Upper Left Back Pain: Causes, Symptoms, Treatment, Diagnosis

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 lower portion of the neck, the left shoulder area, shoulder blades, region behind the chest and ribs on the left side and middle portion of the back.

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 affecting rib cage and muscles. The upper left back pain can be felt as sudden, sharp or sometimes dull, aching, which can be felt as a general overall pain or can be pinpointed. Depending on the cause pain in the upper left back can be short lasting or chronic in nature.

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.
• Pain may be generated on left side from Injured muscles, ligaments or injuries of surrounding soft tissues. Pain often radiates to left side of the neck, left shoulder joint, left upper back and left middle back.
• Sports injuries.
• Cuts, wounds or abrasions on the upper left back region.

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.

• Pinched nerve from spinal problems can cause radicular pain spread over left side of upper back and may spread to left arm and hand.
• Stroke affecting nerves of the upper left back causes severe pain, numbness or weakness spread over left back and arm.
• Tensed or spasm of back muscles can cause upper left back pain, which may spread to side of back and neck.
• Infections like shingles, where nerve supplying upper left back is affected can cause severe pain.

Following conditions can cause upper left back pain-

• 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 and insect bites can cause upper left back pain. These conditions are easily noticed and is often accompanied with itching and burning sensation.
• Certain gastrointestinal conditions like indigestion and bloating, pancreatitis and perforation of peptic ulcers causes pain in middle and upper left back. In such cases gastric complaints like nausea, vomiting, changes in bowel habits and burning stomach pain may be present.
• Conditions related to urinary system like kidney stones or infection can cause pain in the upper and middle back or flank region, which may radiate to the groin.
• Women may occasionally experience referred 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 and spread of certain types of cancers can be the cause of upper left back pain.

Upper left back pain is itself a symptom. Complaints may include constant or intermittent pain in upper left back. Pain in the upper left back may be accompanied with difficulty in movement of back, shoulder or arms. Upper left back pain may become severe following coughing, sneezing, movements of left side of chest and deep breathing. 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 of skin and muscle spasm.

Diagnosis can be made after thorough history taking and physical examination. Recent history of fall, accidents injuries and stings may suggest the cause of upper left back pain. 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 as well as diseases of lung and abdominal organs. Nerve conduction studies, ECG and other cardiac related investigations may be performed, if appropriate.

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.

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