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Back pain on the upper left side can be distressing and puzzling, particularly when the cause is unknown. Depending on your medical history, you may question whether the pain is emanating from your spine, shoulder, ribcage, or an internal organ such as your heart. Let’s examine the possible causes of upper left back pain and when you should seek medical attention.

Muscle strain

Muscular strain is a common cause of upper back pain, which can range from a moderate ache to a sharp or burning sensation. Muscle strain is by far the most common cause of recent onset moderate to severe upper left back pain. Possible causes of muscle strain include:

    Excessive use. When conducting repetitive actions such as painting or rowing, the shoulders and upper back may become overworked and strained. A muscle in the upper back may be strained when raising a heavy object.

    Poor posture. Slouching forward or to one side while seated may cause back and muscle strain. Sitting with poor posture for extended periods of time or on a consistent basis can result in muscle strain, which may be felt more on one side than the other.

    There was a collision. High-impact collisions, such as those in football and ice hockey, can cause muscle discomfort and injury.

A tiny muscle between adjacent vertebrae, the intercostal muscle, can be strained in the upper back, causing pain and sometimes breathing difficulties.

A narrowing of the foramen

Each side of each vertebra contains an intervertebral foramen through which the spinal nerve departs the spinal canal. Foraminal stenosis occurs when this foramen becomes constricted as a result of osteoarthritis of the facet joints, bone spurs, and/or a herniated disc. When the foramen becomes constricted, the spinal nerve may become compressed or irritated.

The pain caused by cervical foraminal stenosis in the lower neck can extend to the shoulder blade region. Although less common, thoracic foraminal stenosis can cause discomfort on the left side of the upper back. Radicular pain caused by foraminal stenosis can range from mild to severe or electric-like, and is sometimes accompanied by tingling, paralysis, and/or a loss of strength.

Vertebral compression fracture

A vertebral compression fracture occurs when minute fractures in a vertebra result in the loss of at least 15% of its height. Compression fractures of the vertebrae are most prevalent in the thoracic spine (middle and upper back). The most prevalent cause of compression fractures is osteoporosis, a condition in which bones become fragile. They can occur without a collision or fall of significant force. Vertebral compression fractures can also result from heavy lifting, sports, automobile or bicycle accidents, or collapses.

The majority of compression fractures of the spine are felt identically on both sides of the spine. In certain circumstances, the distress may be felt more on one side than the other. Some compression fractures are more severe and may involve spinal nerve compression. Consequently, if the left spinal nerve becomes compressed or irritated, discomfort may be felt more on the left side.

Internal organ disorder

An internal organ disease can occasionally manifest as upper left back discomfort, although this is uncommon. Here are some instances:

    A cardiac attack has taken place. Most but not always, heart attacks are accompanied by chest pain. It is possible for heart attack symptoms to manifest as a unilateral pain in the arm, shoulder, or upper back. However, they can also occur on the right side or on both sides. Other potential symptoms include weakness, dizziness, difficulty inhaling, and jaw or neck discomfort.

    Lung cancer is an illness that affects the airways. Despite the fact that wheezing, hoarseness, and chest pain are common early indicators of lung cancer, back pain may be the first noticeable sign. For instance, a tumor in the left lung may extend to the surrounding spine or ribs, resulting in upper left back pain. 

There are additional causes of upper left back discomfort.

When should you consult a physician?

When discomfort in the upper left back persists for several weeks, it is time to see a doctor for an accurate diagnosis and pain relief. If left upper back pain is accompanied by numbness, weakness, severe headache, vertigo, difficulty walking, bowel/bladder incontinence, or other disturbing symptoms, seek immediate medical attention.

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