Upper left back pain usually occurs from the base of neck to end of the rib cage. The ribs in the body are attached to a flat bone in the chest called Sternum. If a nerve in this area is injured, the pain may also be felt in other areas where the nerves travel which includes arms, legs, chest and stomach. The Upper left Back Pain includes vital bones of the upper body which includes:
- 12 vertebrae which are further attached to Rib bones which protect the vital organs of the body
- Discs which separate each vertebra and act as shock absorbers
- Muscles and ligaments which binds the spine together(1)
Upper left back pain may be associated with injuries which are related to joint strains and muscle sprains. Upper left back pain can also be caused due to conditions like arthritis or Cancer.
Causes – Some of the major causes of upper left back pain includes:
- Muscle Strain: Muscle strain is developed when the muscles are strained beyond their capacity, causing the fibres to tear. Injury can also cause tearing of fibres. These muscle strains cause inflammation, redness, soreness or a bruise leading to upper left back pain.
- Joint Sprains: Joints in the Upper back include connection of ribs with the spine and the connection of vertebrae with each other. The pain in the body due to Joint Sprains is sharp and the pain increases while moving. Shoulder joint can also be affected due to this.
- Osteoarthritis: This is caused by the synovial fluid between the joints is diminished causing the bones to rub against each other. Pain may become sharp when you are moving your arms or can also initiate while resting. This may affect the joints of the spine
- Rheumatoid Arthritis: In this condition, the body attacks healthy tissues. This usually affects multiple joints at the same time. The pain might decrease with some rest, but it again aggravates.
- Primary Cancer or metastasis: Primary cancer or metastasis can also affect the upper back and shoulder. This usually occurs in case of lung cancer which causes upper left back pain and shoulders
- Other Causes: Heart attack is also associated with back and shoulder pain
Upper Left Back pain could also be associated with following causes –
- Poor Sitting Posture: Sitting job for long hours with wrong sitting postures can also result in structural changes to the spine and upper back. As a result, muscles of the upper back may become weak and may not be able to hold or support the back and spine properly in a neutral position. As a result, the head and shoulders move forward a bit causing the muscles, ligaments and tissues to pain-causing Upper left back pain
- Improper lifting techniques: Lifting a heavy object incorrect position where the weight is going towards one direction can cause the upper left back pain. This may result in ligament or tissue breaks down.
- The sudden change of work style: Doing work which accompanies lifting heavy weights for a day long could also lead to injuries and upper left back pain.
- Accident or collision: Accidental collisions while driving a four-wheeler or a two-wheeler. Falling from high altitude or accident while playing some sport could also lead to injuries due to muscle, tissue or a ligament tear. Causing extreme Upper left back Pain.
It has been observed through a study that patients who have undergone a Coronary Artery Bypass Surgery (CABG) to restore normal blood flow to the body also experience Upper left back pain. Many patients have been found to suffer from ‘Post CABG pain’ (PCP). This causes pain in the chest area which travels back to the upper back. (2)
Some of the common symptoms of Upper left back pain include:
- Sharp Pain: The pain is sometimes excruciating which usually starts from one point and spreads to the nearby area.
- An ache or throbbing pain might occur in the upper back and slowly spread to adjacent body parts like neck, shoulders or the lower back.
- Stiffness: When the sharp pains worsens, it could lead to stiffness of the upper back which leads to reduced movement. This affects the arm movement and causes pain while doing some sport involving the role of upper body part or exercise
- Radiating pain: This type of pain travels from upper back to various other body parts which include chest, arms or legs. The pain that travels could be sudden, or it could be continuous. This type of pain usually occurs towards one side of the body.
- Numbness or weakness: This numbness also travels from upper back to various body parts and causes numbness or sharp tingling. Usually, these pains travel around the circular periphery usually near the ribs. (3)
Diagnosis of Upper Left Back Pain:
- Patient History: It is important to have the patient history like when the symptoms of the pain started, where is the pain located? And what is the lifestyle of the person suffering from the back pain? It is also essential to know the family history of the person.
- Physical Examination:
o Observation: Observation of the person walking style and sitting position can help you detect the problem
o Palpation: By feeling or touching the upper back. A physician or a specialist can come to know if there is any inflammation, sourness or tenderness in the back
o Clinical Tests: Sometimes the examiner can check for specific movements if these increase the symptoms
Diagnostic Tests for Upper left back pain includes:
o X-Ray: Use of electromagnetic Rays can help to diagnose if there is any fracture, deformity or a tumour
o MRI: Magnetic Resonance Imaging utilises radio waves and strong magnets to cross-sectional images which can help to detect if there is any damage to spinal nerve/ligament damage or if any nerve is pressed.
o Medial Branch Nerve Block: Using X-Ray guidance (fluoroscopy), an anaesthetic is injected near the nerve endings, and if it is found that it has helped to reduce the pain then you have found the cause of suffering
o Bone Density Test: This is again done using X Rays to see how much of the Rays are observed. This is usually used to test if any damage is done through osteoporosis. Osteoporosis can occur in the thoracic vertebrae and upper left back.(4)
Treatment of Upper Left Back Pain:
Some of the treatment ways to heal up the upper left back are listed below:
If the back is hurting or paining too much, sometimes taking a break helps. But studies have proved that Bed rest is not an ideal way of curing Back pain. It is absolutely necessary to take a break from the strenuous activity for a while and then get back to work slowly. Taking bed rest for too much time can worsen the situation.
Over the Counter Medicines (OTC products):
Some time the OTC medicines like gel, ointment for topical application help to reduce the pain of the upper left back. Medication like acetaminophen or Non – steroidal anti-inflammatory drugs (NSAIDS) is also helpful in relieving pain. But while taking these medicines, one should follow the instructions given on the label and should also visit the doctor in case the pain persists.
Heating Paid or Ice Pack:
Applying a heating pad or an Ice pack on the affected area can also help to reduce stiffness in the upper back. It can also help to reduce pain and swelling in the affected part. Ideally, you need to discover which out of the two is more helpful to the affected region.
You can also ask your doctor or the physiotherapist regarding the activities that can help you strengthen the muscles of the upper back which help in giving support to the spine, neck, shoulders and the head. You can also discuss the posture of the back that can help you improve your posture and can also help you maintain a balance. This would also help in decreasing the chances of injury or pain in the upper left back in future.
Many people have also found massage a helpful in reducing the numbness and tenderness in the affected areas. Massage accentuates the blood flow to the affected body part. It is essential to have the massage from the knowledgeable person to avoid the problem from exaggerating rather than curing.
Practising right postures:
Most important thing is the prevention. You can prevent a lot of these back related issues by improving the postures while you are sitting at your work position, doing some exercise or walking. You should avoid sudden movements whenever you are changing your position like you should not stand suddenly from a sitting or a sleeping position.
It is more about practising the right postures and making it a part of your lifestyle.
Even smoking is found to aggravate the chronic back pain, so it is also advisable by some studies to quit smoking for a quicker relief(5),(6)