Upper back pain on the left side is a common complaint encountered by physicians. Upper left back pain is pain felt in the area extending from the neck to the end of the rib cage on the left side. The upper left back area includes left side of neck, the left shoulder area, shoulder blades, region behind the chest and ribs on the left side and middle portion of the back too.
Upper left back pain can be a result of various causes, more commonly musculoskeletal conditions but sometimes it can be related to other causes and conditions as well. The pain can be felt as sudden, sharp or sometimes dull, aching, which can be felt as a general overall pain or can be pinpointed. Pain in the upper left back can be short lasting or chronic in nature depending on the cause.
What Causes Upper Left Back Pain?
Some of the common causes of upper left back pain include:
- Injuries of various types can cause upper left back pain.
- Fracture of ribs, bones or any spinal vertebra on the left side can cause upper left back pain.
- Injury to muscles and ligaments or soft tissues on the left side of the neck, left shoulder joint, upper and middle back.
- Sports injuries.
- Cuts, wounds or abrasions on the upper left back region.
Musculoskeletal Causes of Upper Left Back Pain
Conditions affecting the muscles and joints are often the causes of upper left back pain.
- Poor posture, body movements or improper ways of twisting and lifting can cause upper left back pain.
- Pulls and strains of the upper left back muscles from lifting heavy weights, awkward movements, overuse and overstretching.
- Disorders of the spine, including intervertebral disc protrusion, damage to the disc, compression of nerves can also cause pain in the left upper back.
- Fibromyalgia, myofascial pain and other muscle pain related conditions causing pain of different muscle groups in the neck, left shoulder and upper left back region.
- Conditions affecting the ribs, disorders of the joints, like osteoarthritis, sometimes rheumatoid arthritis affecting the shoulder joint, vertebrae and other associated joints in the area of upper left back.
Upper Left Back Pain Caused Due to Nerve Conditions
- Pinched nerve from spinal problems, tensed muscles causing upper left back pain, left arms and hands.
- Conditions affecting nerves of the left upper back or left arm, stroke, etc. causing pain, numbness or weakness.
- Infections like shingles, where nerve supplying upper left back is affected can cause severe pain.
Other Causes of Pain in the Upper Left Back
Other conditions that can cause upper left back pain include
- Respiratory conditions or lung infections can cause pain in chest and upper left back. Commonly associated with cough, difficulty in breathing and sometimes fever.
- Skin conditions affecting skin and subcutaneous tissue like boils, abscesses, stings, bites etc. can cause upper left back pain. It may be easily noticed and is often accompanied with itching, burning sensation.
- Certain gastrointestinal conditions like indigestion and bloating, pancreatitis, complication or perforation of peptic ulcers, etc. too can cause pain in middle and upper left back area. Associated gastric complaints like nausea, vomiting, changes in eating and bowel patterns, burning in stomach, etc. may be present.
- Conditions related to urinary system like kidney stones, etc. can cause pain in the upper and middle back or flank region, which may radiate to the groin.
- Women may occasionally experience menstrual pain or pain from uterine related conditions in the region under lower left ribs.
- Cardiac conditions, particularly chest pain from a heart attack can extend to left upper back, neck and jaw. This needs immediate medical care.
Rarely certain infections, tumors or cancers in the area, spread of certain types of cancers can be the cause of upper left back pain.
Symptoms of Upper Left Back Pain
Upper left back pain is itself a symptom, which presents itself depending on the underlying cause. Complaints may include constant or intermittent pain in upper left back. Pain may be accompanied with difficulty in movement of back, shoulder or arms. Pain may worsen on coughing, moving, breathing, etc. Nerve related causes may show burning, pain with numbness and tingling in arms. Musculoskeletal causes often show a history of injury or strain and may be associated with bruising, tensed muscles, etc.
Diagnosis of Upper Left Back Pain
Diagnosis can be made after thorough history taking and physical examination. Recent history of falls, accidents or injuries, stings, etc. are noted. Presence of fever is assessed to rule out possibility of infections. Blood investigations help to detect infections, inflammation and other possible conditions. X-rays, bones scans and MRI may be performed to find bone, muscle, ligament and soft tissue damage, and for lung and abdomen related causes. Nerve conduction studies, ECG and other cardiac related investigations may be performed, if appropriate.
Treatment of Upper Left Back Pain
Treatment is based on the cause. Injuries, fractures, muscle and ligament strains may be treated with rest, ice, compression and elevation (RICE formula). Hot and cold compresses may be used, as required. Limiting the activity causing pain is important. Non-steroidal anti-inflammatory medicines are given. Infections are treated with appropriate medicines. Cardiac causes and other serious conditions need immediate medical attention and hospitalization.