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Burning Pain in the Back: Possible Causes and When to See a Doctor
Short answer: Burning is a common way people describe nerve pain [1], and a burning feeling in the back can come from an irritated nerve in the spine, such as sciatica. But it can also come from shingles, which can cause burning pain before any rash appears, from a kidney infection, and occasionally from the heart. Because the causes differ so much, the other symptoms matter: a rash, fever, pain when passing urine, chest pain, breathlessness, sweating, weakness or numbness. Back pain with chest pain, breathlessness or sweating needs emergency care.
Key takeaways
- A burning feeling does not point to one cause. Where it is and what comes with it give your doctor clues.
- Nerve problems in the spine, shingles, kidney infection and heart problems can all cause a burning sensation in or around the back.
- Shingles can start with burning, tingling or stabbing pain on one side of the body, a few days before a rash appears [4][5][6].
- Burning, pressure or pain in the chest that spreads to the back, especially with sweating, nausea or breathlessness, is an emergency [9].
- This page cannot diagnose you. Only a doctor who examines you can.
Why does back pain feel like burning?
Nerve pain, also called neuropathic pain, tends to have a burning quality. Some people also feel shooting, electric-shock sensations, or find that even light touch over the area is painful [1][2]. A burning feeling in the back can therefore suggest that a nerve is involved. But pain from other causes can feel like burning too, so the description alone cannot tell you the cause.
Possible causes of burning pain in the back
An irritated nerve in the spine (including sciatica)
Sciatica happens when the sciatic nerve, which runs from the lower back down to the feet, is irritated or compressed. The NHS lists a sharp, burning pain down the back of the leg, tingling like pins and needles, numbness and weakness among the symptoms, which may be worse when moving, sneezing or coughing. A slipped disc is the most common cause [3]. Sciatica usually affects the buttock and the back of one leg. The NHS notes that you probably do not have sciatica if you only have back pain [3]. It usually gets better in 4 to 6 weeks, but can last longer [3].
If this sounds like you, see our pages on L4-L5 disc bulge and lumbar spondylosis.
Shingles
Shingles is caused by a virus that can reactivate in the nerves. It often starts with pain, tingling, itching or a burning or stabbing feeling in one area of skin, followed by a rash with blisters [4]. The rash usually appears on one side of the body, along the line of a nerve, and does not cross to the other side. The chest and back are common places for it [4][5]. Before the rash appears, shingles can be mistaken for a back or muscle problem.
Treatment with antiviral medicines works best when it is started early, usually within about three days (72 hours), so it is important to get medical advice as soon as you suspect shingles [4][5][6]. Tell a doctor straight away if a rash is near an eye or if your immune system is weakened [6]. Some people have nerve pain that continues after the rash has healed, which is called post-herpetic neuralgia [2].
A kidney infection
A kidney infection is a painful type of urinary tract infection that can be serious if it is not treated [8]. Symptoms can include pain and discomfort in the side, the lower back or around the genitals, a high temperature, shivering or chills, feeling very weak or tired, loss of appetite and feeling or being sick. There may also be pain or a burning feeling when passing urine [7]. NHS advice is to get urgent medical help if you think you have a kidney infection and you have a very high temperature, feel hot, cold or shivery, or have pain in the lower tummy or in the back just under the ribs [8].
A heart problem
Pain from the heart is not always felt in the chest only. The NHS says a heart attack can cause chest pain, such as pressure, heaviness, tightness or squeezing, that may spread to the arms, jaw, neck, back or stomach [9][10]. Women are more likely than men to have symptoms such as breathlessness, feeling sick, and back or jaw pain [17]. A burning feeling in the middle of the chest is often heartburn, but it can be hard to tell heartburn from a heart problem, and the NHS advises you not to self-diagnose [9][11]. If you have any doubt, get medical help.
Muscle strain and other causes
Strained or overworked muscles can also feel hot or burning for some people. Nerve pain can also come from conditions such as diabetes or vitamin B12 deficiency, which more often affect the hands and feet [2]. Less common causes exist, which is why burning pain that is severe, lasting or unexplained should be assessed by a doctor. See also our page on leg numbness.
What comes with the burning: clues to the cause
What you notice | What it may point to |
Burning or shooting pain from the back or buttock down a leg, with tingling, numbness or weakness | An irritated nerve in the spine, such as sciatica [3] |
Burning, tingling or stabbing pain on one side, followed days later by a rash or blisters in a band | Shingles [4][5] |
Pain in the side or lower back with fever, chills or feeling sick, with or without burning when passing urine | A possible kidney or urinary infection [7][8] |
Chest pain, pressure or burning that spreads to the back, with sweating, nausea or breathlessness | A possible heart problem: emergency [9][10] |
Numbness around the genitals or buttocks, trouble with the bladder or bowels, or weakness in both legs | A possible emergency involving the spinal nerves [13][14] |
This table is only a guide. It cannot diagnose you, and the patterns overlap.
When to get emergency help
Go to a hospital emergency department now if you have back pain or burning in the back together with any of the following:
- Chest pain or pressure, or pain that spreads to the arm, neck, jaw, stomach or back, especially with sweating, feeling sick, light-headedness or breathlessness [9];
- new difficulty controlling your bladder or bowels, or difficulty passing urine [14][15];
- numbness or tingling around the genitals, buttocks or inner thighs [13][14][15];
- weakness, numbness or tingling in both legs, or difficulty walking [12][14];
- a serious accident or fall.
These signs are described in more detail in our guide to back pain red flags.
When to see a doctor soon
Contact a doctor promptly, the same day if you can, if:
- you think you may have shingles, for example burning or tingling pain on one side with a rash or blisters starting to appear [4][5][6];
- you have back or side pain with a fever, chills or feeling unwell, or burning when passing urine [7][8];
- burning pain with a leg problem has not improved after a few weeks of home care, is getting worse, or is stopping you doing normal activities [3];
- pain wakes you at night, or you have unexplained weight loss [15];
- you are pregnant or have diabetes and think you may have a urinary or kidney infection [18].
You do not need to have one of these symptoms to see a doctor. If something feels wrong to you, get it checked. You can also read which doctor to consult for lower back pain and our page on pain between the shoulder blades and spine.
What a doctor may do
Because burning pain has many causes, a doctor will ask where it is, how it started and what else you have noticed, and will usually examine your back, legs and skin. Depending on what they suspect, they may suggest tests such as urine or blood tests, or imaging of the spine. Most back pain does not need a scan, but scans are used when a serious cause is suspected [16].
Frequently Asked Questions
Why does my back feel like it is burning? Possible causes include an irritated nerve in the spine, shingles, a kidney infection, muscle strain and, less often, a heart problem. What comes with the burning, such as a rash, fever, leg symptoms or chest pain, helps show which is more likely. A doctor can examine you to find out.
Is burning back pain a sign of a nerve problem? Burning is a common way that people describe nerve pain [1][2], but it does not always mean a nerve problem. Pain from other causes can feel like burning too.
Can shingles cause burning pain in the back? Yes. Shingles can start with burning, tingling or stabbing pain on one side of the body, with a rash appearing a few days later. The rash often appears on the chest or back [4][5]. See a doctor quickly if you suspect it.
Can a kidney problem cause burning pain in the back? A kidney infection can cause pain in the side or lower back, usually with a high temperature, chills and feeling sick, and sometimes burning when passing urine [7]. It needs prompt medical attention [8].
Can burning pain in the back come from the heart? Pain from a heart attack can spread to the back, and women may be more likely to have back or jaw pain [10][17]. If back pain comes with chest pain or pressure, sweating, feeling sick or breathlessness, get emergency help [9].
Why do I have burning pain in my upper back or between my shoulder blades? There are many possible causes, and a doctor needs to examine you. Upper back pain with chest pain, breathlessness or sweating needs emergency care [9]. Our page on pain between the shoulder blades and spine has more.
How long does burning back pain last? It depends on the cause. Sciatica usually gets better in 4 to 6 weeks but can last longer [3]. If burning pain does not improve, keeps returning or worries you, see a doctor.
How The Spine Foundation can help
If you have burning back pain that keeps returning, comes with leg symptoms, or worries you, a proper assessment can help. The Spine Foundation provides spine care and runs camps across India. Find a spine care centre near you or contact our team to ask about upcoming camps.
Our camps are not an emergency service. If you have any of the emergency signs described above, go to the nearest hospital emergency department now.
This article is for general information only and is not a substitute for medical advice, diagnosis or treatment. Always speak to a qualified doctor about your own condition.
References
- Gloucestershire Hospitals NHS Foundation Trust. Nerve pain. gloshospitals.org.uk
- Royal Buckinghamshire Hospital. Neuropathic pain. royalbucks.co.uk
- NHS. Sciatica. nhs.uk
- British Association of Dermatologists. Shingles: patient information leaflet. skinhealthinfo.org.uk (PDF)
- British Skin Foundation. Shingles (herpes zoster). britishskinfoundation.org.uk
- nidirect (Northern Ireland). Shingles. nidirect.gov.uk
- nidirect (Northern Ireland). Kidney infection. nidirect.gov.uk
- NHS. Kidney infection: urgent advice. nhs.uk
- NHS. Chest pain. nhs.uk
- British Heart Foundation. Heart attack: signs and symptoms. bhf.org.uk
- British Heart Foundation. Chest pain. bhf.org.uk
- NHS. Check if this is the right service for you (back and joint problems). nhs.uk
- Northamptonshire Healthcare NHS Foundation Trust. Back pain: urgent symptoms check. nhft.nhs.uk
- St George’s University Hospitals NHS Foundation Trust. Back pain advice (patient information). stgeorges.nhs.uk (PDF)
- Gloucestershire Hospitals NHS Foundation Trust. Red flags in back pain. gloshospitals.org.uk
- Sikina M, Kiel J. Re-evaluating red flags for back pain. American College of Emergency Physicians, Sports Medicine Section; August 2022. acep.org
- NHS factsheet: Heart attack (hosted by AXA Health). axahealth.co.uk
- nidirect (Northern Ireland). Urinary tract infections in adults. nidirect.gov.uk
