Diagnosis
It is important that a burning sensation in the back is medically clarified in order to exclude serious causes such as a heart attack. For this purpose, an anamnesis (questioning by the doctor) is carried out, whereby further information such as accompanying symptoms is requested by the doctor. This is followed by a physical examination, in which the heart and lungs are listened to and the spine and back are palpated.
If angina pectoris or a heart attack is suspected, an ECG must be recorded immediately, which gives indications of heart disease. If pneumonia is suspected, an X-ray of the chest should be taken. In the rare case of a ruptured aortic aneurysm and also after accidents in which bony structures can be injured, a CT should be made.
If the burning sensation is caused by muscular problems, the affected person usually feels tension in the back for a long time. If bony injuries – such as those to the ribs – are responsible for the pain, this can lead to restricted mobility in the chest and also after accidents, for example, bruising at the affected area. Shingles is accompanied by a typical skin rash: the skin is reddened on one side and covered with nodules and papules.
The affected skin is also usually very sensitive to touch. The general condition may also be reduced and fever may occur. Angina pectoris can develop into a heart attack and can then radiate as a burning sensation not only in the back but typically and most frequently in the left arm.
It can also lead to shortness of breath, cold sweat and feelings of anxiety. If pneumonia or bronchitis is responsible for the burning sensation, the pain is usually breath-related. This may be accompanied by a reduced general condition, fever, cough with sputum and other cold symptoms.
Stinging pain is often accompanied by a muscular cause. In this case, those affected can directly identify the origin of the pain. Such a muscular hardening can irritate the nerves and, in addition to the stabbing pain, cause a burning sensation that is more difficult to localise.
Lumbago or a herniated disc can also cause stabbing pain in the upper back. Furthermore, the pain can be stabbing in the case of bronchitis or pneumonia. If the burning sensation is felt in the chest, muscular problems at the front of the ribs can also be responsible.
Also in connection with pneumonia, the burning sensation may not be limited to the back but may also be felt in the chest. However, if the burning sensation occurs after physical exertion, in cold weather or during strong emotional stress, angina pectoris should be considered. This is described by those affected as a tightness of the chest, which is characterised by pain behind the breastbone with frequent radiating into the left arm, a feeling of pressure and also pain in the upper back.
Angina pectoris is often accompanied by cold sweat, feelings of anxiety and shortness of breath. Furthermore, chest pain can also be caused by an inflammation of the heart muscle (myocarditis). Compared to a heart attack, myocarditis can also affect young people.
Myocarditis is usually caused by viruses or bacteria, but can also occur in the context of autoimmune diseases such as systemic sclerosis. Do you have chest pain?
