An aching back is a common problem that affects a quarter of the U.S. population over a three-month period of time. Back pain is often related to straining from heavy lifting or poor posture, but back pain can also be a symptom of a heart attack. How are back pain and heart attack related? The most common cause of a heart attack (myocardial infarction) is a blood clot that lodges in an artery and blocks blood flow to the heart muscle. This often causes a painful pressure, cramping or squeezing sensation in the chest. The discomfort can radiate, or move from your chest into your back. You may feel chest and back pain together, or an aching or discomfort anywhere in your upper body without any chest pain at all. Upper body discomfort without chest pain is more likely for women experience a heart attack. What else could cause my back pain? People often assume that their back pain is caused by overdoing an activity, such as weight training, gardening, or work that requires a lot of digging, lifting or twisting. However, there are many causes of back pain. Fortunately, most causes are not as serious as a heart attack. Other causes of back pain include: Back muscle spasm, sprain or strain due to overuse or injury Degenerative disc disease is a breakdown of your spinal discs that cushion your spine. Herniated (bulged or ruptured) disc between the bones of your back (vertebrae). Discs act as shock absorbers for your spine. Osteoarthritis is wear and tear of your spine. Osteomyelitis is infection or inflammation of your spinal bones. Osteoporosis is thinning of your bones. Spinal stenosis is a narrowing of the space around your spinal cord. This causes painful nerve compression. Spondylitis is infection or inflammation of the joints in your spine. A life-threatening cause of back pain is an aortic dissection, a condition in which the biggest artery in your chest tears. When should I call my doctor or 911? It is difficult to tell without seeing your doctor if your back pain is caused by a minor back strain or something more serious, such as a heart attack. See your doctor if you have had ongoing mild to moderate back stiffness, back pain, or problems bending over or moving your back. Don’t ignore your symptoms. It is never a bother to ask for help. People who have a heart attack often say they experience anxiety or fear; a vague uneasiness or nervousness; or a clear sense of dread or doom. Call 911 if you have these feelings with back pain or if you have sudden or severe back pain with any of the following symptoms: Chest discomfort, such as dull ache, pain, or a feeling of something compressing your chest Stomachache, feeling seasick, nauseous, or throwing up Pallor or looking “white as a ghost” Breaking out in a cold sweat Pain spreading from your chest to your back, shoulders, arms, neck or jaw Shortness of breath or other problems breathing, such as panting or difficulty taking a deep breath Fainting or feeling as if you are going to pass out Weakness or feeling more tired than usual It is not unusual to feel reluctant to call 911 because you think your back pain is due to something minor. Medical professionals stress the importance of calling 911 if there is any possibility that you are having a heart attack. Every second that passes without treatment for a heart attack can destroy more of your heart muscle. As a precaution, all emergency personnel will treat you as if you are having a heart attack until all your tests are complete. Do not get a ride or drive yourself to the hospital. Calling 911 will allow emergency medics to treat you immediately to reduce your chances of permanent heart damage or death due to a heart attack.