Upper Back Pain on the Left Side: 12 Possible Causes

Written by Leah Bell-Steele
Physiotherapist, University of Queensland
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on July 5, 2022

Woman holding her Upper Left Back in Pain

Upper left back pain is often related to a muscle sprain or joint injury. It can also be related to organ pain that refers to the back. Minor pain usually resolves independently, while more chronic and severe conditions may require treatment.

What are the Symptoms of Upper Left Back Pain?

The symptoms of upper left back pain depend on the cause of the pain. Muscle strains often result in burning pain, while spinal injuries may cause sharp, shooting pain or a constant dull ache. Some discomfort is relieved by rest, while other pain persists no matter the activity.

Causes of Upper Left Back Pain

There are many different causes of upper back pain. Damaged muscles, joints, ligaments, herniated discs, scoliosis, poor posture, fractures, arthritis, various pain disorders, and organ pain can all contribute to upper left back pain.[1]

1. Myofascial pain syndrome

Myofascial pain syndrome is a common cause of upper left back pain. The syndrome is caused by the development of trigger points in the muscles. Trigger points are sensitive nodules of tight muscle fibres that develop with muscle strain or overuse that cause the muscle to become taut and painful. The symptoms of myofascial pain syndrome include:

  • Tenderness in the muscles

  • Weakness

  • Difficulty lifting the arm

  • Painful arm or neck movements

2. Muscle strain

A muscle strain is a pulled, stretched, or torn muscle. Muscle strains can occur on the left and right side of the upper back and often occur with repetitive movements, lifting heavy objects, poor posture, or a sudden sharp movement of the neck or shoulders. The pain from a muscle strain can be anything from a dull ache to an intense burn. The symptoms of muscle strain include:

  • Difficulty lifting the arm

  • Pain with neck and shoulder movements

  • Muscle spasms in the upper back

  • Pain with deep breathing.

3. Foraminal Stenosis

Foramina are the openings on each side of the vertebrae from which the spinal nerves branch out of the spine. Foraminal stenosis is a condition where these foramina become narrowed and compress the nerves, causing inflammation and pain that radiates into the upper back or down the arm.

Foraminal stenosis is caused by:

  • Osteoarthritis

  • Bone spurs

  • Disc herniations

The symptoms of foraminal stenosis include:

  • Sharp, shooting, electric-like pain in the upper back and/or arm

  • Tingling

  • Numbness

  • Weakness

  • Loss of bladder or bowel control

4. Bulging Disc

Discs are rounds of cartilage that act as shock-absorbers in the spine. When discs bulge, they bulge out into the spaces where the spinal nerves exit the spine. A bulging disc in the thoracic spine often causes radiating pain, tingling, and numbness in the upper back. The causes of herniated discs include:

  • Degenerative disc disease. This occurs with wear and tear of the disc, resulting in calcification, bone spurs, and disc herniation.

  • Traumatic injuries of the upper back. Examples of a traumatic injury include falls or a sports injury that places a force on the upper back.

5. Vertebral fractures

Vertebral fractures in the upper back often cause pain on one side. Vertebral fractures often occur with traumatic events such as sports injuries, car accidents, or falls. People with osteoporosis are also more susceptible to sustaining fractures because their bones are weak and more porous.[2] Symptoms of a vertebral fracture include:

  • Severe pain that worsens with movement

  • Weakness and tingling in the arms

  • Inability to twist the upper back or bend forwards.

6. Arthritis

Osteoarthritis is the most common type of arthritis of the spine. It is a degenerative condition where the cartilage in your spine wears away. Every time the spine moves, the injured cartilage rubs against the adjacent cartilage, causing friction and further injury. It usually affects people over the age of 50 and often results in inflammation and pain in the joints. Other symptoms of osteoarthritis include:

  • Upper back stiffness

  • Difficulty moving

  • Constant, aching pain

7. Poor posture

A poor posture is when the shoulders, head, and neck hunch forward, placing strain on the upper back's joints, ligaments, discs, and muscles. Additionally, suppose a person leans more to one side, such as while working on a computer or carrying a heavy bag over one shoulder. In that case, it could also cause an imbalance in the muscles, resulting in one-sided upper back pain. Other symptoms of poor posture include:

  • Neck pain and headaches

  • Shoulder pain

  • Upper back stiffness

8. Heart attack

Upper back pain can signify a heart attack, especially in women. A heart attack is when the blood that brings oxygen to the heart muscle is severely reduced. The upper back pain associated with a heart attack includes burning, tingling, or pressure sensations that may refer to the arms. Other symptoms of a heart attack include:

  • Shortness of breath

  • Chest pain

  • Dizziness

  • Nausea

  • Heartburn

9. Pancreatitis

Acute pancreatitis is inflammation of the pancreas. The pancreas produces enzymes and hormones that aid digestion. When these enzymes become active while still in the pancreas, they irritate the cells in the pancreas, causing inflammation. Pancreatitis often causes nausea and pain in the upper abdomen, but the pain can refer to the upper back. Pancreatitis worsens after eating a large, fatty meal. The symptoms of pancreatitis include:

  • Pain in the upper abdomen after eating

  • Pain in the upper back

  • Tenderness over the abdomen

  • Bloating

  • Fever

  • Nausea

Diagnosing Upper Left Back Pain

To diagnose upper left back pain, your doctor or physiotherapist will require a detailed medical history, ask about your symptoms, and perform a physical examination. The physical examination consists of inspecting the upper back for swelling and inflammation and assessing your posture. The examiner will also ask you to move in different directions to ascertain which movements increase the pain. Additionally, the examiner may perform special clinical tests to try and exacerbate the symptoms.

Sometimes further investigation may be required, including X-rays, CT scans, magnetic resonance imaging (MRI) scans, an EMG (in case of suspected heart issues), ultrasound scans, scopes, or blood tests. The medical history and physical examination will determine which test will be required.

Once the nature and cause of symptoms have been established, treatment may begin.

Treatment for Upper Left Back Pain

The treatment of upper left back pain depends on the underlying cause. Minor pain may be treated with:

  • Non-steroidal anti-inflammatories, such as naproxen or ibuprofen.

  • Hot and cold packs for treating painful muscles.

  • Resting from aggravating activities.

  • Gentle exercises to keep the spine moving and improve muscle strength.

More severe pain may require more serious treatment, including:

  • Injections and prescription medications to relieve the pain.

  • Physiotherapy to restore movement, increase muscle strength, and improve posture.

  • Surgery for severe cases of upper back pain, including disc herniations, vertebral fractures, spinal stenosis, and heart attacks.

  • IV fluids to treat conditions such as pancreatitis.

Upper back pain caused by a heart attack, pancreatitis, a herniated disc, vertebral fractures, or foraminal stenosis requires immediate medical treatment.


Upper back pain can be caused by various conditions, including spinal issues, muscle strain, poor posture, and organ pain.

Upper back pain is diagnosed through a detailed physical exam and other investigative tests. Minor upper back pain is treated with rest, heat and ice, over-the-counter pain relievers, anti-inflammatories, and gentle exercise. More severe pain may require prescription medications, physiotherapy, and even surgery.

If you suspect you may be having a heart attack or are experiencing numbness, shortness of breath, or fever, with your upper left back pain, seek immediate medical help.

Written by Leah Bell-Steele
Physiotherapist, University of Queensland
Published on July 5, 2022
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on July 5, 2022
Medical reviewers
Last medically reviewed on July 5, 2022
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