Numerous diseases may be responsible for back pain also called backache. The precise location of the pain, the mode of onset, aggravating or ameliorative circumstances, and time of occurrence should be investigated by the doctor. They are mostly of muscular origin, which is sometimes the case in a pulled muscle, excessive stress on the back when carrying heavy loads, sometimes trauma. It can also result from diseases of the spine such as arthritis or a hernia, but is rare in the thoracic vertebrae. More rarely, pain from the heart, lungs, or digestive tract can be felt in the back.