24/7 Emergency Care. Our patients are first.

Call Us 24/7
Check In Online
Call Us 24/7
Check In Online

Burning Back Pain (Burning Sensation in the Back): Causes, Symptoms, and What to Do

Spinal Burning Sensation

A burning sensation in the back can feel alarming—especially if it starts suddenly, spreads, or doesn’t match typical “sore muscle” pain. The most important thing to know is this:

Burning back pain is a symptom, not a diagnosis. It can happen when nerves are irritated, muscles are strained, or pain is referred from another part of the body (such as the digestive or urinary system). The best clues come from where the burning is, how long it’s been present, and what other symptoms occur with it.

Quick overview

Burning back pain is most commonly linked to:

  • Nerve-related issues (irritation, compression, neuropathy)
  • Muscle strain or spasm
  • Shingles (sometimes pain starts before a rash appears)
  • Referred pain (for example, reflux/heartburn or urinary/kidney problems)

Many cases improve with conservative care. However, burning pain with weakness, numbness, fever, or bladder/bowel changes should be evaluated by a clinician.

What burning back pain can feel like

Burning back pain can be described as:

  • A hot, heated, or “on fire” feeling
  • Stinging or raw discomfort
  • Tingling or “pins and needles”
  • Electric, zapping, or shooting pain
  • Burning that radiates to the neck/arm or buttock/leg

A burning quality often suggests nerve involvement, but it can also occur with muscle inflammation, shingles-related nerve irritation, or referred pain.

Common causes of burning back pain

A practical way to understand burning back pain is to group causes into a few common categories.

Nerve-related causes

Burning pain is a classic “neuropathic” symptom—especially when paired with tingling, numbness, or radiating pain.

Common nerve-related contributors include:

  • Herniated (slipped) disc / pinched nerve. A disc problem can irritate a nearby nerve root. In the low back, this may cause pain that radiates into the buttock, leg, or foot.
  • Sciatica (lumbar radiculopathy). Often felt as burning or shooting pain traveling down one leg, sometimes with numbness or tingling.
  • Spinal stenosis. Narrowing around spinal structures can trigger back pain and leg symptoms (tingling, heaviness, cramping) that often worsen with standing or walking and improve with sitting or leaning forward.
  • Peripheral neuropathy. Conditions such as diabetes can cause burning or tingling symptoms due to nerve changes.

Clues that make nerve pain more likely:

  • Burning plus tingling/numbness
  • Pain that radiates in a line into an arm or leg
  • Symptoms worsened by certain positions or movements
  • New weakness (needs medical evaluation)

Muscle and soft-tissue causes

Muscles can also produce a burning sensation—especially when inflamed, overused, or in spasm.

Common muscle-related contributors include:

  • Strain from lifting, twisting, or overuse
  • Muscle spasm
  • Postural overload (long hours sitting, laptop work, prolonged driving)
  • DOMS (delayed-onset muscle soreness) after unfamiliar exercise

Clues that make muscle pain more likely:

  • Local tenderness and tightness
  • Burning that worsens with a specific movement or sustained posture
  • Improvement with gentle movement and time
  • No radiating “nerve-line” pattern and no numbness/tingling

Shingles and post-viral nerve pain

Shingles (herpes zoster) can begin with burning, tingling, or sensitivity in a localized area, often before a rash appears. Some people develop postherpetic neuralgia, a longer-lasting nerve pain complication after shingles.

Clues that point toward shingles-related pain:

  • Burning in a strip/band-like pattern
  • Often one-sided
  • Skin sensitivity (even clothing brushing the area may hurt)
  • A rash appears days later (though not always)

Referred pain from organs

Sometimes the burning feeling is not coming from the back muscles or spine.

Examples include:

  • Urinary tract infection (UTI) or kidney infection. Can cause back/side discomfort (often below the ribs), sometimes with fever, chills, nausea, fatigue, or burning with urination.
  • Reflux/heartburn (GERD). Heartburn is typically felt as a burning sensation in the chest, but symptoms can overlap with upper back discomfort—especially around the chest/upper torso region.
  • Gallbladder-related pain. Can refer pain to the upper back or right shoulder blade area and often occurs with upper abdominal symptoms.

If burning back pain is paired with systemic symptoms (fever, vomiting, urinary symptoms, shortness of breath), evaluation is important.

Inflammatory and other causes

Persistent burning back pain can also be associated with:

  • Arthritis/degenerative changes in the spine
  • Inflammatory back conditions (often worse at night and improved with movement)
  • Rarely, spinal infection or tumor (more likely when specific red flags are present)

Burning upper back pain (including burning between shoulder blades)

Burning in the upper back or between the shoulder blades is often related to posture and muscle tension, but not always.

Common possibilities include:

  • Postural muscle strain (desk work, driving, carrying loads)
  • Thoracic spine irritation (joints/discs—less common than low back issues)
  • Shingles (especially if one-sided, band-like, with skin sensitivity)
  • Reflux/heartburn (especially if symptoms relate to meals or lying down)
  • Gallbladder-related referred pain (often right-sided, with upper abdominal symptoms)

Important: If upper back burning occurs with chest pressure, shortness of breath, sweating, nausea, dizziness, or pain spreading to the jaw/arm, seek medical evaluation urgently.

Burning pain in the middle of the back

Mid-back burning is commonly musculoskeletal but may also reflect nerve irritation or shingles.

Common possibilities:

  • Muscle strain/spasm
  • Thoracic nerve irritation
  • Shingles

If mid-back burning occurs with fever, chills, or feeling very unwell—especially with urinary symptoms—medical evaluation is recommended.

Burning lower back pain

Lower back burning commonly falls into either muscle-related or nerve-related patterns.

Common possibilities include:

  • Muscle strain or spasm
  • Herniated disc / pinched nerve
  • Sciatica
  • Spinal stenosis

Lower back burning can also be referred from urinary/kidney issues—particularly if accompanied by urinary symptoms or fever.

Burning lower back pain on one side (left or right)

One-sided burning can occur with:

  • A muscle strain on that side
  • Nerve root irritation on that side
  • Shingles (often one-sided)
  • Kidney/urinary causes (often felt more as flank/side pain)

One-sided location alone does not diagnose the cause. The associated symptoms and pattern matter most.

Burning back pain without a rash

Burning without visible skin changes is common in:

  • Nerve irritation/compression
  • Peripheral neuropathy
  • Early shingles (before a rash appears)

If you have a new, localized, one-sided band of burning with marked skin sensitivity, it is reasonable to discuss shingles with a clinician even if no rash is visible yet.

Burning lower back pain in women (and during pregnancy)

Women can experience the same muscle and nerve causes as anyone else, but a few considerations are more common:

  • UTIs are more common in women and may cause urinary urgency/frequency, burning with urination, and sometimes back/side pain. Fever and significant flank pain raise concern for kidney involvement.
  • Pregnancy-related changes (posture shifts, ligament laxity, muscle fatigue) can contribute to back discomfort, including burning or aching sensations.

Seek medical care sooner if burning back pain occurs with fever, significant urinary symptoms, or during pregnancy with severe pain or other concerning symptoms.

Symptoms that help narrow down the cause

These associated symptoms can be more informative than burning alone:

  • Tingling/numbness → suggests nerve involvement
  • Weakness → needs clinical evaluation
  • Radiating pain down a leg or arm → often nerve-related
  • Fever/chills, nausea, feeling ill → may indicate infection/systemic illness
  • Burning with urination or urinary changes → suggests UTI/kidney causes
  • Rash or skin sensitivity → suggests shingles
  • Symptoms related to meals/lying down → may suggest reflux/heartburn

When to see a doctor

Consider medical evaluation if:

  • Burning back pain lasts more than several days, worsens, or keeps returning
  • Pain interferes with sleep, work, or daily activities
  • Symptoms spread or new areas of burning/tingling appear
  • You develop numbness, tingling, or weakness
  • Pain travels down the leg (especially below the knee) or down the arm
  • You have fever, chills, or feel significantly unwell
  • You have burning with urination, blood in urine, or notable back/side pain under the ribs
  • The pain started after a significant injury (fall, collision)
  • You have concerning risk factors (history of cancer, immune suppression, unexplained weight loss)

Seek urgent evaluation for new bowel/bladder control problems, numbness around the genitals/buttocks, or progressive leg weakness.

What you can do at home (non-medication options)

If symptoms are mild and there are no red flags, conservative care can help—especially for muscle-related pain.

Keep moving (gently)

Avoid prolonged bed rest. Instead:

  • Take short walks
  • Change positions often
  • Avoid the single movement that sharply aggravates pain, but keep general activity going

Use heat or cold

  • Heat may help muscle tightness and spasm
  • Cold may help after a flare or strain (often within the first 24–48 hours)

Use whichever feels better; some people alternate.

Try gentle mobility (not aggressive stretching)

Examples include:

  • Knee-to-chest (if comfortable)
  • Cat-cow or child’s pose (if comfortable)
  • Gentle thoracic extension over a chair back (upper/mid-back tightness)

Stop if pain intensifies—especially if you notice radiating symptoms.

Ergonomics and posture resets

If symptoms worsen with sitting or screen time:

  • Bring screens to eye level
  • Use lumbar support
  • Take brief movement breaks every 30–45 minutes
  • Avoid carrying heavy bags on one shoulder

Sleep positioning

  • Side sleeping: pillow between knees
  • Back sleeping: pillow under knees
  • Avoid positions that twist the spine for hours

If reflux seems involved

If burning is linked to meals or lying down:

  • Avoid late heavy meals
  • Consider elevating the head of the bed slightly
  • Track trigger foods

If you have chest pain concerns, do not assume it is reflux—seek evaluation.

How doctors evaluate burning back pain

Evaluation typically includes:

  • A targeted history (location, duration, triggers, radiation, associated symptoms)
  • A physical exam assessing movement and basic neurologic function
  • Testing when indicated (for example, imaging for persistent symptoms or neurologic findings; urine testing when urinary symptoms suggest infection)

Not every case requires imaging; many common back pain patterns are managed conservatively first.

Frequently Asked Questions

What causes a burning sensation in the back?

Common causes include nerve irritation, muscle strain/spasm, shingles, and sometimes referred pain such as reflux or urinary/kidney issues. Location and associated symptoms help narrow it down.

Can a pinched nerve cause burning back pain?

Yes. Nerve irritation often produces burning, tingling, electric-like pain, and may radiate into an arm or leg.

Why do I feel burning between my shoulder blades?

This is often due to muscle tension or posture, but shingles and reflux-related patterns can also contribute. If symptoms occur with concerning chest symptoms, seek urgent evaluation.

Why does burning back pain spread to the leg?

Burning or shooting pain traveling down a leg commonly suggests sciatica/radiculopathy, where a lumbar nerve root is irritated.

Can shingles cause burning back pain without a rash?

Shingles often causes pain before a rash appears. Shingles without a rash is possible, though harder to confirm. One-sided, band-like burning with skin sensitivity is a reason to discuss shingles with a clinician.

Can heartburn cause upper back burning pain?

Reflux typically causes chest burning, but symptoms can overlap with upper torso discomfort. Because chest/upper back symptoms can also be serious, persistent or severe symptoms should be medically assessed.

What causes burning lower back pain in women?

Women can have the same muscle/nerve causes as anyone else, but UTIs are more common and may contribute—especially with urinary symptoms or fever. Pregnancy-related biomechanical changes can also contribute.

Why does my back burn after exercise?

This is often due to muscle fatigue, overuse, or strain, especially with new or intense activity. Burning plus numbness, weakness, or radiating symptoms warrants evaluation.

Reference List