Upper Left Back Pain: Causes & How to Get Relief

Key takeaways:

• Upper left back pain usually results from conditions related to the spine, muscles of the upper back, or internal organs.
• Minor acute back pain usually resolves with rest and at-home care.
• Sudden or severe pain in the upper back that’s accompanied by certain symptoms should prompt you to seek medical care immediately.

Back pain is among the most frustrating and debilitating types of pain. Upper left back pain, while not as common as lower back pain, can be puzzling for patients. Compounding the frustration and confusion are the numerous potential causes.

Upper left back pain usually results from muscle strain or injury. Accordingly, rest and at-home care are often enough to alleviate the discomfort. In other cases, however, upper left back pain can result from chronic spinal conditions or processes in internal organs like the heart, lungs, or pancreas. Keep reading for a rundown of some common causes, benign and serious, of upper left back pain.

Upper left back pain defined

Upper back pain refers to discomfort or pain that occurs between the shoulder blades extending from the base of the neck to just beyond the bottom of the ribs. It can vary from mild and intermittent to severe and persistent. Upper back pain is less common than lower back pain.

Health risks associated with upper left back pain

Although upper left back pain usually results from muscle sprain or injury, it can sometimes result from chronic or complex conditions in the spine or nearby internal organs. Structures in other parts of the body, including the pancreas and gallbladder, may radiate pain to the upper left back.

Symptoms associated with upper left back pain

Symptoms of upper back pain due to a musculoskeletal condition can help to differentiate minor acute upper back pain from chronic back conditions and pain resulting from an internal organ.

Some of the symptoms related to acute conditions in the musculoskeletal system include:

• Knife-like, sharp pain
• Dull pain
• Pain that increases with movement
• Muscle tenderness
• Muscle swelling
• Muscle spasms
• Stiffness
• Difficulty with movement.
• Numbness or tingling in the upper back or arms
• Neck pain
• Shoulder pain

Symptoms associated with structural problems of the vertebrae

Symptoms related to structural problems of the vertebrae (fractures, spinal stenosis, spondylolisthesis, disc herniation) can include the following symptoms:

• Increased pain when bending backward
• Weakness in arms or hands that feels worse in the morning
• Difficulty with fine motor tasks when first waking up
• Numbness or tingling that starts in the upper back and may extend into the arms

Causes of upper left back pain

There are many causes of upper left back pain, and symptom patterns may help distinguish them. This section will explore acute and chronic causes of upper back pain.

Muscle strain or injury

Muscle strain is a common cause of pain in the upper left back. Muscle injury from overuse or trauma is a common cause. These injuries can occur in the upper back due to poor posture, repeated heavy lifting, or overuse of the shoulders and arms. Other symptoms of muscle strain are swelling, tenderness, muscle spasms, stiffness, and problems with movement. Sometimes, pain occurs with deep breathing.

Poor posture

Many people who work all day at their desks or on a computer without changing their posture may develop upper back pain. Poor sleep posture can also cause upper back pain. Depending upon the posture, this can affect one or both sides of your back.

Herniated disc

Discs are the rubber cushions between the vertebrae that act as shock absorbers for the vertebrae. A herniated disc is sometimes called a slipped or ruptured disc.

Disc herniation occurs when an injury, sprain, or degenerative disc disease causes the breakdown of the disc’s firm outer layer.

A slipped disc can press on a spinal nerve as it exits the spinal column, which can cause numbness, tingling, or weakness in the areas supplied by the nerve. When a disc herniates in the middle or upper back, you may feel pain in the upper back and have neurological symptoms in the arms and upper back.

Scoliosis

Scoliosis is an abnormal curvature of the spine that often begins in adolescence. Scoliosis causes sideways curvature of the spine, usually to the right side. Mild to moderate cases do not usually cause back pain, but severe cases can cause upper back pain. The spinal curvature can limit the expansion of one lung, and people with severe scoliosis may have pain with breathing.

Kyphosis

Kyphosis is another abnormal curvature of the spine. It results in a hunched-over posture with a forward curvature of the back. It can limit lung inflation. Although mild cases don’t usually cause pain, the pain often occurs in midlife with the progression of the deformity. Kyphosis can also cause upper left back pain with breathing.

Spinal stenosis

Spinal stenosis develops when the central space within your spine narrows, creating pressure on the spinal cord and spinal nerves. Think of your spinal canal as a tunnel that houses your spinal cord. When this tunnel narrows, it can compress the spinal nerves, causing pain and neurological signs like numbness or weakness.

Pain from spinal stenosis typically feels worse upon first waking because fluid accumulates in the spinal tissues during rest. People often report their pain improves after moving around for 30-45 minutes. Spinal stenosis affects up to 20% of adults over 60

Common symptoms include:

• Numbness or tingling that starts in the upper back and may extend into the arms
• Increased pain when bending backward
• Weakness in arms or hands that feels worse in the morning
• Difficulty with fine motor tasks when first waking up

Vertebral fractures

A vertebral fracture can develop after an injury and can affect the left side of the upper back if it presses or severs a nerve. Vertebral fractures can also occur without significant trauma in people with bone fragility or osteoporosis. This type of fracture occurs gradually. When the fracture completes, it can result in nerve pressure and pain in the upper back.

Other causes of upper left back pain based on another symptom or situation

There are many potential sources of upper left back pain. Sometimes, the diagnosis is suspected based on an accompanying symptom or situation. The following examples illustrate some symptoms associated with specific disorders.

Sharp or stabbing upper left back pain

Sharp pain in your upper left back can result from any one of several conditions. The list below is not exhaustive, but it does cover some common causes:

• Costovertebral joint inflammation (cartilage inflammation)
• Pleurisy (inflammation of the membrane surrounding your lungs and interior of your chest cavity)
• Myofascial pain syndrome
• Pneumothorax (occurs when air enters the space between the pleura and the chest wall)

Burning upper left back pain

Disc herniation, spondylolisthesis, and spinal stenosis can cause burning upper left back pain. Another possible cause is acid reflux into the esophagus, which usually causes pain on both sides.

Upper left back pain when breathing

Some disorders that cause upper left back pain when breathing include structural disorders like severe kyphosis, scoliosis, a herniated disc, and respiratory infections. Asthma and pleurisy may also be responsible.

Upper left back pain after eating

Pancreatitis is inflammation of the pancreas, a large gland behind the stomach near the first part of the small intestine. Pancreatitis causes pain in the middle of the abdomen under the sternum, which often radiates to the upper back. Other symptoms include nausea and vomiting, fever, and fatty stool.

Upper left back pain felt under the ribs

The mid-back, under the ribs, is sometimes considered part of the upper back. Left back pain under the ribs can be caused by kidney stones or gallbladder disease. An infarction in the spleen can also cause upper left back pain felt under the ribs.

Upper left back pain during pregnancy

There are many possible causes of upper left back pain in pregnancy. These include changes in the center of gravity in pregnancy, changes in posture, and breast tissue growth. Hormonal changes and stress can also contribute to upper left back pain during pregnancy.

Upper left back pain pain in females and those assigned female at birth (AFAB)

In addition to the causes of upper left back pain that can affect anyone of any gender or sex, hormonal fluctuations during pregnancy cause upper left back pain in pregnant people. Osteoporosis and heavy breasts also affect women and individuals AFAB.

Upper left back pain in males and those assigned male at birth (AMAB)

Muscle strain, heart attack, dissection of an aortic aneurysm, and other cardiovascular conditions may cause upper left back pain in this group, as members are more susceptible to these conditions.

How to get short-term relief from upper left back pain

If you have upper left back pain without “red flag” symptoms, the likely cause is muscle strain or injury. The following measures may provide some relief.

Over-the-counter medications

Over-the-counter anti-inflammatory pain relievers include acetaminophen (Tylenol), naproxen (Naprosyn, Anaprox, Anaprox DS), and ibuprofen (Motrin, Advil) are nonsteroidal anti-inflammatory drugs (NSAIDs). They can reduce inflammation and pain. Topical NSAIDs like diclofenac sodium (Voltaren gel) are applied to the skin and penetrate to relieve pain in underlying muscles.

Ice

Icing your sore muscles constricts the blood vessels, which reduces the amount of inflammatory cells in the area of injury.

Gentle movement, stretches, and massage

If you have upper left back pain due to muscle strain, you can relieve your pain somewhat by gentle repetitive movements that stretch the muscle. Massage can also provide relief from muscle pain and spasms. Foam rollers or tennis balls work well for massage if you don’t have a second pair of hands.

Stress reduction

Mental and emotional stress can contribute to back pain. Back pain may increase your stress level. These factors can create a feedback loop that makes recovery difficult.

Reducing mental stress can reduce your physical pain. Music, deep breathing, yoga, and nature may help relieve stress and speed your recovery.

How to prevent upper left back pain

Preventing upper left back pain begins with understanding the cause. You can avoid further episodes by making changes.

Check your posture

Poor posture is a common cause of upper back pain. Strengthen your core muscles to support your upper back. Align your head and hips. Seeing a physical therapist may help your posture.

Avoid carrying a heavy backpack or purse

Heavy backpacks can place a strain on your muscles. When carrying a bag is unavoidable, alternate sides frequently to avoid spine and muscle imbalances.

Stop smoking

Smoking constricts the blood vessels and delivers hundreds of toxins to your tissues. These circumstances reduce your ability to heal from injury.

Support your breasts

Wear a bra with proper support if you have a large amount of breast tissue, which can strain the upper back.

Weight loss

Losing weight will reduce strain on your back.

Exercise

Strength training will build your core muscles and help support your back. Aerobic exercise will improve your capacity to utilize oxygen efficiently, which is important for healing. You may also lose weight with exercise.

Nutritional considerations

Vitamins and minerals are essential for healing muscles, bones, and connective tissue. Vitamins C and D are essential, as are B vitamins and magnesium. Consult with your doctor before adding a supplement, especially if you have underlying health conditions or take other medications.

When you should see a doctor about upper left back pain

Although most episodes of upper left back pain are due to muscle strain or injury, it may signal a more serious condition. Chronic conditions often require specialized medications or surgery.

You should see a doctor if:

• Your pain lasts beyond two weeks despite home care
• Your pain worsens despite medication, rest, and other conservative measures
• You have numbness or tingling
• You experience difficulty with basic movements
• You have an underlying back condition and experience new upper back pain after sleeping
• You find it challenging to sleep or perform basic tasks due to pain

You should go to the emergency room if:

• You have progressive weakness or numbness, particularly if developing rapidly
• You experience severe pain unrelieved by any position change
• You are incontinent
• You are short of breath
• You have a fever of at least 101.5 degrees Fahrenheit
• You have chest pain (call 911)

Questions to ask your doctor about upper left back pain

Asking your doctor the right questions and seeking timely care can help you find effective treatment.

• Is there a serious condition I should be concerned about?
• What tests will be necessary to diagnose the underlying cause of my upper left back pain?
• What treatment options would be most helpful?
• How long will recovery take?

How a doctor may help treat upper left back pain

Healthcare providers use various approaches to treat upper left back pain, depending on the cause.

Muscle relaxers and pain medications

If the pain is due to muscle strain, your healthcare provider may recommend over-the-counter or prescription medications to reduce pain and inflammation.

Physical therapy

Physical therapy can target chronic pain by strengthening the upper back muscles, improving posture, and relieving tension.

Imaging or diagnostic testing

Radiologic imaging with X-rays, CT scans, or MRI can pinpoint a lesion or provide visual clues that your doctor can use in diagnosis.

Frequently asked questions: upper left back pain

Many people who have experienced upper left back pain have had questions similar to the ones below.

Is upper left back pain a sign of a heart attack?

Although upper left back pain is usually the result of muscle strain, upper left back pain in patients with risk factors for coronary artery disease is concerning for ischemic heart disease. Risk factors include male or AMAB, advancing age, family or personal history of cardiovascular disease, smoking, and diabetes.

How long should upper back pain last before you see a doctor?

If your upper back pain lasts more than two weeks, gets worse, or is accompanied by symptoms like weakness, numbness, fever, or difficulty breathing, it’s important to see a doctor.

What specialists or medical professionals can help treat upper left back pain?

Start with your primary care doctor, who can evaluate the pain and refer you to a specialist. Depending on the cause, a physical therapist, orthopedist, neurosurgeon, chiropractor, pain management specialist, cardiologist, or pulmonologist might be involved in your care.

Things to remember about upper left back pain

There are many potential causes of upper left back pain, including acute injury, chronic causes of spinal deformity or dysfunction, or disease processes in other organs. The most common reason is muscle strain that will resolve with rest and at-home treatment within days to weeks.

Other more severe conditions can cause upper back pain. It is critical to know when your upper left back pain could be urgent or life-threatening so you can receive appropriate care as early as possible.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Lane Thaut, DO.

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