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Duodenal ulcer pain can radiate to the back. A sudden onset of severe back pain in a patient with a duodenal ulcer may be due to posterior perforation. Symptoms such as epigastric pain and dyspepsia suggest the diagnosis.
Pancreatitis may also radiate to the back. The patient typically gains relief from sitting forward. The presentation is usually accompanied by a history of nausea, vomiting and epigastric pain.
Similarly, thoracic structures can give rise to pain in the thoracic region of the back, e.g. the inflammation of the pleura overlying the lower lobes of the lung posteriorly, or dissection of the thoracic aorta (sudden catastrophic chest pain radiating to the back).