Hello, Since you have fatty liver, pain in the abdomen can be dull but pain can radiate to the back. Severe backache with fatty liver can be indicative of enlarged liver. Enlarged liver can also cause pain in the back and shoulder blades. You are suggested to get repeat tests and investigations done. Get CT, MRI, liver biopsy, liver enzyme tests, CBC, glycated hemoglobin tests, etc. Your treatment will depend on the diagnosis made. In the meantime, avoid smoking, alcohol, recreational drugs, etc. Avoid taking spicy, oily food. Take boiled home-made food and boiled water. Avoid taking food that takes a longer time to digest. Keep away from red meat and fatty dairy products. Take lean meat, half boiled eggs, skimmed meat, well-cooked veggies, fruits and cereals. Take quality sleep at night at least 8 hours. Take water and fluids so that you are well hydrated. Take digestives and liver tonics. To help reduce backache you can take naproxen after food, one stat when needed. Take antacids or PPIs to prevent heartburn or acidity. Do regular walking and lose weight. Take healthy diet to prevent feeling weak like whole grains, fruits, vegetables. Maintain blood pressure and sugar levels at normal. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Nupur K., General & Family Physician