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Back pain on the upper left side can be both unpleasant and perplexing, especially if the cause is unknown. Depending on your medical history, you may wonder if the pain is coming from your spine, shoulder, ribs, or an internal organ like the heart. Let’s look at some of the possible causes of upper left back discomfort and when you should see a doctor.

Muscle tension

Upper back pain is frequently caused by a muscular strain, which can range from a mild ache to a sharp or scorching sensation. Muscle strain is by far the most prevalent cause of mild to severe upper left back discomfort with recent onset. Among the possible causes of muscle strain are:

    Overuse. Muscles in the shoulders and upper back may get overused and strained when performing repetitive actions such as painting or rowing. An upper back muscle might be strained when lifting a big object.

    Bad posture. Sitting slumped forward or to one side might cause back and muscle strain. Sitting with bad posture for extended periods of time or on a regular basis can cause muscle strain, which may be felt more on one side than the other.

    Collision. A high-impact collision, such as in a football or hockey game, can result in muscular soreness and injury.

An intercostal muscle, a tiny muscle between neighbouring ribs, can sometimes be strained in the upper back, causing pain and sometimes trouble breathing.

Stenosis of the foramen

The intervertebral foramen is a bony aperture on each side of the vertebra through which the spinal nerve exits the spinal canal. Foraminal stenosis occurs when this foramen narrows due to facet joint osteoarthritis, bone spurs, and/or a herniated disc. When the foramen narrows, the spinal nerve might become pinched or irritated.

Cervical foraminal stenosis in the lower neck can cause pain to spread down into the shoulder blade area. While less prevalent, thoracic foraminal stenosis can cause pain in the upper back to one side, typically the left. Radicular discomfort caused by foraminal stenosis can range from mild to scorching or electric-like, and it is occasionally accompanied by tingling, numbness, and/or weakening.

Compression fracture of the vertebrae

A vertebral compression fracture occurs when tiny breaks in a vertebra cause at least 15% of its height to be lost. Vertebral compression fractures most commonly occur in the thoracic spine (middle and upper back). Compression fractures are most common in those who have osteoporosis, a condition in which the bones become fragile. They can occur without any form of high-impact collision or fall. Vertebral compression fractures can also occur as a result of hard lifting, sports, car or bike accidents, or falls.

Most spinal compression fractures are felt similarly on both sides of the spine. However, the discomfort may be felt more on one side than the other in some circumstances. Some compression fractures are more serious and may include the compression of a spinal nerve. As a result, if the spinal nerve on the left side becomes pinched or irritated, pain may be felt more to the left.

Internal organ dysfunction

While uncommon, an internal organ disease can occasionally appear as upper left back pain. Here are a few examples:

  •     A heart attack has occurred. Most heart attacks are accompanied by chest pain, but not always. It is possible to experience heart attack symptoms as a one-sided ache in the arm, shoulder, and/or upper back. These symptoms are more likely to occur on the left side, but they can also occur on the right or both sides. Other possible symptoms include weakness, lightheadedness, difficulty breathing, and discomfort in the jaw or neck.
  •     Cancer of the lungs. While coughing, hoarseness, or chest discomfort are common early indications of lung cancer, back pain may be the first obvious symptom. A tumour in the left lung, for example, may spread to the surrounding spine or ribs, causing upper left back pain. 

Other factors can also contribute to upper left back pain.

When should you see a doctor?

When upper left back discomfort lasts for a few weeks, it’s time to see a doctor for an appropriate diagnosis and pain relief. Seek immediate medical assistance if upper back left pain is accompanied by numbness, weakness, severe headache, nausea, difficulty walking, bowel/bladder incontinence, or other disturbing symptoms.


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