Pain in the upper left shoulder area can come from the spine or the surrounding back muscles. It may be related to poor posture or an underlying medical issue. The sensation can be dull or sharp, and it often gets worse with activity and improves with rest.
Mild upper back discomfort on the left side frequently resolves without intervention. However, if the pain is due to a chronic condition, it may continue until properly treated.
Below is an overview of possible causes of upper left back pain, typical accompanying signs, treatment options, and guidance on when to see a healthcare professional.
Back Structure
The back has a complex structure, so pain can originate from many different sites and problems.
The spine can be divided into three main regions that run from the skull to the tailbone, each made up of stacked vertebrae.
The uppermost section, running along the back of the neck, is the cervical spine. The lowest region, which links the spinal column to the tailbone, is called the lumbar spine.
The middle segment connects the cervical and lumbar regions and contains 12 vertebrae; collectively these are the thoracic spine. The area commonly called the upper back includes most of the thoracic spine and the lower part of the cervical spine.
Some sources of back pain involve injury to vertebrae in the cervical or thoracic areas, while others do not.
Vertebrae are separated by flexible, shock-absorbing discs that allow movement and help protect the spinal cord — a bundle of nerves running through the vertebral column.
Causes of upper left back pain
Upper left back pain can arise from injury, musculoskeletal conditions, or problems with internal organs. Potential causes include:
Muscle strain
A muscle strain involves stretching or tearing of muscle fibers. If it occurs in the left upper back, you may experience pain on one or both sides.
Common causes include:
- repeatedly lifting heavy objects
- overusing the shoulders or arms
- a sudden awkward movement
Other symptoms can include:
- muscle spasms
- cramping
- swelling
- reduced range of motion
- pain when taking deep breaths
Herniated disc
With repetitive strain or a strong force, the discs cushioning the spine can tear. A disc that bulges or ruptures is known as a herniated disc.
If the affected disc is in the mid or upper spine, you may feel pain on one side of the upper back.
Additional symptoms might include:
- leg pain
- chest discomfort
- upper abdominal pain
- numbness or weakness in the legs
- loss of bladder or bowel control
Scoliosis
Scoliosis is a condition in which the spine curves sideways. It often appears in adolescence during growth spurts. When the spine curves to the left it’s called levoscoliosis, which is less common than a rightward curve.
Mild curvatures generally don’t cause pain, but scoliosis-related discomfort becomes more likely by middle age.
Other signs of scoliosis include:
- uneven shoulders
- asymmetry in the waist or hips
- a prominent shoulder blade
- uneven arm or leg length
- head not centered over the pelvis
Severe scoliosis can lead to:
- rotation of the spine
- lung impairment
- heart complications
Spinal stenosis
Spinal stenosis is a narrowing of the spinal canal where the spinal cord runs. It’s often due to bone overgrowths called bone spurs. You’re at higher risk for bone spurs if you have conditions like scoliosis or osteoarthritis affecting the back.
If the narrowing compresses nerves or the spinal cord, you may notice pain on one side of the back. Left-sided back pain suggests nerves supplying that side are involved.
Typical symptoms include:
- neck discomfort
- pain radiating into the legs
- pain, weakness, or numbness in the arms or legs
- foot problems
Kyphosis
Kyphosis is an excessive outward curvature of the upper spine.
A mild curve often causes no symptoms, but a severe curve can produce pain in both the upper and lower back.
Severe kyphosis may also result in:
- shoulder blade pain or stiffness
- numbness, weakness, or tingling in the legs
- breathing difficulty
- poor posture
- marked fatigue
Vertebral Fracture
A break in one of the spinal vertebrae can cause upper back pain.
Spinal fractures are more common in people with osteoporosis, a condition that makes bones porous and fragile. With advanced osteoporosis, even a simple reach can cause a fracture.
Vertebral fractures can also occur after severe trauma, such as:
- a motor vehicle crash
- a sports injury
- a fall from height
Symptoms vary with the injury type and can include:
- worsening pain with movement
- weakness
- numbness or tingling in the limbs
Medical emergency A vertebral fracture from trauma is an emergency. Call 911 immediately.
Poor posture
When posture is poor, the spine and body are misaligned, placing strain on back muscles.
Poor posture is a frequent cause of unilateral upper back pain. Other signs include:
- neck pain
- shoulder discomfort
- headaches
- breathing difficulty
Overly stiff attempts to “correct” posture can also lead to back pain.
Osteoarthritis
Osteoarthritis involves degeneration of the cartilage at bone ends. It can occur throughout the body and is the most common form of arthritis to affect the spine.
If osteoarthritis affects your spine, you may have upper back pain along with:
- stiffness
- reduced flexibility
- a grating feeling in the joints
- bone spurs
Myofascial pain
Myofascial pain syndrome causes sensitive trigger points within muscles. Pressing these points produces localized aches and referred pain.
The trapezius muscle in the upper back commonly harbors trigger points.
Myofascial pain may also cause:
- muscle weakness
- restricted joint motion
- tender muscle knots
Pancreatitis
Pancreatitis, inflammation of the pancreas, causes pain in the upper abdomen that can radiate to the upper back and often worsens after meals.
Acute pancreatitis may additionally produce:
- fever
- nausea
- vomiting
- rapid heart rate
- abdominal swelling
When pancreatitis is chronic, symptoms may include:
- foul-smelling, oily stools
- diarrhea
- weight loss
Kidney stone
As a kidney stone exits the kidney, it can cause dull, one-sided pain in the upper abdomen that may radiate to the lower abdomen, groin, flank, and upper back.
Other kidney stone symptoms include:
- intermittent, cramping pain
- painful urination
- foul-smelling or cloudy urine
- discolored urine (brown, pink, or red)
- frequent urination
- passing small volumes of urine
- nausea
- vomiting
Heart attack
A heart attack occurs when blood flow to part of the heart is blocked. Symptoms vary, but it can lead to chest pain that radiates to the neck, jaw, or upper back.
Other possible signs include:
- chest pressure
- shortness of breath
- extreme tiredness
- dizziness
- nausea
- cold sweats
- heartburn-like sensations
- abdominal discomfort
Medical emergency If you think you or someone else is having a heart attack, call 911 right away.
Obesity
Excess body weight increases stress on the spine and back muscles, which can cause soreness or injury.
Lack of physical activity
Inactivity weakens the back and core muscles, raising the risk of pain across the back, including the upper left side.
Age
Age-related wear and tear is a frequent reason for back pain and often begins around the 30s or 40s.
As you age, you’re also more prone to symptoms from spinal conditions like scoliosis.
Smoking
Smokers who injure their back are more likely to experience prolonged pain. Smoking reduces blood flow to the spine and slows healing.
Chronic coughing associated with smoking can also contribute to upper back pain.
Other symptoms of upper left back pain
Because many different problems can cause upper left back pain, note any additional symptoms you experience.
Upper left quadrant pain radiating to your back
If pain begins in the upper left abdomen and spreads to the back, possible causes include:
- muscle strain
- herniated disc
- kidney stone
- pancreatitis
Upper back pain on the left side and under your shoulder blade
Pain beneath the left shoulder blade and in the upper left back may be due to:
- muscle strain
- poor posture
- vertebral fracture
- severe kyphosis
- heart attack
Upper left back pain while breathing
Conditions that may cause left upper back pain with breathing include:
- muscle strain
- vertebral fracture
- severe kyphosis
- advanced scoliosis
- heart attack
Upper left back pain after eating
Pancreatitis commonly causes upper left back pain after eating, particularly following a high-fat meal.
Upper left back pain and arm pain
Pain in the upper left back accompanied by arm pain may be linked to:
- spinal stenosis
- myofascial pain
- vertebral fracture
- heart attack
Diagnosing upper left back pain
To determine the cause of upper left back pain, a clinician may:
- review your medical history
- ask about your symptoms
- perform a physical examination
They might also order:
- blood tests
- X-rays
- CT scans
- MRI
- electromyography (EMG)
Treatment for upper back pain on left side
Treatment depends on the cause and your overall health and may combine home care and medical interventions.
Home remedies
For mild back pain, these self-care strategies can help:
- Over-the-counter pain relievers. NSAIDs such as ibuprofen or naproxen can reduce pain and inflammation.
- Heat and cold therapy. Applying hot or cold packs can ease sore back muscles.
- Gentle activity. Light exercise like walking and stretching may aid recovery; prolonged immobility can worsen pain.
Medical treatment
If pain is severe or persistent, a doctor may recommend:
- Prescription medications. If OTC drugs fail, providers may prescribe muscle relaxants, stronger pain medications, or steroid injections.
- Physical therapy. A therapist can teach strengthening exercises and use modalities such as electrical stimulation or heat to relieve symptoms.
- Surgery. Occasionally surgical intervention is necessary for structural problems like severe spinal stenosis.
- Condition-specific treatments. For issues such as kidney stones, pancreatitis, or heart attacks, targeted hospital-based care may be required.
When to see a doctor
Most minor upper back pain improves on its own. See a healthcare provider if the pain is severe, persists, or you have markedly reduced mobility that doesn’t improve.
Also seek medical attention after an injury or if you experience:
- numbness or tingling
- fever
- difficulty breathing
- unexplained weight loss
- problems passing urine
Preventing upper back pain
Although back pain is common, you can reduce your risk of musculoskeletal back problems. Consider these tips:
- Maintain good posture. Sit and stand with a straight back. When seated, keep hips and knees at right angles.
- Exercise regularly. Cardio and strength training help build back muscles and lower injury risk.
- Keep a healthy weight. Excess weight increases strain on the spine.
- Quit smoking or avoid starting. Stopping smoking improves blood flow and healing after back injury. A clinician can help you develop a cessation plan if needed.
Takeaway
Upper left back pain can stem from a spinal or musculoskeletal issue, an injury, or a problem with an internal organ.
For mild pain, home measures like OTC medication and heat or cold packs often provide relief. For more severe or persistent pain, a healthcare professional may recommend prescription drugs, physical therapy, or other targeted treatments.
If upper left back pain occurs with fever, numbness, difficulty breathing, or follows a major injury, seek prompt medical attention.
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