that something more serious is going on, particularly when pain is severe, sudden, or comes with other red-flag symptoms.

1. Kidney stones

Kidney stones are small, hard mineral deposits that form in the kidneys and can cause excruciating pain when they move. Classic symptoms include:

• Sudden, severe pain in the back, flank (side), or lower abdomen that may come in waves.
• Nausea and vomiting because the pain is so intense.
• Blood in the urine, frequent or painful urination.

Kidney stones usually require medical evaluation. Larger stones or stones causing infection may need medications, procedures to break them up, or rarely surgery.

2. Kidney infection (pyelonephritis) or severe UTI

A urinary tract infection that spreads to the kidneys can cause flank or back pain, fever, chills, nausea, and vomiting. This is more serious than a simple bladder infection and usually requires prompt antibiotics, sometimes in the hospital.

Seek urgent care if you have:

• Fever and chills with back or side pain.
• Nausea, vomiting, or feeling very unwell.
• Burning with urination, urgency, or blood in the urine.

3. Gallstones and gallbladder disease

Gallstones and gallbladder inflammation (cholecystitis) can cause pain in the upper right abdomen that radiates around to the back or right shoulder blade, often after a fatty meal. Nausea and vomiting are common.

Intense, persistent pain, fever, or yellowing of the skin or eyes (jaundice) are all reasons for urgent evaluation. Gallbladder problems sometimes require surgery.

4. Pancreatitis

Pancreatitis is inflammation of the pancreas, an organ that sits behind the stomach. It typically causes severe, constant pain in the upper abdomen that radiates straight through to the back, often with nausea and vomiting. Leaning forward may slightly ease the pain.

Pancreatitis is a medical emergency. Common causes include heavy alcohol use, gallstones, certain medications, and very high triglycerides. It usually requires hospital care, IV fluids, and close monitoring.

5. Appendicitis

Appendicitis usually starts with vague pain near the belly button that later shifts to the lower right abdomen. Nausea, vomiting, low-grade fever, and loss of appetite are common. In some people, especially if the appendix is tucked behind the bowel, pain can radiate to the back or flank.

Appendicitis almost always needs surgery. Sudden worsening pain, inability to stand up straight, or pain when you gently “bump” the heel or ride in a car over bumps can be warning signs.

6. Ulcers and other digestive conditions

Peptic ulcers can cause burning upper abdominal pain, nausea, and sometimes back pain, especially if the ulcer is on the back wall of the stomach or duodenum. Gallbladder disease, diverticular disease, and other digestive problems can also cause combined back and abdominal pain with nausea.

7. Pregnancy-related emergencies

Most pregnancy back pain and nausea are benign, but certain complicationslike ectopic pregnancy, severe preeclampsia, or liver problemscan cause dangerous symptoms, including intense abdominal or back pain, severe nausea, headaches, and vision changes. Anyone who is pregnant and feels suddenly very unwell should seek immediate care.

When the problem really is your back

Sometimes the main issue is a spinal or muscular problem, and nausea shows up because the pain is so severe or because of medication side effects.

Common back-specific causes include:

• Muscle or ligament strain: from lifting, twisting, or poor posture.
• Herniated disc: a disc between the vertebrae bulges or ruptures and irritates nearby nerves, causing back and leg pain.
• Osteoarthritis and spinal wear-and-tear: age-related changes in the spine that can cause chronic stiffness and pain.
• Spinal stenosis: narrowing of the spinal canal that can cause pain, numbness, or weakness.

While these conditions don’t directly cause nausea, living with constant or severe pain, reduced sleep, and anxiety about symptoms can definitely make your stomach feel off.

When to see a doctor or go to the ER

You don’t need to run to the emergency room for every episode of back pain and nausea. But there are situations where getting help quickly is crucial. Based on guidance from major health systems, you should seek urgent or emergency care if you have back pain and nausea plus any of the following:​

• Sudden, severe back or abdominal pain that doesn’t improve.
• High fever, chills, or feeling very ill.
• Repeated vomiting, or you can’t keep fluids down for more than 12–24 hours.
• Blood in your vomit, stool, or urine.
• Chest pain, shortness of breath, or pain that feels like it might be coming from your heart.
• Weakness, numbness, or tingling in your legs; trouble walking.
• Loss of bladder or bowel control, or numbness around the groin (these can be signs of a spinal emergency).
• Severe pain after a fall, injury, or accident.
• Back pain and nausea in pregnancy that are new, severe, or worsening.

If you’re unsure, it’s always reasonable to call your doctor’s office or a nurse line for advice. They can help you decide whether home care is enough or if you should be seen right away.

How doctors figure out what’s going on

When you see a healthcare professional for back pain and nausea, they’ll usually start with a detailed history and physical exam. Expect questions about:​

• Where the pain is located, what it feels like, and what makes it better or worse.
• How long you’ve had symptoms and whether they came on suddenly or gradually.
• Recent injuries, new activities, or heavy lifting.
• Urinary changes, bowel changes, fever, weight loss, or other symptoms.
• Medication use, alcohol intake, and medical conditions like ulcers or gallstones.

Tests may include:

• Blood tests to look for infection, inflammation, or organ problems.
• Urine tests to check for infection, blood, or kidney issues.
• Ultrasound, CT scan, or MRI for suspected kidney stones, gallbladder disease, appendicitis, or spinal problems.
• Pregnancy tests in people who could be pregnant.

Treatment options for back pain and nausea

1. Treating the underlying cause

Treatment depends completely on what’s causing your symptoms. Some examples:

• Kidney stones: pain control, hydration, medications to help pass the stone, or procedures to break it up if it’s large.
• Kidney infection or UTI: antibiotics, fluids, and sometimes hospitalization for severe infections.
• Gallbladder disease or appendicitis: often require surgery.
• Pancreatitis: usually managed in the hospital with IV fluids, pain control, and rest for the pancreas.
• Ulcers: acid-reducing medications and sometimes antibiotics for Helicobacter pylori infection.
• Mechanical back pain: activity modification, physical therapy, and pain management.

2. Medications for pain and nausea

For mild to moderate back pain, healthcare providers often start with acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) if they’re safe for you. It’s important not to exceed recommended doses and to check with a professional if you have liver, kidney, stomach, or heart issues.

Short-term anti-nausea medications may be used when nausea is severe or interfering with hydration and nutrition, especially under medical supervision.

Never start, stop, or change prescription medications without talking to your doctor, and be cautious about mixing over-the-counter remedies if you’re already taking other drugs.

3. Home care for mild symptoms

If symptoms are mild and you don’t have red flags, home care can help:

• Gentle movement, not strict bed rest: For most back pain, light activity and short walks are better than lying still all day.
• Heat or cold: A heating pad or warm shower can ease muscle tightness; ice packs sometimes help with acute strains.
• Hydration: Sip water, oral rehydration solutions, or clear liquids to prevent dehydration when you feel nauseated.
• Bland foods: Once nausea eases, start with small amounts of easy foods like toast, rice, bananas, or plain crackers.
• Posture breaks: If you sit a lot, adjust your chair and screen height, and set reminders to stand and stretch every 30–60 minutes.

Everyday habits to protect your back and calm your stomach

While you can’t control everything (looking at you, random kidney stones), you can lower your risk of many causes of back pain and nausea:

• Stay active: Regular physical activity and core-strengthening exercises support your spine and reduce back pain risk.
• Maintain a healthy weight: Extra weight adds stress to your spine and can worsen reflux or digestive discomfort.
• Lift smart: Bend at the hips and knees, keep objects close to your body, and avoid twisting while lifting.
• Limit heavy alcohol use: This can reduce your risk of pancreatitis and some liver problems.
• Stay hydrated: Drinking enough fluids supports kidney health and may help reduce stone risk in some people.
• Manage stress: Yoga, walking, breathing exercises, therapy, or meditation can ease both muscle tension and digestive symptoms.

Real-life–style experiences and practical lessons

The weekend DIY warrior

Imagine someone who spends the workweek at a desk and then decides, on Saturday, that it is finally time to move all the heavy boxes in the garage. They spend hours lifting, twisting, and dragging things around. That night, their lower back starts to ache. The next day, they wake up sore and a little nauseated. They barely slept, their muscles are tight, and the combination of pain plus fatigue leaves them feeling queasy and off their food.

In a case like this, a simple mechanical back strain plus poor sleep and maybe a slightly greasy “reward” meal can explain the back pain and nausea combination. Gentle stretching, short walks, over-the-counter pain relief (if appropriate), and lighter meals often help things settle within a few days. The big takeaway: your back is not a forklift, and weekend heroics are a risky way to find your core strength.

The new parent shuffle

Now picture a new parent who spends half the night rocking a baby and the other half half-asleep in a weird position on the edge of the bed. Their posture is permanently hunched; they grab whatever food is fastest, and coffee is its own food group. Over time, their mid- and lower back start to ache from all that bending and lifting. On days when they’re especially tired, they notice a low-grade nausea, especially if they’ve gone too long without a proper meal.

Here, the fix isn’t only treating the pain; it’s also about adjusting the routine. A supportive baby carrier, better chair setup for feeding, scheduled stretching breaks, and prepping simple, balanced snacks in advance can make a huge difference. This “experience” shows how chronic strain plus sleep deprivation and erratic eating can team up to create that unpleasant combo of back pain and queasiness.

The “I thought it was just indigestion” moment

Another common story: someone ignores mild, recurring upper abdominal discomfort after heavy meals. One evening, the pain suddenly ramps up, moves into the right side and back, and nausea hits hard. They assume it’s just “bad indigestion,” but over a few hours the pain doesn’t let up, and they begin to feel feverish. In the ER, tests show a gallbladder problemsomething that needed treatment, not antacids and wishful thinking.

That experience underlines an important point: when your symptoms change charactersuddenly more intense, more localized, or paired with fever and vomitingit’s time to stop guessing and get evaluated. Many people try to “tough it out” because they’re worried about overreacting. In reality, getting checked early can prevent complications and shorten recovery time.

What these experiences have in common

Across all these scenarios, a few patterns show up:

• We underestimate our backs: We ask them to tolerate long hours of sitting and sudden bursts of activity without warm-up.
• We ignore early signals: Mild, nagging pain or occasional nausea gets brushed off until it becomes more intense.
• Lifestyle multiplies symptoms: Poor sleep, stress, rushed meals, and dehydration all make back pain and nausea feel worse.

The good news? Small, proactive changesconsistent movement, smarter lifting, more mindful eating, and watching for red flagscan prevent a lot of “how did I end up like this?” episodes.

How to talk to your doctor about back pain and nausea

Many people feel nervous about bringing up multiple symptoms at once, but your doctor actually wants the full picture. To make the most of your visit:

• Write down when the pain and nausea started and what you were doing at the time.
• Note anything that makes symptoms better or worse (food, position, movement, time of day).
• Keep track of fevers, changes in bowel or bladder habits, or weight loss.
• List your medications, supplements, and any alcohol or tobacco use.

Clear information helps your provider sort out whether this is likely a muscle strain, a digestive or kidney problem, a pregnancy-related issue, or something else entirely. It also helps them decide which tests you actually needand which you can safely skip.

Most importantly, remember that you don’t have to self-diagnose. Your job is to notice your symptoms and seek help when they’re worrying; your healthcare team’s job is to connect the dots and guide you toward the right treatment.

Citations: Healthline back pain and nausea; Mayo Clinic back pain; MedlinePlus back pain; Cleveland Clinic nausea/vomiting; Medical News Today back pain and nausea; additional clinical references include sources on kidney stones, UTIs, gallbladder disease, pancreatitis, abdominal emergencies, stress and pain, and back pain prevention.