<s>[INST] Hi im 42 yeats old, not overweight and im waking up in the mornings with a central chest pain like someone sitting on me, and a back pain around the same area. I have had these pains before but not when waking up. I have had stress tests, tilt tests, ECGs, holter test etc and on all they have found nothing, but now the pass month or so I am getting the pain when I wake up and it lasts for around 10-15 mins. Any ideas. [/INST] Thanks for your question on Chat Doctor. I can understand your concern. No need to worry about heart related pain as your extensive cardiac work up is normal. Central chest pain commonly seen with HERD (gastroesophageal reflux disease). HERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause symptoms of chest tightness, central chest pain, back pain etc. So follow these steps for better symptomatic relief. 1. Avoid hot and spicy food. Avoid junk food. 2. Avoid stress and tension, be relaxed and calm. 3. Avoid large meals, instead take frequent small meals. 4. Take pantoprazole tablet on empty stomach. 5. Keep 2-3 pillows under head in bed to prevent reflux. 6. Quit smoking and Alcohol if you have these habits. Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>